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Quest, IBM Aim to Broaden Access to Precision Cancer Treatments as They Mull Future Initiatives

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NEW YORK (GenomeWeb) – Clinicians looking for help in determining the appropriate precision therapy for their cancer patients have a growing number of options when it comes to tumor sequencing and analysis. However, a partnership launched this week promises to integrate the capabilities of one of the largest clinical labs in the nation with those of a major cancer center and research center, and a data analytics powerhouse to serve community oncologists throughout the US.

The partnership, announced Tuesday, brings together IBM Watson's cognitive computing power with Quest Diagnostics' genomic sequencing capabilities, Memorial Sloan Kettering Cancer Center's OncoKB precision oncology knowledge base, and the Broad Institute's genome sequencing services.

The new service, IBM Watson Genomics from Quest Diagnostics, has a focus on oncology diagnostics and providing options for evidence-based methods of treating cancer. But future collaborative efforts involving Quest and IBM could include providing genomic analytics for numerous disease areas, the positioning of diagnostic test facilities in international locations, and other healthcare initiatives centered around analytics and diagnostics, Jay Wohlgemuth, chief medical officer at Quest Diagnostics, told GenomeWeb.

"Both Quest and IBM have invested heavily in cancer diagnostics because it's one of the leading areas in precision medicine, and the most advanced with respect to genomics and complex information guiding the use of targeted therapies and clinical trials," Wohlgemuth said. "But the model being used for oncology applies across many disease areas where similar informatics and integrated solutions need to be brought to bear."

He added that because Quest has for some time been pursuing an approach of empowering better health with diagnostic insights and becoming an integrated solution provider, the experience has given the firm a sense of how the current initiative can be applied across other areas of clinical testing in genomics.

The service provides an important benefit of scaling access to treatment insights and making cancer genome sequencing and analysis available throughout the US, according to Quest. The firm said it's available not only to patients and physicians, but also to community oncologists who provide the majority of US cancer care.

"Quest is the national company that's going to make this work in the community, and IBM is bringing a scalable solution for informatics," Wohlgemuth said. "Memorial Sloan Kettering, a leader in cancer care, has said that it wants this approach practiced around the country."

The service employs laboratory sequencing and analysis of a tumor's genetic structure to help uncover mutations that may enable clinicians to prescribe precise therapies for treating cancer and enable researchers to develop oncology drugs through clinical trials. A treating physician uses the service by sending tumor tissue to Quest for sequencing, after which genetic data is transferred to Watson.

Each month, Watson absorbs around 10,000 scientific articles and information on around 100 new clinical trials, and the cognitive computer uses its large database of research papers, drug data, and clinical trials information as it searches and evaluates treatment options that might target the tumor's mutations. From there, Quest's pathologists review Watson's report and send it back to the treating physician.

Watson enables access to knowledge and scientific insight on a broad scale, whether a patient is being treated in an urban academic medical center or a rural community clinic, said John Kelly, senior vice president of IBM Research and Cognitive Solutions. The partnership with Quest and others relies on insights from leading clinical and pathology experts in the cancer community, he said, and it would broaden access to thousands of new patients.

Memorial Sloan Kettering's database of clinical evidence plays a key role in helping Watson uncover treatment options that may be used to target genetic mutations causing cancer growth and, as a result, clinicians will spend significantly less time sifting through literature and comparing findings, according to Quest.

"We now know that genetic alterations are responsible for many cancers, but it remains challenging for most clinicians to deliver on the promise of precision medicine since it requires specialized expertise and a time-consuming interpretation of massive amounts of data," said Paul Sabbatini, deputy physician-in-chief for clinical research at Memorial Sloan Kettering Cancer Center. Through this collaboration, he added, oncologists will have access to MSKCC's expertly curated information about the effects and treatment implications of specific cancer gene alterations.

The multi-entity partnership has been in the making for some time. Quest has been working with Memorial Sloan Kettering for around four years, Wohlgemuth said. "We put in place a platform that allows for recording of the clinical significance of mutations in cancer with respect to a target therapy or clinical trial," he added.

The dialog with IBM began around a year ago. Moving the initiative forward was made easier by the "alignment among parties around the vision of bringing this to the rest of the country and the rest of the world," Wohlgemuth said.

Wohlgemuth said he expects that reimbursement for use of the new service will follow standard payment procedures for genomic and sequencing testing within cancer care, and that Quest will split its allocated revenues with IBM. 

"Reimbursement around a core set of genes and a key set of cancers is now [substantial] enough that [Quest] and others can invest in bringing [this type of service] to the community and to the country," he said. "However, one of the things we're seeing is that there's a major need for more health economics around cancer genomics. Most thought leaders believe that reimbursement relative to the value that's being brought to the system is not there yet."

A Broader Context

Quest and IBM are also working on a broader roadmap to explore and develop initiatives that have similar characteristics to the new service. These initiatives would be built around integrating big data analytics from IBM Watson with Quest's national access, diagnostic testing, and other capabilities, Wohlgemuth added.

One area of opportunity is integrating information from Quest's services that provide testing solutions to employers with Watson's capabilities to provide decision support for employees making choices related to insurance and health.

Wohlgemuth said that Quest last month joined the Health Transformation Alliance, a group of 30-plus large employers that represent 6 million covered lives. Its objective is to improve the way corporations provide healthcare benefits and create better healthcare outcomes for their employees. IBM Watson is the underlying analytics component of HTA, he added.

The new initiative with Watson also reflects a broader trend in diagnostics and healthcare towards better data sharing, integration, and analysis, he said.

"In the last year or two, I've seen more and more positive healthcare contributions from a data-sharing perspective," he added. "When people realize that when they are sharing data they are going to advance healthcare," then achieving results from similar initiatives becomes far easier, Wohlgemuth said.

"When you talk about delivering to the patient community, a big part of this for us involves our healthcare information technology solutions. Our new service Quanum is connected at some level to almost every EMR, so there's a platform piece around this that is beyond what people traditionally think of as Quest's operational footprint — our laboratories, patient service centers, etc." 

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