Virtual review of cancer clinical trial treatment options quicker than conventional method

WASHINGTON — Using virtual, cloud-based, interconnected computing techniques applied to 51,000 variables, researchers at Georgetown University Medical Center and colleagues reduced the time needed to assess a cancer patient’s tumor profile and suitability for clinical trials from 14 to 4 days. This method also increased two-fold, over a four-year period, the number of cases that could be assessed compared to conventional methods.

That is the finding of a new study based on tumors from more than 1,700 people that was published online October 9, 2019, in the

Journal of the American Medical Informatics Association (JAMIA)

.

“Our platform is unique in that it integrates patient-specific data with genomic knowledge bases to provide a comprehensive report on potential trial enrollment opportunities,” said corresponding author Subha Madhavan, PhD, FACMI, Chief Data Scientist and Director of the Innovation Center for Biomedical Informatics at Georgetown University Medical Center. “While the majority of the cases we examined were in pancreatic cancer, our platform was designed to be applicable to any type of advanced cancer.” Madhavan is also a member of Georgetown Lombardi Comprehensive Cancer Center.

A conventional tumor board is comprised of oncologists, pathologists, and patient advocates, among others. They meet in person to review cancer gene sequencing reports to determine if a patient’s tumor has gene alterations that point to drugs that could act against those alterations. This approach is burdensome and typically does not allow tumor board review for all cases.

In their study, the researchers modeled virtual molecular tumor boards (VMTB) to assess the genetic makeup, previous treatment history and other factors for 1,725 cancer patients. They also compared VMTB outcomes with reviews by five gastrointestinal oncologists who performed tumor board duties in a conventional manner. The time spent assessing appropriate trials was noted and the results were compared to the virtual method.

Over a four-year period, the investigators found that virtual boards could make assessments based on patient tumors for over 2,000 clinical trials, more than 1,000 cancer drugs, and nearly 200 genetic biomarkers associated with targets known to be amenable to treatment. From 2014 to 2017, the number of cases assessed virtually increased from 46 to 622 compared to conventional board assessments going from 3 cases to 14.

Additionally, the virtual board process integrated comprehensive information about the distance between a patient and a potential treatment center, providing practical resources for a patient looking for a clinical trial. Notably, fewer than 5% of pancreatic cancer patients currently enroll in clinical trials, but 22% of such patients whose cases were reviewed by a virtual board enrolled in a clinical trial.

“As cancer diagnoses and treatment become more data driven and complex, a VTMB allows for deep discussions and insight into many aspects of a person’s unique cancer profile,” said Michael J. Pishvaian, MD, PhD, Associate Professor, Department of Gastrointestinal Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, co-first author who conducted this research while at Georgetown. “Additionally, while there are just a few immunotherapy-related biomarkers currently known for all types of cancer, VTMBs have tremendous potential, when new biomarkers are discovered, to assist in finding patients the best possible clinical trials for their treatment.”

###

Pishvaian and Edik M Blais, PhD, of Perthera, are co-first authors. Additional authors include: R Joseph Bender, PhD, Perthera; Shruti Rao, MS, MBA, Georgetown; Simina M Boca, PhD, Georgetown; Vincent Chung, MD, City of Hope Cancer Center; Andrew E Hendifar, MD, Cedars-Sinai Medical Center; Sam Mikhail, MD, Mark H. Zangmeister Cancer Center; Davendra PS Sohal, MD, MPH, Case Comprehensive Cancer Center; Paula R Pohlmann, MD, MSc, PhD, of Georgetown; Kathleen N Moore, MD, Stephenson Oklahoma Cancer Center; Kai He, MD, Cedars-Sinai Medical Center; Bradley J Monk, MD, Arizona Oncology; Robert L Coleman, MD, MD Anderson Cancer Center; Thomas J Herzog, MD, University of Cincinnati Cancer Institute; David D Halverson, MD, Perthera; Patricia DeArbeloa, MD, Perthera; and Emanuel F Petricoin III, PhD, Perthera. Blais, Bender, Halverson and DeArbeloa are employed by Perthera, Inc. Petricoin III is co-founder of and consultant to Perthera Inc. Pishvaian, Petricoin and Madhavan are on Perthera’s scientific advisory board.

This work was partly funded by the National Cancer Institute (P30 CA51008, R21 CA220390), the Georgetown-Howard Universities CTSA (NCATS TR000102), and the Pancreatic Cancer Action Network.



About Georgetown Lombardi Comprehensive Cancer Center


Georgetown Lombardi Comprehensive Cancer Center

is designated by the National Cancer Institute as a comprehensive cancer center — the only cancer center of its kind in the Washington, DC area. A part of Georgetown University Medical Center and MedStar Georgetown University Hospital, Georgetown Lombardi seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Connect with Georgetown Lombardi on

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About Georgetown University Medical Center

Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis — or “care of the whole person.” The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. Connect with GUMC on Facebook (

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This part of information is sourced from https://www.eurekalert.org/pub_releases/2019-10/gumc-vro100319.php

Karen Teber

km463@georgetown.edu
http://gumc.georgetown.edu 

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