Web App Advances Personalized Cancer Treatment

Health IT Boosts Patient Care, Safety

How individual cancer patients respond to treatment depends in part on the patient's medical history, therapies they've already tried, whether the cancer has spread, and their tumor's molecular makeup. A free Web-based application aims to help patients get more personalized treatments and provide doctors with more timely cancer research information.

That's good news, especially for patients who don't live close to major cancer centers and for oncologists who don't have sophisticated IT tools or research resources.

The Targeted Therapy Finder--Melanoma application is the fruit of collaboration between the American Society of Clinical Oncology (ASCO) and CollabRX, a company launched about three years ago by Jay Tenenbaum, a melanoma survivor, tech entrepreneur, and former chief scientist at Commerce One.

While the app for melanoma is the first tool being offered, the collaboration between CollabRX and ASCO could lead to decision support tools for other cancers as well, Tenenbaum said.

Some researchers believe that malignancies are a compilation of many rare diseases caused by a combination of numerous factors. Among those factors are various gene mutations that often differ between individuals who are diagnosed with the same general type of cancer, whether it's melanoma, breast cancer, leukemia, and so on.

The new Web tool, which can run on mobile devices like iPhones and iPads, helps doctors and patients identify diagnostic tests, treatment options, and clinical trials for specific subtypes of melanoma and specific patient characteristics, said Tenenbaum in an interview.

Patients or doctors enter information about the individual's melanoma, including the disease's stage, origin, metastatic sites, and genetic mutations, and the tool helps narrow down drugs and clinical trials to consider.

Hyperlinks connect doctors and patients to additional information about the drugs and clinical trials, as well as definitions of terms and descriptions of specific mutations.

The melanoma tool is powered by expert knowledge from an open source database set up by CollabRX called Cancer Commons, Tenenbaum said.

That expert knowledge includes data from molecular disease models, including a melanoma disease model that was recently published in PLoSOne, an international, peer-reviewed, open-access research publication site.

As part of their collaboration, ASCO is also providing CollabRx with access to all of its published melanoma content, including data presented at the society’s annual meetings, and study results described in peer-reviewed journals.

The goal of the Cancer Commons database is to include outcome information about how patients are responding to various treatments. The hope is that these insights--for instance, the success of certain drugs for patients with various subtypes of cancer--can be disseminated more quickly, Tenenbaum said.

"Every day in oncology, there are thousands of experiments that go on but no one captures that data," he said. That includes patients who receive various chemotherapy cocktails in hopes of targeting specific subtypes of cancer. The ability to share outcome data on those patients who have uncommon combinations of genetic mutations, chronic conditions, and other characteristics could help make it easier for oncologists to zero in on treatments for other patients who have rare similarities.

Clinical trials for new treatments are often considered failures if only a handful of patients out of thousands respond positively to the new drugs, Tenenbaum said. But for those few patients who do respond well and have renewed hope, those trials are hardly failures.

Services offered by CollabRX eventually could also be useful to clinical trial organizers to recruit potential patients.

Many large healthcare providers, including Mayo Clinic, Moffitt Cancer Center, and Vanderbilt University Medical Centerare increasingly deploying decision support, analytics, and business intelligence tools to improve the care they offer to patients. Some of these efforts include personalized medicine initiatives that aim to bridge the multi-year time gap that often exists with new cancer research findings reaching bedside clinicians.

The collaboration between ASCO and CollabRX can help bring such technology-fueled tools more quickly to busy oncology practices that don't have big IT budgets.

"A lot of lives can be saved just getting people matched up with their best available drug options sooner," he said. "That's what we're trying to do."