ASCO Knowledge Part V: CancerLinQ

“Shoppers have Amazon.

Students have Google.

Oncologists will have CancerLinQ”

-CNN

That quote appeared on a brochure I saw at ASCO and it peaked my interest in a special patient advocate session that was being held to introduce us to CancerLinQ, a health information technology platform. In January of 2015, ASCO and SAP, a software company teamed up to create a Big Data software platform. 

ASCO’s Chief Medical Officer, Rich Schilsky began the session by sharing some important facts with the advocates.

Only 3% of adults participate in clinical trials. 

Older adults (>65)  may not qualify to participate in clinical trials so their outcomes and adverse effects may not be known by others who also treat older adults. 

As more drugs get approved through the quick FDA approval process there is a need to capture the knowledge that is being generated as patients use these drugs.  

Currently cancer patient data is in “silos”( my word choice) at various cancer centers – NCI centers, academic centers, and community oncologist groups.

 CancerLinQ will gather data from patients from around the country into a secure, searchable database. 

CancerLinQ In A Nutshell : 

Electronic Medical Records (EMR) of cancer patients will be collected, “de-identified” and entered into the database. Once the data is entered an number of things can take place:

-Providers can compare the care they provide to guidelines.

-Oncologists can search the database for patients with similar attributes, diagnosis, mutations, and treatments. The oncologists can then with their patients decide which treatment plan is best.

-Researchers can look for patterns in the patient data

In the fall of 2015, the first version of CancerLinQ will roll out and include 500,000 individual records from 15 oncology practices in the US. 

For more information please visit CancerLinQ.org

Dee
Every Day is a Blessing!

ASCO Knowledge Part III: Value Concepts in the Management of OC

This education session at ASCO covered a number of important topics early detection, personalized medicine, treatment choices and treatment costs. 

Early Ovarian Cancer : Can we find it, Can we stop it, Cane we afford it?

Usha Menon

Dr Menon practices in London , England. She  explained that ovarian cancer screening is a process . She noted that:

• picking up low grade Ovarian Cancer (OC) is different that picking up high grade OC
• 50% of OC  cancer arises in the fallopian tubes
• OC takes an average of 4 years to develop, stage 1&2 disease size is < 1cm
• Focus should be on finding low volume disease 

Her suggestions for following low risk women include:

• CA-125 over time
• Autofluorescense high resolution imaging
• Ultrasound with microbubbles
• ctDNA (circulating tumor DNA)

For high risk women Dr Menon recommended CA-125 every 4 months. In the ROCA
(Risk of Ovarian Cancer Algorithm) study 53% of the women had a CA-125 < 35 yet had invasive ovarian cancer. 

Personalized Treatment in OC:Fancy Science or Expensive Hype

Douglas Levine

There is a broad applicability of personalized medicine.

We have developed treatments for BRCA mutations so we know what to do with those but we are not too sure what to do when we learn about these other mutations. 
Some points Dr Levine made include:

• Genomic scarring may occur. It is a mechanism of DNA repair which leaves a scar or signature . Those signatures can be used to classify tumors . 
• Chemoresistant tumors contain an extensive number of alterations – including BRCA1& BRCA 2
• There are other mutations (6% of the women have a pTen mutation) but we few to date are clinically actionable. In other words we know about mutations but there are no treatments currently available for that mutation.
• Tumor tissue will change and evolve over time so it is important to profile the tumor in the time it needs to be treated.
• ctDNA ( circulating tumor DNA) can be found in blood plasma. It may be able to be used to monitor for recurrence and response .

Crossroads in Treatment :Primary Treatment Choices , Consolidation, and Postplatinum Endgame

David Spriggs

Value is patient centric. It drives care during primary treatment. Treatment cost for patients is heavily loaded in 1^st year (hospital / treatment /diagnostic /drugs) . The actual amount the physician charges is a very low percentage of that total cost.Primary surgery done by a gynecologic  oncologist increases  5 year survival of women with OC. (gynecologic -oncologist 38% , non gynecologist 30% )

Dr Spriggs presented a few new terms that I was unfamiliar with so I want to share them with you. The quality-adjusted life-year (QALY) measures the value of health outcomes. QALY combines the value of the length of life and quality of life in one number. Researchers are evaluating the cost of drugs using the ICER(incremental cost-effectiveness ratio) . From the ASCO DAILY NEWS article “Cost of Cancer Drugs Should be a part of Treatment Decisions” The estimated ICER range for the US is between $50,000/QALY and $200,000/QALY. Dr Spriggs in his presentation mentioned that the ICER for Olaparib a newly FDA Approved Parp inhibitor was $193,000 .

 Dr Spriggs noted that IP ( interperitoneal ) treatment continues to show an survival advantage and that consolidation treatment for OC using paclitaxel is more cost effective than bevaciszumab (Avastin)( Lesnock) .

Tomorrow’s post will report on ASCO’s CancerLINQ  a health information technology platform.

Dee 

Every Day is a Blessing!

ASCO - Connections Part II - Twitter

In the last post, I wrote about the  face to face connections I made with advocates , oncologists and researchers at the ASCO Annual Meeting. But connections were made in other ways too. I made connections with others through twitter as I tweeted with the #gyncsm and #ASCO15 hashtags.

There were many people at the meeting tweeting research results to their followers as can be seen by the tweet stats posted by @ASCO.

#ASCO15 Day One: 7,169 Tweets sent by 2,793 people with a potential audience of over 42 million pic.twitter.com/8yfM8gYI1X

— ASCO (@ASCO) May 30, 2015

#ASCO15 Day Two: 15,094 Tweets sent by 4,368 people. An average of 629 Tweets per hour! pic.twitter.com/Q8md6tgLER

— ASCO (@ASCO) May 31, 2015

#ASCO15 Day Three: 16,594 Tweets sent by 4,771 people led to over 57 million impressions pic.twitter.com/O1w1w5xSmU

— ASCO (@ASCO) June 1, 2015

Look at how the tweets increased as the meeting progressed. Below is a graphic of  how the number of #ASCO15 meeting Tweeters, Tweets, Impressions and avg tweets/hr differed from the 2014 annual meeting. 

pic.twitter.com/MiZcFJb0gh

— ASCO (@ASCO) June 6, 2015

People were not only tweeting to their followers but doctors were also interacting with patient advocates at and about the meeting . Greg Matthews (@chimoose) was able to capture these interactions visually one day during the meeting.

Patient-physician interactions at #ASCO15 have been fascinating; here's a visualization: http://t.co/bBUDKInggj pic.twitter.com/GEJMb7DXQD

— Greg Matthews (@chimoose) June 1, 2015

The physicians are blue dots and the yellow dots are patients. The size of the dot represents how many times that account was mentioned. Check out the yellow dot in the upper right quadrant. That's me, @womenofteal,  and my interactions with others at the meeting.  Thank you Greg for allowing me to use the chart in this post. You can view/ enlarge the chart by visiting this page. This chart was based on research by MDigitalLife"s  Social Oncology Report - http://MDigitalLife.com/socialoncology)

Coming up next are the first of a number of posts I call "ASCO: Knowledge"  which will report on the many studies that were reported on at ASCO.  

Dee
Every Day is a Blessing!