Sorry to get TMI on you, but we all spend a lot of time in the bathroom. And many things about that room — the fact that you're alone in there without distractions, the amount of fixed design elements crammed into a small space, the potential for dirt and clutter — give it the potential to look outdated quite quickly. No wonder it's consistently been the most popular home renovation project in this country.
In one of the largest initiatives of its kind, the for-profit hospital chain Hospital Corporation of America (HCA) has embarked on a plan to molecularly profile the tumor of cancer patients, marry the genomic information to clinical data from a patient’s electronic health record, and recommend targeted therapies.
In a one-size-fits-all approach, patients who now receive a cancer diagnosis get the standard of treatment, which may or may not work. Those who fail first-line treatments are then subjected to other therapies through trial and error. “We’re seeing the light,” says Howard Burris, chief medical officer of Sarah Cannon, an arm of HCA which runs 75 cancer centers across the country and the U.K., and is heavily involved in cancer drug development. Its facilities treat more than 100,000 newly diagnosed cancer patients annually.
Two years ago, Sarah Cannon profiled the tumor of 1,000 late-stage cancer patients to match them with the appropriate early phase clinical trial, and hopefully boost their outcomes. The results which Sarah Cannon presented at the American Society of Clinical Oncology last year, showed that up to 25% of patients enrolled in a trial based on their mutation.
While promising, the project proved overwhelming in terms of tracking various clinical and genomic data. To profile cancer patients on a grand scale, patient information had to be aggregated and displayed in a way doctors can understand, to enable them to recommend the right therapy or clinical trial.
To do so, HCA reached out to Syapse, a venture-backed start-up that counts Intermountain Healthcare, University of California San Francisco, and Stanford University School of Medicine among its customers. It is deploying its software to some 60 oncologists in Nashville, Tenn., HCA’s headquarters, before expanding to other Sarah Cannon outposts in Florida and other states later this year. Through its platform, doctors will be able to measure the impact of a tailored treatment in conjunction with a patient’s history, other treatments, biopsies, side effects, and other relevant clinical information that reside in an electronic health record. “We’re collaborating with them to implement this at scale,” says Jonathan Hirsch, Syapse’s founder.
“The real missing piece is the physician looking at the cancer patient, and determining that the patient needs to be profiled. They might think they don't need it yet, or some don't have the education,” says Burris.
Patients who’ve experienced a recurrence, have advanced or a hard to treat cancer will have their tumor profiled. Insurance companies typically don’t reimburse genomic profiling of newly diagnosed patients.