PRECISE: A clinical-grade automated molecular eligibility screening and just-in-time (JIT) physician decision support solution for molecularly-selected oncology trials.

Tao, Jessica; Eubank, Michael H.; Pamer, Erika G.; Cangemi, Nicholas A.; Drilon, Alexander; Harding, James J.; Schram, Alison M.; Smyth, Lillian M.; Jhaveri, Komal; Li, Bob T.; Chakravarty, Debyani; Zehir, Ahmet; Berger, Michael F.; Schultz, Nikolaus; Pinkhasik, Alisa; Thomas, Stacy B.; Stetson, Peter D.; Gardos, Stuart; Hyman, David M.

doi:10.1200/jco.2018.36.15_suppl.6507

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PRECISE is not the only system designed to address the emerging need of matching patients to relevant clinical trials on the basis of the patient’s genomic profile. Several other centers have developed strategies by which to achieve this goal that range from on-site or virtual molecular tumor boards to automated matching platforms 13 , 18 - 23 (Appendix Table A1 ). Each of these systems offers physician decision support that aims to bridge the gap between genomic alteration detection and identification of the appropriate genome-driven therapy.…”

Section: Discussionmentioning

confidence: 99%

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Tao

Eubank

Schram

et al. 2019

JCO Precision Oncology

Self Cite

View full text Add to dashboard Cite

PURPOSE Matching patients to investigational therapies requires new tools to support physician decision making. We designed and implemented Precision Insight Support Engine (PRECISE), an automated, just-in-time, clinical-grade informatics platform to identify and dynamically track patients on the basis of molecular and clinical criteria. Real-world use of this tool was analyzed to determine whether PRECISE facilitated enrollment to early-phase, genome-driven trials. MATERIALS AND METHODS We analyzed patients who were enrolled in genome-driven, early-phase trials using PRECISE at Memorial Sloan Kettering Cancer Center between April 2014 and January 2018. Primary end point was the proportion of enrolled patients who were successfully identified using PRECISE before enrollment. Secondary end points included time from sequencing and PRECISE identification to enrollment. Reasons for a failure to identify genomically matched patients were also explored. RESULTS Data were analyzed from 41 therapeutic trials led by 19 principal investigators. In total, 755 patients were accrued to these studies during the period that PRECISE was used. PRECISE successfully identified 327 patients (43%) before enrollment. Patients were diagnosed with 29 tumor types and harbored alterations in 43 oncogenes, most commonly ERBB2 (21.3%), PIK3CA (14.1%), and BRAF (8.7%). Median time from sequencing to enrollment was 163 days (interquartile range, 66 to 357 days), and from PRECISE identification to enrollment 87 days (interquartile range, 37 to 180 days). Common reasons for failing to identify patients before enrollment included accrual on the basis of molecular alterations that did not match pre-established PRECISE genomic eligibility (140 [33%] of 428) and external sequencing not available for parsing (127 [30%] of 428). CONCLUSION PRECISE identified 43% of all patients accrued to a diverse cohort of early-phase, genome-matched studies. Purpose-built informatics platforms represent a novel and potentially effective method for matching patients to molecularly selected studies.

show abstract

Section: Discussionmentioning

confidence: 99%

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Tao

Eubank

Schram

et al. 2019

JCO Precision Oncology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our system is unique as compared with others described in the literature in that it incorporates genomic testing results from multiple sources, which are then stored and normalized in an internal database. [27][28][29][30][31][32] This model allows our providers access to a range of high-quality, innovate tests offered through commercial partners, but also makes structured data available to our internal MTB team. Our model allows for implementation at any oncology practice, even those not The Duke NGS Experience associated with academic centers capable of comprehensive genomic profiling.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Molecular Tumor Registry to Support the Adoption of Precision Oncology Within an Academic Medical Center: The Duke University Experience

Green

Bell

Hubbard

et al. 2021

JCO Precision Oncology

View full text Add to dashboard Cite

PURPOSE Comprehensive genomic profiling to inform targeted therapy selection is a central part of oncology care. However, the volume and complexity of alterations uncovered through genomic profiling make it difficult for oncologists to choose the most appropriate therapy for their patients. Here, we present a solution to this problem, The Molecular Registry of Tumors (MRT) and our Molecular Tumor Board (MTB). PATIENTS AND METHODS MRT is an internally developed system that aggregates and normalizes genomic profiling results from multiple sources. MRT serves as the foundation for our MTB, a team that reviews genomic results for all Duke University Health System cancer patients, provides notifications for targeted therapies, matches patients to biomarker-driven trials, and monitors the molecular landscape of tumors at our institution. RESULTS Among 215 patients reviewed by our MTB over a 6-month period, we identified 176 alterations associated with therapeutic sensitivity, 15 resistance alterations, and 51 alterations with potential germline implications. Of reviewed patients, 17% were subsequently treated with a targeted therapy. For 12 molecular therapies approved during the course of this work, we identified between two and 71 patients who could qualify for treatment based on retrospective MRT data. An analysis of 14 biomarker-driven clinical trials found that MRT successfully identified 42% of patients who ultimately enrolled. Finally, an analysis of 4,130 comprehensive genomic profiles from 3,771 patients revealed that the frequency of clinically significant therapeutic alterations varied from approximately 20% to 70% depending on the tumor type and sequencing test used. CONCLUSION With robust informatics tools, such as MRT, and the right MTB structure, a precision cancer medicine program can be developed, which provides great benefit to providers and patients with cancer.

show abstract

PRECISE: A clinical-grade automated molecular eligibility screening and just-in-time (JIT) physician decision support solution for molecularly-selected oncology trials.

Cited by 2 publications

References 0 publications

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Implementation of a Molecular Tumor Registry to Support the Adoption of Precision Oncology Within an Academic Medical Center: The Duke University Experience

Contact Info

Product

Resources

About