Bringing Precision Medicine to Community Oncologists

Quest Diagnostics has teamed up with Memorial Sloan Kettering Cancer Center (MSKCC) in New York, NY, and with IBM Watson Health in Cambridge, MA, to create IBM Watson Genomics, a new service that combines cognitive computing with genomic tumor sequencing. The initiative is aimed at advancing precision medicine beyond large cancer centers to thousands of community oncologists across the country.

“The real innovation is making this data clinically actionable for community oncologists,” says Jay Wohlgemuth, MD, chief medical officer and senior vice president of research and development at Quest Diagnostics, based in Madison, NJ. “Oncologists can now get a report that summarizes all of the relevant literature, data, and expert opinion surrounding a patient's specific tumor mutations, along with any potential drug and clinical trial options.”

IBM Watson Health is a cloud-based platform that searches tumor sequencing data, uploaded by oncologists, for actionable mutations, while simultaneously reviewing the most current evidence-based guidelines, clinical trials, journal articles, and patient outcomes.

The program is already being used at many large cancer centers, whose experts have been helping to “train” Watson by providing both clinical data and feedback on the quality of the platform's analyses. This new partnership with Quest, which has relationships with half of the country's hospitals, marks the first time that Watson will be made widely available to community cancer centers.

With the new service, oncologists can send a patient's solid-tumor biopsy sample to Quest, where it will be sequenced and the results fed into Watson. Watson will then compare the findings against its clinical and research databases and uncover any available drug therapies that target the patient's mutations.

MSKCC is contributing its existing precision oncology knowledge base, OncoKB, to Watson's trove of data. OncoKB contains detailed information about specific alterations in 418 cancer genes, including their biological effects and prevalence, based on sequencing data collected at MSKCC and curated by its expert panel.

“Sequencing data are complex and need expert interpretation,” says Paul Sabbatini, MD, deputy physician-in-chief for clinical research at MSKCC. “Some of the information surrounding genomic alterations is too new to be described in the published literature. However, we're able to provide input on what we know today.”

Community oncologists have often struggled to interpret the basic information provided in a patient's tumor sequencing report, Sabbatini says. Through IBM Watson Genomics, in addition to a list of mutations, they will also receive the benefit of expert guidance on prognostic and treatment implications, which he considers a giant step forward.

IBM Watson Genomics is available immediately to all physicians and hospitals that use Quest Diagnostics' services, says Wohlgemuth. The entire process—from ordering the test to analyzing the data—takes 2 to 3 weeks.

Besides better informing treatment decisions, collaborators expect the initiative will help advance targeted drug development, adds Wohlgemuth.

“To date, sequencing has largely been performed at major cancer centers, which has limited trial enrollment,” he says. “We hope this new service will speed up the patient matching process and reach people in the community who may not otherwise be connected with many clinical trials.” –Janet Colwell

For more news on cancer research, visit Cancer Discovery online at http://cancerdiscovery.aacrjournals.org/content/early/by/section.