Across the U.S. and Globally, Healthcare Systems are Collaborating to Accelerate Precision Cancer Medicine Development

September 23, 2016
by Heather Landi

Leading healthcare systems are developing innovative collaborations with other health systems as well as with commercial partners to drive forward advancements in precision medicine, with an eye to accelerating personalized cancer treatments.

Earlier this month, Salt Lake City-based Intermountain Healthcare, a 22-hospital health system, announced a partnership between its genomics division, Intermountain Precision Genomics, and Singapore-based Asia Genomics to collaborate on offering genomics testing in four Southeast Asian countries—Singapore, Philippines, Vietnam and Malaysia. The collaboration is the first for Intermountain Precision Genomics outside the U.S.

As part of the agreement, Asia Genomics, a molecular diagnostics company, now contracts with Intermountain Precision Genomics to offer Intermountain’s ICG100 testing in those four countries.

Intermountain Precision Genomics is a service of Intermountain Healthcare, which offers genetic sequencing of solid tumors.

Asia Genomics has been offering various types of genomic tests in the healthcare environment since 2014. The primary focus of the tests Asia Genomics offers center on reproductive health and cancer care. “We are excited to be the first value-adding partner with Intermountain Precision Genomics outside of the U.S. Leveraging Intermountain Precision Genomics’ years of experience in cancer research, diagnosis and treatment, we aim to improve survival and quality of life for cancer patients in Asia,” Wong Mun-Yew, M.D., CEO and founder of Asia Genomics, said in a prepared statement.

According to Don Tarinelli, Intermountain Healthcare’s business development director, the collaboration will entail Intermountain Precision Genomics serving as the reference laboratory for the ICG100 next-generation sequencing testing. Essentially, Asia Genomics will be a distributor for the ICG100 test in Singapore, Philippines, Vietnam and Malaysia.

“Later this year, Asia Genomics will likely expand the testing into Thailand and Indonesia. In the future, Asia Genomics hopes to do next-generation sequencing in-house, at which point we will act more as a collaborative partner for the interpretation and the bioinformatics portion of the process,” Tarinelli says.

The collaboration comes at a time when the Obama Administration’s Cancer Moonshot initiative aims to accelerate cancer research. As reported by Healthcare Informatics Senior Editor Rajiv Leventhal, earlier this month, a Blue Ribbon Panel released a report describing a set of consequential recommendations for fast-tracking cancer research. The report presents 10 recommendations and one of those recommendations focused on developing new enabling cancer technologies. Specifically, the report calls for support for the development of promising new technologies that will accelerate testing of therapies and characterization of tumors.

Many U.S. healthcare systems are collaborating on genomic and molecular testing in order to share expertise and combine capabilities with the aim of accelerating precision medicine. Earlier this month, Pittsburgh, Pa.-based Allegheny Health Network (AHN) Cancer Institute announced plans to collaborate with Johns Hopkins Kimmel Cancer Center in order to provide molecular testing to AHN patients with certain late-stage cancers to deliver more targeted drug therapies.

“As we move into a new era in the war on cancer, collaboration among institutions is an essential ingredient to success,” David Parda, M.D., Chair, AHN Cancer Institute, said in a statement.

Back in May, Lincoln Nadauld, M.D., Ph.D., executive director of precision medicine and precision genomics at Intermountain Healthcare, spoke to Healthcare Informatics about Intermountain’s just announced clinical genomics partnership with Stanford Genome Technology.

“I think one thing that [Vice President Joe] Biden’s MoonShot for Cancer team really wants to see is inter-institutional collaboration and cooperation. I think our effort with Stanford is an ideal example of what they are helping to promote. …Now we are going to marry those two strong capabilities for the benefit of patients, and I think that’s exactly what Biden and the MoonShot team want to see; that’s what they are trying to promote,” Nadauld says.

In a press release announcing the Intermountain Precision Genomics and Asia Genomics collaboration, Terri Kane, vice president of Intermountain Healthcare’s southwest region, which includes Intermountain Precision Genomics, said targeted therapies are proving to be the most effective treatment for late-stage cancer patients.

Intermountain’s ICG100 test is next-generation sequencing that identifies individual mutations within a person’s cancer cells to identify specific DNA targets for personalized drug treatments. Currently the ICG100 test is approved for late-stage cancer patients who have failed a traditional treatment method.

Intermountain Precision Genomics scientists developed its ICG100 test to detect any irregularities or cancer markets within a patient’s genes and DNA. According to Intermountain, its researchers have identified 96 genes that can play a part in developing cancer, and the ICG100 test looks at each one to determine if any show abnormalities.

Tarinelli says, “From a basic patient-centered level, what we do is that the physician will send us a tumor biopsy, we extract the DNA, the cancer cells, out of that sample, and through this process of next generation sequencing and our bioinformatics, we’re able to determine what genes have mutated in that patient and are causing the cancer to grow. And that’s half the battle,” Tarinelli says.

In order to accommodate the diverse variants generated by its sequencing chemistry, Intermountain Precision Genomics developed a collaborative, interdisciplinary board, a Molecular Tumor Board, consisting of scientists and physicians in genomics from across the western United States. The board meets weekly to discuss individual, effective treatment options based on genomic data and clinical relevance.

“The Molecular Tumor Board reviews the patient samples and the reports and, in addition to just identifying the mutations, we actually make specific recommendations as to what drugs to use to target that specific mutation. And with a lot of patients today we’re able to recommend oral medications that can be taken at home and don’t have all the side effects of traditional therapies,” Tarinelli says.

Intermountain Healthcare leaders report they are seeing promising results from the more personalized treatments for late-stage cancer patients due to the advancements in genomic diagnostic technology.

Earlier this month, researchers with Intermountain Healthcare, along with researchers from University of Utah School of Medicine, Durham, N.C.-based Duke University School of Medicine and Stanford University School of Medicine, published a study in Journal of Oncology Practice based on a retrospective analysis of precision medicine outcomes in patients with advanced cancer. According to the study authors, the study findings indicated improved progression-free survival without increased healthcare costs.

“We’re part of an integrated care delivery system, so we are able to track outcomes from patients that receive targeted therapies and the outcomes have been very good,” Tarinelli says, referencing that particular Journal of Oncology Practice study.

For that study, researchers analyzed the outcomes of patients who received genomic testing and targeted therapy, or precision cancer medicine, compared with control patients who received standard chemotherapy.

The study findings indicated, Tarinelli says, that the average progression-free survival was 23 weeks for patients who received precision cancer medicine compared to similar patients with traditional therapy, in which the average progression-free survival was 12 weeks. “So, effectively, we’ve been able to double the progression-free survival rate for our patients,” he says.

“Another significant benefit to these targeted treatments is there isn’t all the side effects as with traditional chemotherapy. These patients grow their hair back, they get out of the wheelchair and some are going back to work and living their lives, and more importantly, living their lives on their terms and are able to enjoy the additional time that they have spending time with their families, as opposed to being in a hospital bed or in a hospice,” he says.

Moving forward, the collaboration with Asia Genomics enables Intermountain Precision Genomics to increase its volume of testing.

“And, more importantly, we are able to expand our reach for this particular test, which has been able to help a tremendous amount of patients in Utah and across the U.S.,” Tarinelli says. “We’re going to be able to leverage it to help patients across those four countries in Asia. And we’ll be able to work with them from a research perspective, but also really expand our borders from Intermountain.”