Tag Archives: NCI

Feds Fund Two Cancer Information Apps

It sounds cute and perky, but Ask Dory! is actually an informative app that helps patients find information about clinical trials for cancer and other diseases.

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Along with another app, My Cancer Genome, the two recently won $20,000 each from the federal government.

Ask Dory! integrates data from www.clinicaltrials.gov. My Cancer Genome provides “therapeutic options based on the individual patient’s tumor gene mutations, making use of  National Cancer Institute’s physician data query clinical trial registry data set and information on genes being evaluated in therapeutic clinical trials,” according to a statement.

The two apps are part of the rapidly growing field of mHealth — or use of mobile devices for health purposes. Some are calling it an “mHealth bubble,” as thousands of groups large and small are rushing to develop the next great app for diabetes, cancer, infectious diseases, weight management,  addictions, and more.

Seeing the potential benefit for patients and providers, federal officials are providing incentives, and funding initiatives as simple as free text messaging reminders for pregnant women and new moms, to apps like Ask Dory!

“What makes these health IT challenges so powerful is their ability to catalyze the expertise and creativity of innovators both in and out of health care,” said Wil Yu, special assistant for innovation at the  Office for the National Coordinator for Health Information Technology (ONC), which awarded the prizes.

In collaboration with the National Cancer Institute, ONC launched the “Using Public Data for Cancer Prevention and Control: From Innovation to Impact” challenge in summer 2011. The two winners were among four semifinalists who submitted their products to the ONC challenge in November 2011.

—Naseem S. Miller (@NaseemSMiller on Twitter)

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Filed under Health IT, IMNG, mHealth, Oncology, Practice Trends

NCI’s Cancer Research Gambit

If the National Cancer Institute (NCI) is able to pull it off, the landscape for cancer research and clinical trials will be vastly different by 2014.

A year ago, the Institute of Medicine (IOM) at the NCI’s behest, assembled a panel of experts to look at whether there was a way to take the NCI’s  Clinical Trials Cooperative Groups system and streamline them into a more focused and nimbler enterprise.  The Cooperative Groups have existed since 1955 and are the recipients of a portion — though not the majority portion — of the NCI’s research budget.

Via Flickr Creative Commons, Wellcome Library

It is a loose-knit, largely volunteer federation of academic and community medical centers who share knowledge, but compete for the NCI’s grants.  The Coop Groups are considered a very influential and important place to do research. The federal government, private industry and patient advocates all make use of the power of the groups.

But the IOM pointed out in its early 2010 report that the Coop Groups have been suffering — from decreasing funding and duplicative efforts. And, disappointingly, patient recruitment is still hideously low.

Patients are the ultimate losers in this, as the most important questions may not be asked, and it is taking longer to get answers.

Often, such reports become fodder for policy wonks and just gather dust somewhere. They rarely become catalysts for fast action.  Not in this case.  Since that report was issued and the NCI subsequently gave notice that it expects to see major change in the next few years, 7 of the 10 cooperative groups have said they will assimilate into 3 new entities.

At a meeting earlier this week in Washington convened by the National Cancer Policy Forum and the American Society of Clinical Oncology to talk about the process, some of the nation’s leading oncologists were in attendance. They clearly were struggling with the idea that instead of competing with each other for money and attention, they now would be working in a much more collaborative way.

They all acknowledged the reality of the declining pot of gold at the end of the rainbow.  And there was some trepidation about what the new trial system would look like.

“I don’t think any of us in this room know if this is going to work,” said Dr. Peter C. Adamson, a leader in the Children’s Oncology Group (one of the NCI Coop Groups), and oncologist at the Children’s Hospital of Philadelphia.

But plunging ahead without knowing for sure if something will be effective seems to be the stock and trade of oncology. And, if the IOM is to be believed, the cancer research enterprise is not yet terminal, but is entering a late-stage of illness.  The time to act is now.

To read more analysis and news about the drive to retool the Cooperative Groups, you can go here and here.

—Alicia Ault (on Twitter @aliciaault)

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Filed under Health Policy, IMNG, Oncology

The Budget Axe Falls on Cancer Trials

From the Association of Community Cancer Centers, National Harbor, Md.

Clinical trials for cancer therapies might just be the latest victims of the continuing recession.  At a gathering of business managers and physicians from hospital-based oncology programs and private practices, word was that some are taking a look at the economics of conducting trials and deciding that it’s time to pare back.

Credit: Flickr Creative Commons user viceadmiraljon

Credit: Flickr Creative Commons user viceadmiraljon

That’s bad news, indeed.  There is a crushing need for more evidence on the comparative effectiveness and outcomes of different cancer regimens.  The lack of study participants has been a continuing blight on cancer research.  The American Cancer Society estimates that fewer than 5% of adults with cancer participates in a clinical trial.

Thomas A. Gallo, executive director of Community Oncology Services in Richmond, Va., said that his physicians feel obligated to participate in trials, but “we don’t make money doing this.”  With continuing revenue restraints, “you have to wonder at some point, are physicians going to continue to be willing to lose money to advance the science?”

Dr. Richard B. Reiling, ACCC’s immediate past president, and medical director of the Presbyterian Cancer Center in Charlotte, N.C., said that drug company largesse allows his physicians to barely break even on trials.  The surgeon said he believes that community oncologists have definitely cut back on trial participation.  But he’s hopeful that stimulus money given to the National Cancer Institute will trickle down.

Physicians don’t delude themselves that they’ll ever make a profit from trials, said oncologist Dr. Edward Braud of Springfield, Ill.  But the bleak economy means that more will choose to forgo the cost and hassle.

“That mom and pop shop of three to four medical oncologists who’ve been doing it out of a passion, their accountant is gonna come up to them, add up all the red ink and say you can’t keep doing this,” he said.

—Alicia Ault
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Filed under Oncology, Practice Trends

What’s So Hot About GWAS?

Image courtesy of NIH

Image courtesy of NIH

From the National Cancer Institute’s Science Writers’ Seminar, Gaithersburg, Md.

If you’ve read any medical literature or been to a medical meeting lately, chances are that you’ve heard of GWAS—genome-wide association studies.  GWAS are hot and with good reason. Genetic studies of the past have been limited either to looking at linkages among related individuals or to the candidate gene approach, which directly tests the effects of genetic variants of a potentially contributing gene—already believed to play a role in a disease—in an association study.

With GWAS, researchers are now able to scan markers across the genomes of thousands of individuals and to identify genetic variation associated with a particular disease. The approach allows researchers to identify candidate genes that were previously unknown and may even occur in long stretches of noncoding—-or unexplored—regions of DNA. This approach has already been put to use in disorders as disparate as autism, type 2 diabetes, and inflammatory bowel disease. Just within oncology, GWAS have identifed 15 new candidate SNPs (single nucleotide polymorphisms) for prostate cancer, 12 for breast cancer,  and 10 for colorectal cancer.

Researchers can barely contain their excitement with this amazing new tool. But—and you KNEW there was a but—it will be quite a while before the research translates to useful information for physicians and patients like improved risk models, screening tests, or novel targeted drugs.  GWAS have to go through several iterations just to determine whether the initial candidate SNPs identifed are not merely statistical figments of the imagination. Then, once you have “real” candidate SNPs, what do you do with them? You have to figure out what they mean: Do they play a role in etiology or gene-environment/lifestyle interactions? Are there druggable targets? What, if any utlity is there for risk prediction?

Yes, GWAS hold great promise, but today they are just the begining of the begining.

—Kerri Wachter
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