SMART Precision Cancer Medicine

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Presentation transcript:

SMART Precision Cancer Medicine Jeremy Warner MD, MS Assistant Professor of Medicine and Biomedical Informatics Vanderbilt University June 26, 2017

Three questions every cancer patient asks Who’s like me? How long have I got? What are my options?

Current state Who’s like me? How long have I got? What are my options?

No Data – No tools! Poll of ASCO membership, 2016

FHIR-enabled workflow EHR/ Clinical Systems Order Genetic Tests 1 3 Present & Contextualize Genetic Test Results SMART on FHIR Clinico-Genomics Apps Diagnostic Order App Diagnostic Reporter App FHIR® Data FHIR® Data Sequencing Lab SMART Precision Cancer Medicine App 2 Return Genetic Test Results Warner et al. Genome Med 2016

SMART Precision Cancer Medicine Purpose: to present real-time population-level genomic health information to oncologists and their patients, as a component of clinical practice Means: an open-source application based on the SMART on FHIR Genomics API for native data representation of somatic genomic data Secondary Objective: demonstrate the ease of including seamless links to external knowledge bases within the app Warner et al. JAMIA Precision Medicine Special Issue 2016

Warner et al. JAMIA Precision Medicine Special Issue 2016

“Patients Like This” This patient has the most common variant of KRAS seen in the lung cancer population.

In this exploded view, the user can see enumerated information as well.

The user can access Gene Wiki information about the gene, directly from the exploded gene view

The user can access MyCancerGenome information about the gene variant, directly from the exploded gene variant view “What are my options?”

Under the hood LDAP SSO SMART PCM HIS Security Module Authentication Authorization Genome Knowledge Module Education Prognosis Genome-directed therapy HIS Patient Data Module Demographics Cancer data NGS panel data Regimen Knowledge Module Education Efficacy Toxicity Presentation Module “patients like this” genomic therapy treatment ranking

Unpublished work, Krysten Harvey Presented by: Jeremy L. Warner MD, MS Unpublished work, Krysten Harvey

Unpublished work, Krysten Harvey Presented by: Jeremy L. Warner MD, MS Unpublished work, Krysten Harvey

Acknowledgements Gil Alterovitz Nipun Sud Joseph Burden Ari Taylor Daniel Carbone* Lucy Wang* Tom Chen Daniel Wenner Jake Conway Heming Yao* Krysten Harvey* Peter Yang Sandeep Jain Peijin Zhang Isaac Kohane Shilin Zhu* David Kreda Andrew Malty Past and current funding support: NCATS ULTR000445, NCI CA068485, CA171123, CA194215, ONC 90TR0001/01, PCORI CDRN-1306- 04869, Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation, T.J. Martell Foundation, and an anonymous foundation Josh Mandel Ken Mandl Ross Oreto* Travis Pittman Matthew Rioth Joey Schneider * Directly involved in programming of SMART PCM

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