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  • 1
    In: Cell, Elsevier BV, Vol. 181, No. 2 ( 2020-04), p. 236-249
    Type of Medium: Online Resource
    ISSN: 0092-8674
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    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
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    detail.hit.zdb_id: 2001951-8
    SSG: 12
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  • 2
    In: JCO Precision Oncology, American Society of Clinical Oncology (ASCO), , No. 7 ( 2023-01)
    Abstract: With the growing number of available targeted therapeutics and molecular biomarkers, the optimal care of patients with cancer now depends on a comprehensive understanding of the rapidly evolving landscape of precision oncology, which can be challenging for oncologists to navigate alone. METHODS We developed and implemented a precision oncology decision support system, GI TARGET, (Gastrointestinal Treatment Assistance Regarding Genomic Evaluation of Tumors) within the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute. With a multidisciplinary team, we systematically reviewed tumor molecular profiling for GI tumors and provided molecularly informed clinical recommendations, which included identifying appropriate clinical trials aided by the computational matching platform MatchMiner, suggesting targeted therapy options on or off the US Food and Drug Administration–approved label, and consideration of additional or orthogonal molecular testing. RESULTS We reviewed genomic data and provided clinical recommendations for 506 patients with GI cancer who underwent tumor molecular profiling between January and June 2019 and determined follow-up using the electronic health record. Summary reports were provided to 19 medical oncologists for patients with colorectal (n = 198, 39%), pancreatic (n = 124, 24%), esophagogastric (n = 67, 13%), biliary (n = 40, 8%), and other GI cancers. We recommended ≥ 1 precision medicine clinical trial for 80% (406 of 506) of patients, leading to 24 enrollments. We recommended on-label and off-label targeted therapies for 6% (28 of 506) and 25% (125 of 506) of patients, respectively. Recommendations for additional or orthogonal testing were made for 42% (211 of 506) of patients. CONCLUSION The integration of precision medicine in routine cancer care through a dedicated multidisciplinary molecular tumor board is scalable and sustainable, and implementation of precision oncology recommendations has clinical utility for patients with cancer.
    Type of Medium: Online Resource
    ISSN: 2473-4284
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 13_Supplement ( 2021-07-01), p. 1198-1198
    Abstract: With the advent of next generation sequencing in cancer care, patients' tumors can be genomically profiled and specific genetic alterations can be targeted with precision medicine drugs. However, the abundance of patient sequencing data coupled with complex clinical trial eligibility has made it challenging to match patients to precision medicine trials. To facilitate interpretation of complex tumor sequencing data and clinical trial genomic eligibility criteria, we developed MatchMiner, an open-source platform to computationally match cancer patients to precision medicine clinical trials. MatchMiner supports two distinct workflows: (1) patient-centric mode, in which an oncologist can find clinical trial matches for a specific patient, and (2) trial-centric mode, in which a clinical trial investigator can identify and recruit patients for a specific trial. In MatchMiner at DFCI, there are currently 330+ precision medicine trials and genomic and genomic and clinical data from 39,000+ patients. Although MatchMiner has been operational at Dana-Farber Cancer Institute since early 2017, its impact on patient care has not yet been extensively studied. In this study, we analyzed temporal trends of 170 MatchMiner-driven trial enrollments. We compared these 170 MatchMiner-driven trial enrollments to non-MatchMiner-driven trial enrollments to determine how MatchMiner has impacted patient enrollments. To compare MatchMiner-driven trial enrollments to non-MatchMiner-driven enrollments, we limited the non-MatchMiner group by choosing patients who enrolled on the same trials. We also ensured that all patients in both enrollment groups had a genomic report present in MatchMiner before their consent date. We then analyzed temporal trends between genomic report dates, patient consent and on-study dates, and patient views in MatchMiner. MatchMiner-driven enrollments had a significant decrease in time from genomic report date to consent date compared to non-MatchMiner-driven enrollments. Thus, clinical use of MatchMiner decreased time to enroll in a precision medicine study, and suggests that use of precision medicine trial matching tools such as MatchMiner are important for the future of patient care. The MatchMiner open-source software package is available through GitHub (https://github.com/dfci/matchminer). We are committed to supporting MatchMiner as an open-source software; to our knowledge, at least five cancer centers are implementing MatchMiner. Citation Format: Harry Klein, Tali Mazor, Priti Kumari, James Lindsay, Andrea Ovalle, Ethan Siegel, Pavel Trukhanov, Joyce Yu, Michael Hassett, Ethan Cerami. MatchMiner: An open-source computational platform that accelerates patient enrollment on to precision medicine trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1198.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
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  • 4
    In: Nature Methods, Springer Science and Business Media LLC, Vol. 19, No. 3 ( 2022-03), p. 262-267
    Type of Medium: Online Resource
    ISSN: 1548-7091 , 1548-7105
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2163081-1
    SSG: 12
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  • 5
    In: npj Precision Oncology, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2022-10-06)
    Abstract: Widespread, comprehensive sequencing of patient tumors has facilitated the usage of precision medicine (PM) drugs to target specific genomic alterations. Therapeutic clinical trials are necessary to test new PM drugs to advance precision medicine, however, the abundance of patient sequencing data coupled with complex clinical trial eligibility has made it challenging to match patients to PM trials. To facilitate enrollment onto PM trials, we developed MatchMiner, an open-source platform to computationally match genomically profiled cancer patients to PM trials. Here, we describe MatchMiner’s capabilities, outline its deployment at Dana-Farber Cancer Institute (DFCI), and characterize its impact on PM trial enrollment. MatchMiner’s primary goals are to facilitate PM trial options for all patients and accelerate trial enrollment onto PM trials. MatchMiner can help clinicians find trial options for an individual patient or provide trial teams with candidate patients matching their trial’s eligibility criteria. From March 2016 through March 2021, we curated 354 PM trials containing a broad range of genomic and clinical eligibility criteria and MatchMiner facilitated 166 trial consents (MatchMiner consents, MMC) for 159 patients. To quantify MatchMiner’s impact on trial consent, we measured time from genomic sequencing report date to trial consent date for the 166 MMC compared to trial consents not facilitated by MatchMiner (non-MMC). We found MMC consented to trials 55 days (22%) earlier than non-MMC. MatchMiner has enabled our clinicians to match patients to PM trials and accelerated the trial enrollment process.
    Type of Medium: Online Resource
    ISSN: 2397-768X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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  • 6
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 18, No. 12_Supplement ( 2019-12-01), p. A024-A024
    Abstract: To facilitate interpretation of complex tumor sequencing data and clinical trial genomic eligibility criteria, we developed MatchMiner, an open-source platform to computationally match cancer patients to precision medicine clinical trials based on clinical and genomic features. MatchMiner supports two distinct workflows: (1) a patient-centric mode, in which an oncologist can find clinical trial matches for a specific patient, and (2) a trial-centric mode, in which a clinical trial investigator can identify and recruit patients for a specific trial. MatchMiner has been operational at Dana-Farber Cancer Institute since early 2017. There are currently 250+ trials curated in the system and genomic data from 24,000+ patients. Over 82% of living patients match to at least one open clinical trial, with an average of 6 trial matches per patient. At least 85 patients have enrolled on a clinical trial as a result of MatchMiner. The MatchMiner open-source software package is available through GitHub (https://github.com/dfci/matchminer). MatchMiner is a two-tier web application with a Python-based REST application programming interface (API) server and an AngularJS front-end. MatchMiner utilizes Security Assertion Markup Language (SAML)-based authentication and, when hosted behind a secure institutional firewall, is fully HIPAA-compliant. MatchMiner can connect to existing clinical systems, including clinical trial management systems for real-time trial status. To enable computational matching to clinical trials, we developed clinical trial markup language (CTML), a structured format to encode detailed information about a trial. CTML utilizes boolean logic to define clinical (e.g. cancer type), demographic (e.g. age) and genomic (e.g. specific mutations, copy number alterations, structural variants or mutational signatures) eligibility, which can be applied to individual arms of a trial. We recently refactored the core matching algorithm (the matchengine), which improves upon the original matchengine in several ways. While the original matchengine reported the reason for a patient-trial match, the refactored matchengine provides additional, more granular details. In addition, the original matchengine ran at the cohort level, matching all patients to all trials, whereas the refactored matchengine can also run against individual patients or trials, speeding up the matching process. The refactored matchengine is also easily extensible to match based on additional data types. In summary, we have defined a standard for encoding clinical trial information in a structured and computable form, and we have developed an open-source computational trial matching platform to support patient-specific trial identification as well as trial-specific patient recruitment. We are actively collaborating with clinical groups at Dana-Farber Cancer Institute to understand the role of MatchMiner in their clinical workflows, and we are committed to continuing to evolve MatchMiner to meet clinical needs. Citation Format: Tali Mazor, Rachel B Keller, Priti Kumari, James Lindsay, Eric Marriott, Andrea Ovalle, Ethan Siegel, Elizabeth H Williams, Joyce Yu, Michael Hassett, Ethan Cerami. MatchMiner: An open-source computational platform for genomically-driven matching of cancer patients to precision medicine clinical trials [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr A024. doi:10.1158/1535-7163.TARG-19-A024
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2019
    detail.hit.zdb_id: 2062135-8
    SSG: 12
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  • 7
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 16_Supplement ( 2020-08-15), p. 3382-3382
    Abstract: To facilitate interpretation of complex tumor sequencing data and clinical trial genomic eligibility criteria, we developed MatchMiner, an open-source platform to computationally match cancer patients to precision medicine clinical trials based on clinical and genomic features. MatchMiner supports two distinct workflows: (1) patient-centric mode, in which an oncologist can find clinical trial matches for a specific patient, and (2) trial-centric mode, in which a clinical trial investigator can identify and recruit patients for a specific trial. MatchMiner has been operational at Dana-Farber Cancer Institute since early 2017. There are currently 275+ trials curated in the system and genomic data from 26,000+ patients. Over 80% of living patients match to at least one open clinical trial, with an average of 6 trial matches per patient. At least 98 patients have enrolled on a clinical trial as a result of MatchMiner. To enable computational matching, we developed clinical trial markup language (CTML), a structured format to encode detailed information about a trial. CTML utilizes boolean logic to define clinical (e.g. cancer type), demographic (e.g. age) and genomic (e.g. specific mutations, copy number alterations, structural variants or mutational signatures) eligibility, which can be applied to individual arms of a trial. MatchMiner is an open-source two-tier web application with a Python-based REST API server and an AngularJS front-end. MatchMiner utilizes Security Assertion Markup Language (SAML)-based authentication and is fully HIPAA-compliant when hosted behind a secure institutional firewall. MatchMiner ingests clinical and genomic data, and connects to existing clinical systems, including clinical trial management systems for real-time trial status. We recently refactored the core matching algorithm (the matchengine), which improves upon the original matchengine in several ways: (1) increased granularity in reporting the reason for a match; (2) can match all patients/trials or individual patients/trials; (3) easily extensible to match based on additional data types. The MatchMiner open-source software package is available through GitHub (https://github.com/dfci/matchminer). We are committed to supporting MatchMiner as an open-source software; to our knowledge, at least five cancer centers are implementing MatchMiner at their own institutions. In summary, we have defined a standard for encoding clinical trial information in a structured and computable form, and we have developed an open-source computational trial matching platform to support patient-specific trial identification as well as trial-specific patient recruitment. We are actively collaborating with clinical groups at Dana-Farber Cancer Institute and other institutions to understand the role of MatchMiner in their clinical workflows, and we are committed to continuing to evolve MatchMiner to meet clinical needs. Citation Format: Tali Mazor, Rachel B. Keller, Priti Kumai, James Lindsay, Eric Marriott, Andrea Ovalle, Ethan Siegel, Joyce Yu, Michael Hassett, Ethan Cerami. MatchMiner: An open-source computational platform for genomically-driven matching of cancer patients to precision medicine clinical trials [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3382.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 8
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 1515-1515
    Abstract: 1515 Background: Precision oncology clinical trials often struggle to accrue due to the difficulty of identifying patients whose tumors meet complex tumor genomic matching criteria at propitious moments when they need new treatment. We conducted a pilot of deploying an artificial-intelligence (AI) model to find such patients and facilitate clinical trial matching workflows at a large academic cancer center. Methods: An AI model was trained to predict initiation of new palliative intent systemic therapy within 30 days of a given imaging report (CT, MRI, bone scan, or PET-CT), using the text of that report and prior reports for each patient. The model architecture and performance were previously published (Kehl et al, JCO-CCI 2021 5:622-630). From April to December 2022, the model was applied prospectively each time patients with solid tumors that had undergone next-generation sequencing underwent an imaging study. Model output was linked to the MatchMiner tool, which matches patients to clinical trials using tumor genomics (Klein et al, NPJ Precis Oncol 2022 6(1):69). The output consisted of lists of patients with tumor genomic matches to specific trials, sorted in order of the likelihood of changing treatment within 30 days. This information was provided to an oncology nurse navigator (ONN) charged with coordinating recruitment to early-phase targeted and immunotherapy trials. For 9 high priority trials, the ONN reviewed records for each patient flagged as likely to change treatment and contacted treating oncologists when patients appeared potentially eligible. The proportions of records leading to oncologist contact, and reasons for oncologist non-contact, were analyzed. Results: 2093 patients had tumors with genomic matches to the 9 trials of interest; 492 patients (24%) were deemed “likely” to change treatment by our AI model at least once during the pilot. The treating oncologist for 66 patients (3% of the total; 13% of 492 “likely” patients) was contacted after ONN review for potential eligibility. Reasons for not contacting treating oncologists included cases where they had already decided to continue current treatment (21%); the trial had no slots at the time (14%); or the patient was ineligible on nurse navigator review (12%); or had already been evaluated for the trial (7%), started new treatment (18%), or enrolled in hospice (5%). Of the 66 patients whose oncologists were contacted, 9 patients had a consult regarding early phase trials; 4 consented to participate; and all 4 received protocol treatment. Conclusions: Identifying potential precision clinical trial candidates by using AI to find patients likely to change treatment is feasible, but many other factors also impact potential trial enrollment. A prospective study is planned to evaluate the impact of sharing clinical trial information directly with treating oncologists when our model predicts a high probability of treatment change.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 9
    In: Cancer Cell, Elsevier BV, Vol. 18, No. 1 ( 2010-07), p. 11-22
    Type of Medium: Online Resource
    ISSN: 1535-6108
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2010
    detail.hit.zdb_id: 2074034-7
    detail.hit.zdb_id: 2078448-X
    SSG: 12
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  • 10
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 25, No. 5 ( 2018-05-01), p. 458-464
    Abstract: Misinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation. Materials and Methods We conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians’ genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0–18 and 1–4, respectively, higher score corresponding with improved endpoints). Results One hundred and five physicians at a tertiary cancer center participated (29% participation rate): 67% medical, 20% pediatric, 7% radiation, and 7% surgical oncology; 37% female. Prior to viewing the case-based vignettes, 34% of the physicians reported difficulty making treatment recommendations based on the standard static report. After vignette/report exposure, physicians’ overall comprehension scores did not differ by report type (mean score: interactive 11.6 vs static 10.5, difference = 1.1, 95% CI, −0.3, 2.5, P = .13). However, physicians exposed to the interactive report were more likely to correctly assess sequencing quality (P  & lt; .001) and understand when reports needed to be interpreted with caution (eg, low tumor purity; P = .02). Overall satisfaction scores were higher in the interactive group (mean score 2.5 vs 2.1, difference = 0.4, 95% CI, 0.2-0.7, P = .001). Discussion and Conclusion Interactive genomic reports may improve physicians’ ability to accurately assess genomic data and increase report-related satisfaction. Additional research in users’ genomic needs and efforts to integrate interactive reports into electronic health records may facilitate the implementation of precision oncology.
    Type of Medium: Online Resource
    ISSN: 1067-5027 , 1527-974X
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2018371-9
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