LEXINGTON, Ky. — Just one year after joining the Oncology Research Information Exchange Network (ORIEN), the University of Kentucky Markey Cancer Center has already enrolled more than 1,000 patients. ORIEN is an alliance of 19 major cancer centers that share information to allow its members to push forward evidence-based cancer care to patients.
Markey’s fast growth in ORIEN already places the cancer center in the top third of the consortium in terms of accrual rate. Jill Kolesar, director of the Precision Medicine Clinic at Markey, cites Markey’s cooperative atmosphere as a key reason for their success.
“Everyone at Markey is very collaborative,” Kolesar said. “It’s truly been a group effort with our treating physicians, our Precision Medicine Team, the Kentucky Cancer Registry, and our pathologists, all led by our director Dr. Mark Evers. We are creating a comprehensive database and learning a lot about cancers here in Kentucky.”
ORIEN members follow the Total Cancer Care Protocol, operated by M2Gen, a for-profit subsidiary of the Moffitt Cancer Center in Tampa, Fl. Total Cancer Care is a unique approach to studying patients throughout their lifetime and provides a standard system for tracking patients’ molecular, clinical and epidemiological data. This gives clinicians and researchers access to a searchable, growing database of medical information from respected peers that can help them match patients to targeted treatments.
Because Total Cancer Care follows patients throughout their life, it allows researchers to anticipate trends or changes in the patient’s disease, and to have patients worked up and ready to immediately enroll in appropriate clinical trials as they become available. It will also help predict which patients may need additional cancer screenings that fall outside of standard national recommendations.
“We call it going from ‘reactive’ medicine to ‘proactive’ medicine, where we can anticipate that a patient’s disease may progress,” said Bill Dalton, chairman of the Board at M2Gen.
Studies have shown that the protocol is working to get more patients in clinical trials, and faster. According to Dalton, the system has been proven to find clinical trials for patients and enroll them in target-based clinical trials that recognize unique markers of their disease and may improve patient outcomes.
Researchers are not just tracking the patient’s physical treatment, but their mental and emotional needs as well. The goal is to develop markers to predict issues before they happen, anticipating what a patient may need next in their care. For example – if a patient develops a certain type of breast cancer, are they more likely to be diagnosed with depression later on? If so, how can physicians stay ahead of the curve to help keep that patient physically and mentally healthy?
“While the emphasis is on treatment needs based on genomic and other data, patients have more than treatment needs,” Dalton said. “They have psychosocial needs as well. Our protocol is very holistic.”
Nearly five years ago, UK Markey Cancer Center physician Dr. Tim Mullett was diagnosed with a gastrointestinal stromal tumor (GIST) and continues to visit his oncologist for regular follow-ups. After Markey joined ORIEN in late 2017, Mullett agreed to join the Total Cancer Care protocol – although his cancerous tissue was no longer available, he was given a cheek swab to have his genetic material analyzed.
“As we are going down this precision medicine pathway, we’re learning that it’s more important to know the genetic footprint of a tumor than where it came from,” Mullett said. “I was glad I was still able to contribute even though it’s been almost five years since diagnosis.”
Mullett serves as the medical director for the UK Markey Cancer Center Affiliate Network, a growing coalition of community hospitals that collaborate with Markey physicians to provide care closer to home. Through their connection to Markey, affiliates are now beginning to follow the Total Cancer Care protocol and contributing to ORIEN – Kings Daughters Medical Center in Ashland, Ky. is already on board, with Owensboro Health and St. Elizabeth Healthcare in Edgewood, Ky. in talks to follow.
These community partnerships are vital to the success of the ORIEN study – Dalton notes that of the 230,000 patients they have consented thus far, nearly half of those have come from community hospitals.
“Our goal is to make Total Cancer Care accessible to every patient, and to do that, our academic medical centers need to export this capability to their partners out in the community,” Dalton said. “It’s in the best interest of the patient, and it’s very good for the community providers. What we’ll be able to do from the information generated from their patients is give back to the providers so they can make evidence-based decisions.”
At Markey, patients can be eligible for Total Cancer Care if they 18 years of age or older, have been diagnosed with cancer or at risk for cancer, and if they are willing to participate in research and share information. According to Dalton, M2Gen is currently working on a website for ORIEN patients which will allow them to track trends in their own cancer.
After recently hosting Dalton and other M2Gen representatives, Kolesar says UK is looking to further expand the benefits of Total Cancer Care for more patients.
“There are so many important initiatives in Total Cancer Care,” Kolesar said. “For example, we are working to offer our patients low- or no-cost clinical testing and innovative clinical trials. We’re also planning to open the protocol for our pediatric patients in 2019.”