Purpose: The White House Cancer Moonshot Initiative aims to double the rate of progress against cancer. A component of VA’s efforts to support Cancer Moonshot is VA’s national Precision Oncology Program (POP), which aims to (1) create best practices to provide genomic testing and reporting of tumor samples from patients; (2) provide annotation of tumor molecular analysis panels and consultative services to cancer care providers; (3) facilitate access to matching approved and novel therapies; and (4) institute a learning healthcare system for administrative, clinical care and research purposes. The aspirational goal of POP is to double the survival of patients with advanced NSCLC.
Methods: Standard project management techniques and descriptive statistics were used.
Results: As of June 2016, a Director of POP and an interim advisory group have been appointed. 32 facilities have been contacted and provided an initial response. 18 facilities are enrolled in POP and have sent at least 1 tumor sample; 8 additional facilities are in the activation process. A total of 347 tumor samples have been sent for profiling through one of two vendors, including 231 lung cancer cancers and 75 melanomas. Support for annotation of tumor genetic panels is available from N-of-One and IBM Watson for Oncology. To date, 13 patients have received targeted agents after tumor panel testing including erlotinib or gefitinib (n = 5), crizotinib (n = 3), and 1 patient each for dabrafenib + trametinib, vemurafenib, olaparib, pazopanib, and sunitinib. Research partnerships with other governmental agencies, non-profit organizations, and industry are being pursued to expand access to novel therapies. “Smart” CPRS templates that structure core clinical data elements have been designed to support clinician documentation needs, POP activities, and the learning healthcare system.
Implications: Implementation of the National Precision Oncology Program at all facilities treating patients with advanced cancer is planned.
