Lung cancer patients may benefit from innovative informatics project

May 30, 2014 by Mallory Powell

A multidisciplinary team of doctors, researchers, and informaticists the University of Kentucky is working to improve identification of lung cancer patients who are eligible to participate in clinical trials for novel treatments.

Clinical trials are critical for advancing research into new and better treatments for , and the need for improved treatment of lung cancer is dire: Lung cancer is the leading cause of cancer death worldwide. Its burden is especially significant in the Commonwealth, where rates of lung cancer incidence and mortality are the highest in the country. In Appalachian Kentucky, the situation is even worse, with incidence rates nearly twice the national rate.

Despite high rates of lung cancer, less than 1 percent of enroll in . This is partly due to the difficult and tedious business of identifying and recruiting patients who are eligible for trials, a task currently conducted by research staff who manually reviews patient information for a multitude of (often complex) eligibility factors. The process is time consuming and inefficient, with studies showing that manual identification can overlook up to 60 percent of eligible patients. Furthermore, patient eligibility can vary by study and change over time.

And, unfortunately, the severity of the disease also contributes to the exceptionally low rates of lung cancer patient enrollment in clinical trials. Lung cancer is often diagnosed so late that the median survival time is only eight months, leaving little time for patients to explore treatment options or for doctors to identify patients who are eligible for novel therapeutic interventions offered through clinical trials.

The combination of the burden of lung cancer in Kentucky and the urgency of identifying patients who are eligible for clinical trials motivated Dr. Eric Durbin and his team to devise a more efficient method for screening patient eligibility. Durbin, an assistant professor in the division of biomedical informatics at the UK College of Public Health, is the director of the Cancer Research Informatics Shared Resource Facility at the UK Markey Cancer Center and director of cancer informatics at the Kentucky Cancer Registry.

With pilot funding from the Kentucky Lung Cancer Research Program (KLCRP), Durbin and his team are leveraging the rich and unique electronic data sources managed by the UK Center Clinical and Translational Science (CCTS), the UK Institute for Pharmaceutical Outcomes and Policy (IPOP), the Markey Cancer Center, and the Kentucky Cancer Registry (KCR), which is housed at UK, to design, develop, pilot, and evaluate an innovative, electronic informatics system to automatically identify patients who are eligible for clinical trials. The outcomes of the automated identification system will then be compared to those of the manual identification methods. If successful, the automated system could dramatically increase the speed, completeness, and efficiency of identifying patients for lung cancer clinical trials.

"The need for improvement was pretty obvious, and my colleagues and I thought it would be an ideal project for KLCRP pilot funding," said Durbin, who is the principal investigator on the project. "We're trying to leverage existing and new electronic data sources to improve the efficiency of the identification and recruitment process."

The pilot project will specifically focus on identification of eligible patients at the UK Markey Cancer Center. Due to its designation as National Cancer Institute, Markey offers unique clinical trials that are only available through NCI centers.

"Clinical trial recruitment is critically important to the Markey Cancer Center if we're going to get lifesaving therapeutics to our patients," said Dr. Susanne Arnold, associate professor in medical oncology and radiation medicine at the Markey Cancer Center and member of the project team. "It's also how we make progress in cancer treatment."

It is particularly important to identify and recruit clinical trial participants from the entire pool of eligible patients in order to remove any potential bias from the study results and to ensure that the findings are applicable to the general population. Additionally, under-recruitment in underserved populations, such as Kentucky's Appalachian residents, can be perceived as unequal access to the most cutting-edge treatments and technologies.

"We want to ensure that all patients have the opportunity to enroll in clinical trials," said Durbin.

The two-year project is currently in its seventh month, and the team is in the discovery phase of evaluating the multiple data sources and testing different query methods. In addition to using discrete data elements, such as lab values, the team is utilizing natural language processing methodology to incorporate more conceptual data, such as patient performance status, from the qualitative notes that doctors make in their medical records.

"We are combining discrete data elements with natural language processing approaches to extract complete information," said Durbin. "This is a very important area of informatics."

The objectives of the project align perfectly with the mission of the Kentucky Lung Cancer Research Program, who funded the project and whose mission is to reduce the burden of lung cancer in Kentucky.

"A critical component to reducing this burden is clinical research," said Dr. Nathan Vanderford, assistant director for research at the Markey Cancer Center and the center's liaison to the Kentucky Lung Cancer Research Program.

"The potential to greatly improve enrollment in studies will ultimately translate into improved lung cancer detection, diagnosis, and treatment in the future."

Vanderford recognizes the distinctive capacity of Durbin's team to capitalize on the robust data, expertise, and technology available at UK. In addition to the wealth of electronic health data at UK, the Kentucky Cancer Registry (KCR) is housed at the university by legislative mandate. The KCR operates a population-based electronic pathology reporting system that captures 90 percent of all histologically confirmed cancer cases in Kentucky within days of diagnosis.

"We are very uniquely situated in terms of the data sources and technology we have at UK. And this team is uniquely skilled to do this project. They have a significant number of years of experience and are very familiar with all the data sources. We're very cutting edge in being able to apply all these different data sources to achieve our objective in a much better way," he said.

While the pilot project focuses specifically on lung cancer patients at Markey Cancer Center, the automated identification system could be easily applied to a broad range of cancers and other disease conditions in the future.

"What's really exciting about Dr. Durbin's study is that it has the potential to greatly improve clinical research not only in but in other cancers and disease conditions as well," said Vanderford.

Explore further: Trial confirms promise of stratified lung cancer treatment

Related Stories

Trial confirms promise of stratified lung cancer treatment

May 22, 2014
(Medical Xpress)—Routine tests that look for multiple, specific genetic changes in patients' lung tumours could help doctors select targeted treatments, a US study has confirmed.

Experimental drugs for breast cancer could treat lung cancer too

August 13, 2013
Cancer Research UK -funded scientists have discovered that experimental drugs first developed for breast and ovarian cancer could be used to treat the most common type of lung cancer, reveals research published in Oncogene ...

Study shows value of HRQOL assessment in small cell lung cancer

January 28, 2014
An EORTC study published in Lancet Oncology found that health-related quality of life (HRQOL) assessment in small-cell lung cancer randomized clinical trials provides relevant added information in studies where the treatment ...

Clinical trials to investigate prostate cancer treatment

April 28, 2014
The way prostate cancer is treated could have a radical re-think as two international clinical trials go ahead.

A call to arms in cancer research

May 19, 2014
Hispanics are the fastest-growing demographic group in the United States, and they suffer from major health disparities, including higher rates of cancers of the cervix, stomach and liver.

Team identifies growth factor receptors that may prompt metastatic spread of lung cancer

April 9, 2014
Two cell surface receptors might be responsible for the most common form of lung cancer spreading to other parts of the body, according to a study led by the Translational Genomics Research Institute (TGen).

Recommended for you

No dye: Cancer patients' gray hair darkened on immune drugs

July 21, 2017
Cancer patients' gray hair unexpectedly turned youthfully dark while taking novel drugs, and it has doctors scratching their heads.

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.