Clinical Topics & News

Implementation of a Precision Oncology Program as an Exemplar of a Learning Health Care System in the VA

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Research Activities

For the majority of POP participants, the best hope for improved quality and quantity of life lies with targeted therapeutics that are under development and available only through research protocols. The VISN 1 Clinical Trial Network (directed by Mary Brophy, MD) has developed an Oncology Consortium that includes facilities both within and outside of VISN 1. The consortium has partnered with the National Cancer Institute through a storefront mechanism with the Southwest Oncology Group to become the first national VA cancer consortium to participate in intergroup protocols. Novel therapeutics will be available to POP participants through this and other partnerships with a variety of industry sponsors.

Novel, efficient, and nationally scalable mechanisms have been proposed to facilitate clinician participation and patient enrollment in clinical trials. Additionally, MAVERIC is working with the VA Central Institutional Review Board to advance a distributed enrollment innovation, which brings the clinical trial to the patient rather than have patients travel to facilities where studies are open.

Conclusion

Unique features of the VHA enable a national rollout of the POP, which VISN 1 successfully piloted. The first of its kind effort for precision medicine within the VA holds the promise of delivering cutting-edge, life-enhancing therapy to cancer patients.

This interdisciplinary program incorporates LHS principles so that delivery of care is accompanied by analytics that can be applied to decision making for future patients. Participation in clinical trials, facilitated by the consortium model, is a cardinal feature of the POP. Opportunity exists to explore novel trial designs that meet the unique challenges presented in precision medicine, where therapeutics tailored to uncommon mutations limit patient availability.

Author disclosures
The author reports no actual or potential conflicts of interest with regard to this article.

Disclaimer
The opinions expressed herein are those of the author and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.

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