NCCN News

Flatiron Health Announces Clinical Decision Support Application Through Epic’s App Orchard

Flatiron Health, a healthcare technology company focused on accelerating cancer research and improving patient care, announced the availability of its clinical decision support and pathways application, Flatiron Assist, in the App Orchard.

Flatiron Assist supports oncologists in selecting therapies in line with best clinical practices, including the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines), and in identifying potentially relevant clinical trials. The integrated regimen selection workflow allows clinicians to quickly confirm the clinical data needed to determine adherence to guidelines. Health system administrators can use the clinical data collected by this tool to streamline the prior authorization process, measure variation in care across a practice or health system, and report pathways compliance to payers.

“The rapidly evolving treatment landscape and increasing payer reporting requirements make it challenging for busy oncologists to efficiently get the best treatments to their patients,” said James Hamrick, MD, Senior Medical Director, Flatiron Health. “Flatiron Assist is an EHR-integrated tool that puts the doctor and the patient at the forefront, enabling evidence-based treatment selection, efficient payer authorization, and insight into care patterns across practices and health systems.”

Available in the App Orchard, Flatiron Assist is a SMART on FHIR application that will launch from the patient’s chart in Epic, eliminating the need for duplicate data entry outside the electronic medical record. Flatiron Assist pulls available demographics, diagnosis, and cancer-specific data, such as staging, from Epic and, based on those inputs, surfaces evidence-based therapy options and clinical trials for each patient. Once the oncologist chooses a treatment regimen in Flatiron Assist, the selected regimen is automatically opened in Epic.

“Integrating NCCN’s recommendations into point-of-care apps like Flatiron Assist puts the latest evidence and multidisciplinary expert knowledge at the fingertips of oncologists everywhere,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “NCCN Guidelines are the most frequently updated medical guidelines in any discipline; they should also be the most accessible. The convenience of Flatiron Assist can give doctors more time to engage in shared decision making in order to determine which guideline-concordant treatment plan offers the most benefit.”

For more information on using Flatiron Assist, visit the App Orchard Marketplace, or contact flatironassist@flatiron.com.

Roche Launches NAVIFY Guidelines App to Help Clinicians Easily Access, Personalize, and Document Latest Guidance for Patients With the Most Common Cancers

Roche recently announced the release of its latest app as part of the NAVIFY Decision Support portfolio. The NAVIFY Guidelines app embeds the latest NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) covering the 4 most common cancers within NAVIFY Tumor Board. When opening a patient case, the app identifies the appropriate guidelines based on the patient's cancer type. Clinicians can then select the intended pathway, easily click through the digitized decision tree or flowchart, and personalize individual steps for a specific patient. The pathway is accessible to all tumor board participants, and can be exported to include in the practice’s EMR system, send to patients, or submit for reimbursement approval by payers.

Guidelines in clinical practice help explain a disease and determine the optimal evidence-based treatment for individual patients based on their diagnosis, disease stage, age, and other factors. In addition, clinical guidelines contribute to care management by promoting practice conformity and reducing cost.

Due to advances in medicine, the NCCN Guidelines are updated continuously. At the same time, with the move to more value-based care and respective payment models, clinicians face an increasing need for adhering to proven guideline recommendations. By digitizing the guidelines process, alerting users real-time about new and updated guidelines, and making the respective pathway available as part of the holistic patient dashboard in NAVIFY Tumor Board, the NAVIFY Guidelines app not only ensures that oncology care teams refer to latest information and are aligned regarding what is planned for the patient but also facilitates documentation.

“The NAVIFY Guidelines app provides clinicians with peace of mind that the latest clinical guidance has been considered in treatment decision-making and monitoring. The ability to facilitate and track guidelines adherence, personalization, and documentation supports evidence-based care for patients around the globe. This latest addition to the NAVIFY ecosystem marks another step in supporting the move towards truly individualized care,” said Thomas Schinecker, CEO Roche Diagnostics.

“Digitized guidelines available at point-of-care through clinical decision support software, such as the NAVIFY Guidelines app, help advance our mission of improving and facilitating quality, effective, efficient, and accessible cancer care so patients can live better lives and fits perfectly with our vision to define and advance high-quality, high-value cancer care across the world,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN.

The NAVIFY Guidelines app is available in the United States, Canada, Singapore, Australia, New Zealand, Korea, Japan, Taiwan, and Hong Kong.

Adding a new app to the NAVIFY ecosystem marks another step towards Roche’s personalized healthcare strategy ensuring the right treatment for the right patient at the right time.

Outcomes4Me and NCCN Collaborate to Bring Personalized Clinical Guidelines to Breast Cancer Patients Globally

Outcomes4Me Inc. and NCCN recently announced a new collaboration to integrate the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer into the Outcomes4Me mobile application. The collaboration leverages Outcomes4Me’s personalized platform to enable millions of breast cancer patients worldwide to have access to up-to-date, evidence-based information on treatment options in a patient-friendly design and language.

As part of this collaboration, the Outcomes4Me app will provide patients diagnosed with breast cancer with personalized treatment options based on NCCN Guidelines tailored for their specific diagnosis. The Outcomes4Me mobile app, available globally both on the App Store and Google Play, was launched in March of this year for breast cancer with a plan to expand to other cancers in the near future. The app serves as a digital health partner that proactively delivers timely information of value to empower patients to take more control of their care. The app provides patients with tools to understand their treatment options, match with clinical trials based on their geographic location, and track and manage their symptoms.

“We are excited to collaborate with Outcomes4Me as this app is aligned with our mission to improve the quality, effectiveness, efficiency, and accessibility of cancer care so that patients can live better lives” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “This truly has the potential to provide a unique, personalized, expert-validated experience for patients, helping them share in informed decision-making about their medical care.”

“We are on a mission to empower patients with easy-to-understand, relevant, and evidence-based information. This collaboration with NCCN will further this mission by providing patients with clarity about their best treatment options, enabling them to make better treatment choices in conjunction with their healthcare provider,” said Outcomes4Me’s Co-Founder and Chief Executive Officer Maya R. Said, ScD. “Incorporating the NCCN Guidelines in our application will make those guidelines, traditionally geared to oncologists, widely accessible to cancer patients across the world regardless of race, socioeconomic status, or geographic location,” added Outcomes4Me’s Co-Founder and Chief Medical Advisor Osama E. Rahma, MD.

NCCN Oncology Research Program Supports Clinical Trial for Lung Cancer

The NCCN Oncology Research Program (ORP) announced plans to support a phase II randomized trial for patients with lung cancer. The study is titled TH-138: Phase II Randomized Trial of Carboplatin + Pemetrexed + Bevacizumab, With or Without Atezolizumab in Stage IV Non-Squamous NSCLC Patients Who Harbor a Sensitizing EGFR Mutation or Have Never Smoked. Joseph Treat, MD, Professor, Department of Hematology/Oncology, Fox Chase Cancer Center, will serve as principal investigator, with Hossein Borghaei, DO, and J. Nicholas Bodor, MD, PhD, also from Fox Chase Cancer Center, as co-investigators, along with Jyoti Patel, MD, incoming Assistant Director for Clinical Research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. The study is made possible through collaboration with Genentech, who provided funding and study drugs.

“Lung cancer is the leading cause of cancer-related death in the United States and worldwide,” said Wui-Jin Koh, MD, Chief Medical Officer, NCCN. “As advances are made in the development of targeted therapies and immunotherapies, there is opportunity for greatly needed improvement in outcomes.”

Cigarette smoking remains the primary cause of most lung cancer cases, but nearly 20% occur in people who have never smoked.1 Non–smoking-related cancers generally have a different molecular profile than smoking-related cancers, including mutations in the epidermal growth factor receptor (EGFR), and may have variable response to checkpoint inhibitors.2

This study will focus on patients whose tumors include an EGFR mutation or who are never-smokers (defined as <100 cigarettes in their lifetime). It will examine whether the anti–PD-L1 inhibitor atezolizumab plus carboplatin, pemetrexed, and bevacizumab will improve progression-free and overall survivals in this population compared with carboplatin, pemetrexed, and bevacizumab.

The study is projected to take 31 months, and include >100 patients from across 15 to 20 cancer centers. It is open to people aged ≥18 who have not been previously treated with any systemic therapy other than tyrosine kinase inhibitors.

The NCCN ORP fosters innovation and knowledge discovery that improve the lives of patients with cancer. Visit NCCN.org/ORP to learn more about past and current clinical investigations.

References

  • 1.

    Subramanian J, Govindan R. Lung cancer in never smokers: a review. J Clin Oncol 2007;25:561–570.

  • 2.

    Based on the results of IMpower150, a large global phase 3 study demonstrated that the combination of carboplatin, paclitaxel, bevacizumab, and atezolizumab demonstrated clinically meaningful improvements in OS and PFS in patients with EGFR mutations who have failed TKIs, further hypotheses are being evaluated in TH-138. For more information see Socinski MA, Jotte RM, Cappuzzo F, et al. Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC. N Engl J Med 2018;378:2288–2301.

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New NCCN Guidelines Debut to Manage Complications and Improve Readiness for Stem Cell Transplant Recipients

NCCN recently published new NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Hematopoietic Cell Transplantation (HCT), also known as stem cell transplant or historically as bone marrow transplant. This new resource provides step-by-step information on best practices in evaluating patients for hematopoietic cell transplantation and managing complications afterwards. This type of specialized treatment is increasingly common, occurring approximately 22,000 times a year in the United States in people with various malignancies, most commonly for blood-related cancers.1

“Establishing NCCN Guidelines for HCT is a key accomplishment in the management of blood cancers,” said Ayman A. Saad, MD, Professor of Clinical Medicine, The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Chair of the NCCN Guidelines Panel for HCT. “The current version of the guidelines addresses both pre-transplant evaluation and the management of a common complication: graft versus host disease (GVHD). Given the diversity of practice and expertise, we believe these guidelines will provide a pivotal tool for learning about the continuously updated therapy landscape in HCT. We hope this will help streamline clinical practices and educate new generations of physicians-in-training.”

The guidelines provide recommendations on how to evaluate a potential transplant recipient to determine if the patient is an appropriate candidate for the procedure, and how to best manage different manifestations of posttransplant GVHD. They reflect the latest evidence and consensus from foremost experts across the 28 leading academic cancer centers that comprise NCCN, including hematologists/oncologists, transplant-specific practitioners, and infectious disease specialists.

“These guidelines provide an algorithmic pathway for a systematic approach to allogeneic (donor) transplantation across several different cancer types including leukemia, lymphoma, and multiple myeloma,” explained Marcos de Lima, MD, Professor of Medicine, Case Comprehensive Cancer Center and University Hospitals of Cleveland, Vice-Chair of the NCCN Guidelines Panel for HCT. “Thankfully, the number of blood and bone marrow donors has increased substantially in just the past decade. When you combine the National Marrow Donor Program/Be The Match registry adult donors with cord blood donors and relatives (matched and mismatched), we are now able to perform this potentially cancer-curing procedure on significantly more patients than we could in the past. That’s why it’s so important to set standards for preventing and treating common adverse events and infections.”

“Early referral for consideration of HCT can be life-saving, so we strongly encourage all oncologists to take a look at these guidelines and refer any possible candidates to transplant centers for evaluation,” said Alison W. Loren, MD, MSCE, Director, Blood & Marrow Transplant, Cell Therapy & Transplant Program, Abramson Cancer Center of the University of Pennsylvania, Member of the NCCN Guidelines Panel for HCT. “We also urge oncologists who may be caring for patients after HCT to familiarize themselves with the varied manifestations of GVHD—a very common and significant post-transplant complication—and to consult with transplant providers to optimize their ongoing care. The guidelines explain how to diagnose and treat this condition in order to achieve the best possible outcomes.”

The NCCN Guidelines for HCT are available free-of-charge for noncommercial use at NCCN.org and via the recently improved Virtual Library of NCCN Guidelines App for smartphone and tablet. NCCN will continue expanding blood cancer resources through continuous updates to the HCT guidelines, along with upcoming new NCCN Guidelines for Histiocytosis, Myeloid/Lymphoid Neoplasms, Pediatric B-Cell Lymphomas, and Pediatric Hodgkin Lymphoma.

Reference

1.

D'Souza A, Fretham C. Current uses and outcomes of hematopoietic cell transplantation (HCT): CIBMTR Summary Slides, 2018. Available at: https://www.cibmtr.org/ReferenceCenter/SlidesReports/SummarySlides/pages/index.aspx. Accessed October 30, 2019.

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  • 1.

    Subramanian J, Govindan R. Lung cancer in never smokers: a review. J Clin Oncol 2007;25:561–570.

  • 2.

    Based on the results of IMpower150, a large global phase 3 study demonstrated that the combination of carboplatin, paclitaxel, bevacizumab, and atezolizumab demonstrated clinically meaningful improvements in OS and PFS in patients with EGFR mutations who have failed TKIs, further hypotheses are being evaluated in TH-138. For more information see Socinski MA, Jotte RM, Cappuzzo F, et al. Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC. N Engl J Med 2018;378:2288–2301.

    • Crossref
    • Export Citation
  • 1.

    D'Souza A, Fretham C. Current uses and outcomes of hematopoietic cell transplantation (HCT): CIBMTR Summary Slides, 2018. Available at: https://www.cibmtr.org/ReferenceCenter/SlidesReports/SummarySlides/pages/index.aspx. Accessed October 30, 2019.

    • Export Citation

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