• Personalized Medicine in Action
• Pfizer
• caBIG^®
• HPCGG

The BIG Idea: Information Networks to Enable Personalized Medicine

The cancer Biomedical Informatics Grid^® (caBIG^®) is a network to connect researchers around the world and enable them to share information, helping to unravel the complexities of cancer genetics. caBIG^® enables the collection, analysis, and exchange of data along the research pathway from laboratory bench to patient bedside through its interoperable standards, infrastructure, and tools. caBIG^® was pioneered by the National Cancer Institute (NCI) to fully leverage the power of modern information technologies in the fight against cancer, and caBIG^® capabilities are currently in use at more than 50 NCI-designated cancer centers nationwide, as well as other academic and commercial organizations around the world.

In this world of personalized medicine and BIG science, a program such as caBIG^® will help researchers and clinicians to:

• Predict individual susceptibility to disease based on genetic and other factors;
• Provide more useful and individualized approaches for preventing disease, based on knowledge of individual susceptibility;
• Detect the onset of disease at the earliest moments, based on identified biochemical markers that arise from changes at the molecular level;
• Preempt the progression of disease, as a result of early detection; and
• Select and optimize medicines and dosages more precisely and safely to each patient.

caBIG^® is laying the foundation for a learning healthcare system in which data will flow freely among all stakeholders on the healthcare continuum, enabling researchers, clinicians, patients and consumers to interact and use knowledge in new and productive ways.

This "data liquidity" is a requisite component of a rapid-learning health system. In this biomedical model, clinical outcomes from large populations inform discovery research, and discovery and clinical development of new products is rapidly integrated into clinical practice, with outcomes conveyed back to the bench in real-time to close the "virtuous circle".

caBIG^® in Action: Engaging Consumers in Clinical Research

Currently, fewer than 5 percent of adults diagnosed with cancer each year enroll in clinical trials. This gap represents a missed opportunity to advance personalized medicine—but it doesn't have to be this way.

caBIG^®, in collaboration with the Love/Avon Army of Women, is leveraging 21st century information technology to break down the "invisible wall" that has traditionally existed between the research community and patients—resulting in an interconnected, learning health system to support personalized research and care. Benefits of this novel approach include faster patient accrual, richer study populations, an empowered patient community, and a more nimble biomedical research enterprise.

The collaboration—called the Health of Women (HOW) study—will leverage caBIG^® infrastructure and Web 2.0 technology to create the first online cohort of one million women to support biomedical research.

The process is easy and streamlined: members of the Love/Avon Army of Women are invited to join the HOW study cohort, and may respond to periodic secure online questionnaires concerning their health history. Authorized researchers may access the database and design study protocols based on the clinical profiles and data of potential research participants.

Click here to learn more about this new model for 21st century research: http://cabig.cancer.gov/action/collaborations/aow/

caBIG^® in Action: Developing Electronic Health Records for the Oncology Community

Electronic health records (EHRs) are widely perceived as essential to the achievement of improved healthcare and personalized medicine. While broadly applicable EHRs are widely available, there remains a need for a specialty EHR that addresses the unique data needs and physician support requirements of oncology.

The NCI is collaborating with the American Society of Clinical Oncology (ASCO) to develop an oncology EHR that will leverage caBIG^® standards for interoperability. This new EHR will then be deployed to the participating hospitals of the National Community Cancer Center Program (NCCCP), which will serve as a test environment that provides important information about the use and deployment of EHRs while also providing patient benefit.

The use of standards-based, interoperable EHRs will enhance patient outcomes by bringing the benefits of research discoveries to care, and enabling the integration of modern personalized medicine technology for populations that are traditionally underserved. caBIG^® is currently working with ASCO to create and vet the specifications for an oncology specific EHR, which will then be developed, tested, and deployed in the cancer community. Eventually, this work may serve as a model for other areas of care.

To learn more about caBIG^® and electronic health records, visit http://cabig.cancer.gov/action/collaborations/oncologyEHR/.

caBIG^® in Action: Advancing the Use of Genomics in Clinical Practice

A key component of personalized medicine in action is the use of genomic or genetic information to tailor interventions to a target population to achieve optimal patient outcomes. At Duke University's Clinical Genomics Studies Unit, Dr. P. Kelly Marcom is leading a Phase II Trial, Evaluating the Performance of Genomic Profiles of Chemosensitivity to Direct the Use of Preoperative Chemotherapy in Early Stage Breast Cancer, supported by the U.S. Department of Defense's Breast Cancer Research Program. This trial is one of several underway at the Duke Clinical Genomics Studies Unit testing the clinical utility of genomics guidance of therapy.

Duke team members are applying components of the caBIG^® Clinical Data Management System, including Cancer Central Clinical Database (C3D)-based data architecture to integrate genomic signature data, electronic case report forms, and caTissue for tissue specimen tracking.

The ability to correlate genomic data with clinical information opens up a world of new opportunities for investigators—for example, they can hypothesize associations and immediately test those hypotheses in silico (using a computer), or they can compare the outcomes from patients with comparable conditions who have been treated with different therapies and then cross-compare them with the genomic profiles to see if some drugs are working better in certain genetic sub-groups. All of which leads to smarter, personalized medicine.

For other examples of caBIG^® in action at research institutions, visit http://cabig.cancer.gov/resources/videos/case_studies/.

Learn More

Visit View of the Experts to read an interview with NCI's Dr. Kenneth Buetow about how caBIG^® is enabling personalized medicine.

For more examples of how caBIG^® is working to usher in the age of personalized medicine, visit http://cabig.cancer.gov.