By Allison Proffitt 

June 12, 2015 | Foundation Medicine’s genomic tests have been on the market since 2012—a lifetime in the field of genomics. The company’s two tests—FoundationOne, a cancer genomics assay focusing on solid tumors, and FoundationOne Heme, a DNA and RNA sequencing test looking for mutations common in common in sarcomas and hematologic cancers—have populated FoundationCORE, a database of genomic information.  

At a time when talk of infrastructure to connect patients and data is everywhere, Foundation Medicine already has genomic profiles fom over 43,000 patients, all connected to their oncologists.

Foundation realized that some of the variants it was reporting were extremely rare for institutions, explains Gaurav Singal, Director in the Innovations Unit. In digging into the CORE data, FMI found that 61% of the findings Foundation Medicine reports have never been seen at the ordering institution. But if doctors knew where to go for help outside of their own institution, things looked better: 91% of those novel mutations can be matched within FoundationCORE, Singal says.

“Is there a way to use Foundation Medicine’s database,” Singal asked, “to help match physicians wherever they are who are treating these patients with rare genomic findings and help them learn from each other’s experiences?”

The answer is PatientMatch, a module the company launched in January within its Interactive Cancer Explorer (ICE) dashboard.

“Broadly speaking, the vision is this: the world of cancer care is becoming so nuanced, and these finding are becoming so, so rare. Patient populations are getting so small, that most physicians don’t know which patients they should be comparing,” Singal says. “The concept of precision medicine means that each patient is an individual, but that doesn’t mean that there aren’t similarly unique patients.”

The user interface for PatientMatch is simple. A treating physician views the results of a patient’s FoundationOne or FoundationOne Heme test in the ICE dashboard. Within the FoundationOne results report, ICE lets the physician know how many other FoundationCORE patients have similar mutations.

If the treating physician wants to get more information about patient experiences, PatientMatch generates a simple email to those patients’ doctors identifying the mutation in question and asking four questions: In this case, what drug was used? How long was the patient on it? Is the patient still on the drug? What was the best response? From there, the two physicians can connect and share further information if time and interest allow.

“This is the way medicine has to be practiced,” Singal says. “We have to learn from each other’s experiences. We have to build that community and it’s exciting to be able to bring that to life.”

PatientMatch, Trial Match 

At Sarah Cannon Research Institute, in Nashville, Tenn., Todd Bauer, Associate Director of the drug development program has been using Foundation Medicine’s tests for over a year, and has been beta testing PatientMatch for six to nine months.

Bauer says that the Sarah Cannon oncologists have been very happy to learn and implement a new system to connect their unique patients with the right options.

“There are lots of oncologists still practicing for whom when they completed training there was approximately five drugs to treat cancer. The number and rate of new drugs coming out is just too much for anyone to keep up with,” Bauer said.

He says the Sarah Cannon doctors have found reaching out to other physicians with similar patients well worth it. “It might take them an extra five minutes in clinic, but it’s a necessary five minutes. It’s not a nice add-on; they need to be doing it for their patients, and the majority of them are.”

Although it’s not Foundation Medicine’s primary application of the PatientMatch tool, Sarah Cannon has had great success using the system to connect patients to clinical trials, Bauer said.

“One of the challenges, as I see it, to personalized medicine at this point is the majority of drugs to target the mutations that we’re finding are still being given under the context of clinical trials,” Bauer said. “We are fortunate here in Nashville to have a tremendous number of Phase 1 clinical trials at the Sarah Cannon drug development unit. So by connecting outside referring physicians… we’re really able to help increase patient access to potentially very effective therapies for them.”

Next Steps 

For FMI customers who have yet to see the PatientMatch module in ICE, Singal says the tool is being rolled out site by site as institutions upgrade from ICE 1 to ICE 2. Foundation Medicine staff are visiting sites to introduce doctors to the tool. He expects all Foundation Medicine customers to have access to the module by year end.

As users grow, PatientMatch will “learn” as questions are answered and the system will make sure doctors are not asked the same questions more often than every three months or so to cut down on repetition. New changes are already being planned. Right now treating physicians can only follow up on individual mutations, though like patients could eventually be grouped based on combinations of mutations, demographic factors, etc.

Within the FoundationCORE database, there’s much room for the platform to grow, Singal says.

“There’s infinite complexity we can build in here.”