(CHICAGO) GenomeWeb – Inteliquet, a maker of software for matching cancer patients to clinical trials, said today that it has signed a cooperative research and development agreement with the US National Cancer Institute to develop a web-based tool for helping clinicians make informed therapeutic decisions.
The parties will meld Memphis, Tennessee-based Inteliquet's precision medicine software platform with NCI's oncogenomics browser to create a new bioinformatics tool that will process actionable variants from genetic and genomic data. The technology in development will then present findings to clinicians at the point of care and record patient outcomes, according to Inteliquet.
The work will be performed at the National Institutes of Health Clinical Center in Bethesda, Maryland, with NCI deputy chief of genetics Javed Khan and Inteliquet CTO Jeremy Miller directly involved as co-principal investigators, according to Inteliquet CEO Carla Balch.
Balch expects to "very quickly" roll existing Inteliquet software out to the 70 NCI-designated cancer centers nationwide as the new tool is under development .
"What's out-of-the-box ready we will be taking to the NCI cancer centers around clinical trials that are molecularly informed," Balch said. "Separately, we will then deliver the collaboratively designed and created new information to those centers after we're done."
Inteliquet and NCI officials had a kickoff meeting the week before last to start identifying problems they want to address, according to Balch.
News of this contract comes a little more than a month after the company formerly known as TransMed Systems changed its name to Inteliquet, culminating a pivot from making analytics software to focusing on patient-trial matching that started in 2016. Balch joined as president and COO in July 2017 and was elevated to CEO in August 2018.
From its founding in 2012 until four years ago, the company was trying to sell analytics services to the pharmaceutical industry. Balch said that previous management did not initially understand that pharma already had analytics technology, so the former TransMed made a strategic shift. "The infrastructure and the way we handle data was perfect already for matching patients with trials," Balch said.
"Liquet" means "clarity" in Latin, so the Inteliquet name represents intelligence from clarity, according to Balch. "What we hope we do for our customers is provide them the clarity and transparency they need, and they then have new options for intelligence," she said.
Inteliquet has built proprietary technology to pull data out of electronic medical records, laboratory information systems, molecular diagnostic tests, and other sources to help community oncology practices, hospital systems, academic medical centers, trial sponsors, and contract research organizations identify trial candidates.
Intelliquet pulls this data out in many forms, then applies structure to it using natural language processing and optical character recognition technology — some of it from other vendors, but then customized. The company has developed its own interfaces to EMRs, including those from the big vendors like Epic Systems, Cerner, and Allscripts Healthcare Solutions, as well as from oncology-specific systems.
"If we have high confidence in the data that we're providing back to the clinicians or the pharma sponsors or CROs, we have to own that process from soup to nuts," Balch said.
For privacy and security purposes, Inteliquet does not hold data on its own servers. "All of the data sits behind the firewall of our clients," she said.
This technology is meant to address a major workflow problem in adult oncology, where a small percentage of patients is enrolled in trials. It is the opposite of pediatric cancer, which sees a majority of patients join clinical trials.
Balch said that is "not reasonable" to expect EMR vendors to fix the clinical trial matching problem. "The best product development is listening to the people who are suffering," Balch said. That means principal investigators, the clinical staff, trial sponsors, and CROs.
"They all are in pain and are trying to figure out how to get more patients on trials. We listen and understand and then build what is needed," Balch said.
The decision to concentrate on precision oncology goes back to the company's roots seven years ago, when TransMed was part of a pediatric cancer consortium. Since so many pediatric cancers are inherited, the company already understood genomics, Balch said.
"When we pivoted to clinical trials, pediatrics is pretty much covered [in oncology]. There is a lot of good work going on there," Balch said. "We needed to get the adult [cancer patient] population over 5 percent of possible patients being enrolled."
Other things have changed in the industry since Balch interned at the West Clinic — now called West Cancer Center — in Memphis, as she pursued a master's degree in clinical psychology 20 years ago. In 1999, West created one of the first electronic patient outcome reporting systems, building an 88-question survey on an early medical-grade tablet computer to assess how patients were feeling.
"That got reported to the physicians, and we found pain, sexual dysfunction, and depression off the charts, even more than people had expected," Balch recalled. With physicians able to treat quality-of-life issues, patients had better outcomes, she said.
But there was still a lot of manual labor because paper records predominated.
"Twenty years ago, I was the girl thumbing through the paper chart looking for a patient. There's no way that a clinical staff could be expected to match the patients on inclusion and exclusion criteria without a good technology to do what only technology and data can do," Balch said. "We hear from them that this is exactly what's needed."
Today, records are mostly electronic, but trial matching largely remains manual. "There's an old workflow where clinical staff is still looking through the EMR. They go patient by patient. They have Post-It notes, laminated index cards, and legal pads just trying to remind all the physicians and staff about the trials that they currently have open," Balch said.
"The power of what Inteliquet is doing is looking at all the pain points across the industry and we can match Betty on Main Street to a clinical trial. The faster we can do that, the faster new drugs will get to market to help the patients."
Among Inteliquet's competitors is Altos Solutions, an oncology-specific EMR vendor that Balch actually was president and CEO of before engineering a sale to Flatiron Health in 2014.
After the Flatiron acquisition of Altos, Balch served as president and COO of NantCare, a telehealth company formerly known as Boston Life Labs and now part of NantHealth. The NantCare unit helped set up Patrick Soon-Shiong's controversial Cancer MoonShot 2020 program.
While running NantCare, Balch came across TransMed when she needed a technology that could identify 20,000 immunotherapy patients for the Cancer MoonShot 2020 study. "TransMed was the only one that could do it," she said.
Since 2016, the company now known as Inteliquet has partnered with NantHealth to provide cancer centers in the US with data that can help clinicians improve patient outcomes and speed cancer research.
Others that have developed software for patient-trial matching in cancer include Roche's Navify and Massive Bio. There also are plenty of data aggregation companies matching genotype and phenotype information for clinical and research purposes.
Balch said that Inteliquet provides healthcare systems and medical practices with new perspectives on their patient populations. "We help them find gaps where they weren't aware they had gaps," she said.
Balch gave the example of an unspecified oncology practice in the northeastern US that was able to find that patients with upper gastrointestinal, colorectal, and hematology cancers were underserved in terms of being enrolled in trials.
Her vision going forward is to make sure that providers, sponsors, and CROs never miss patients for clinical trials.
Inteliquet is starting in oncology and only in the US, but plans on expanding into other therapeutic areas and countries. Another component of the future strategy is to become more patient-focused and to help create "one source of truth" for each person's medical and health status, Balch said.
"We look forward to being an advocate for patients getting the right test and knowing what to do with that information," Balch said. While the NCI work should be able to further that pursuit, the company has already been heading in that direction, she added.
"Imagine that you have a new diagnosis," Balch said. A person's first instinct might be to search the internet for information on that disease.
"Instead of going to Google, [imagine] coming to real-world evidence about patients that are just like you, what is happening to them at this moment," Balch said.
"What treatments did they try? Which physicians did they go to? What was the cost of their care? How did they make decisions? Did they have molecular tests or not? You deserve all of those answers," Balch said.
She said that Inteliquet is building that type of system now, in coordination with care providers, trial sponsors, and CROs. "We eventually will add in patients and payors."