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BIA-Brukerstyrt innovasjonsarena

Coremine Vitae - to identify personalized treatment options for cancer patients

Alternative title: Coremine Vita - identifisere persontilpassede behandlingsalternativer for kreftpasienter

Awarded: NOK 13.4 mill.

The “one size fits all” approach which has dominated cancer therapy is increasingly replaced by a “one patient, one therapy” approach based on the individual characteristics of each patient and his / her molecular profile. Precision cancer medicine (PCM) has been demonstrated to provide significant clinical benefit. However, PCM is not yet available to everyone. It is crucial to develop sophisticated bioinformatics tools to efficiently analyze mutation profiles and efficiently identify the best possible treatment options. In response, we want to develop Coremine Vitae (CMV) as a personalised biomedical intelligence solution to identify the best possible treatment option for patients. While the current CMV solution handles many steps manually, we aim to automise by developing machine learning, big data analytics and specialised algorithms to identify and rank evidence and treatment options more efficiently. We have developed a prototype for integrating our solution with medical journals using the data exchange protocol FHIR, including algorithms for PICO element assignment. This allows easy integration of our software with medical journal system using FHIR data exchange protocols. As part of the automation routines, we have we have developed algorithms and AI solutions for creating search strategies based on the patient profile and the different information elements to be handled e.g. biomarkers and clinical trials. For the clinical trial we have used NLP and rule-based reasoning to matches relevant clinical trials to the patient profiles and automatically verify inclusion and exclusion criteria. Annotation algorithms are used to highlight important concepts in the results. Furthermore, we have developed evidence scoring algorithms that uses a combination of patient profile matching and real-world evidence. This has been done by extracting corroborating evidence for scientific literature, clinical trial results and medical news for each identified insight. Based on the overwhelming feedback from both clinicians and patients during this project we saw the needed to strengthen the commercial focus of our product offering. It was recognized that the results from the project gave the foundation for to different two major, but very different business opportunities, thus two daughter companies were spun out: 1. Vitae Evidence AS for the B2B market – a software solution for hospitals, clinics, insurance companies and cancer associations 2. Coremine Vitae AS for the B2C market – a information service targeting patients in need of better understanding their diagnosis and potential treatment plans. Evaluations so far have shown that our automation reduces the production time of a personalized report with between 30 to 50% depending on the case complexity. The production time is expected to be further reduced with additional 20 to 30% as the case database increases and the system starts “learning” from previous cases.

Finalising this project have paved the ground for PubGene and the two spinn-out companies to increase their revenue stram and create profitable businesses. Through this project we have demonstrated the value of our technology and shown how out technology can provide benefit with respect to increasing the number of patients that could benefit from clinically validated personalised treatment options. Even though our solution does not always result in a change of treatment plan, suggesting that that the patient already is on the right treatment plan, the patients still appreciate and sees the value in the reports since it gives them reasurance that all alternatives have been explored. Feed back from our hospital partners suggest that Coremine Vitae SaaS can be a helpful tool for identifying best available treatments and making PCM more available to all cancer patients. We also believe that our solution will reduce the cost of unnecessary hospitalisation, use of expensive and ineffective treatment and at the same time spare the patient from going through tough side effects from ineffective treatments. Due to the limited roll out during the project period we de no yet have firm numbers confirming this. Feedback for patients involved in this project have been overwhelming, more than 95% are very satisfied with the report that they have received. I has given the reassurance that all possible alternatives have been evaluated and at the same time given them a better grounds for understanding and discussing their situation and option with their trating physician.

State-of-the-art treatment of advanced and metastatic cancer is increasingly incorporating next-generation sequencing to characterize tumor DNA and select targeted treatments based on biomarkers such as mutations or other genomic aberrations. Despite fact that Precision Cancer Medicine based on aberration-matched therapies has been demonstrated to provide significant clinical benefits, this is not universally available to most cancer patients. Many cancer drugs are ineffective for a large proportion of patients, 75% or more, consequently, millions of cancer patients are receiving treatments that give little more than unwanted and severe side effects. In response to this, we want to develop Coremine Vitae, a biomedical intelligence system to identify the best possible treatment options to individual patients. The optimal personalized treatment strategy requires consideration of NGS analyses, other biomarkers, patient status, medical history, as well as patient preferences (side effects, mobility, etc.). While the present Coremine Vitae analysis process handles many steps manually, we aim to develop machine learning and big data analytics to identify and rank evidence and treatment options, and thus dramatically decrease the need for manual effort. In addition, the use of the system will improve process results by allowing more comprehensive searches and reduce the risk of bias. Through our partners, Haukeland University Hospital and Sykehuset Innlandet, we have access to patients needed to develop our system, and at the same time obtain clinical validation of the algorithms and resulting Coremine Vitae analysis reports. A successful outcome of this project will allow us to offer Coremine Vitae as a Software as a Service and scale our business substantially enabling us to enter the global market. This will considerably increase the number of patients who can benefit from clinically validated personalized treatment options and anticipated drug response.

Funding scheme:

BIA-Brukerstyrt innovasjonsarena