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The Way Ahead: The Convergence of Technology and Cancer Care: December 2023 Edition

By Waqas Haque, MD, MPH

In this new post of the Oncology Data Advisor Fellows Forum blog series, "Convergence of Technology and Cancer Care," Waqas Haque, MD, MPH, delves into the latest technological advancements seeking to improve the care and outcomes of patients with cancer. In this edition, Dr. Haque explores the potential of an artificial intelligence–based program for providing treatment recommendations, the FDA's groundbreaking approval of the first cell-based gene therapy for sickle cell disease, and integrating a diagonal approach for improving access to cancer treatments and technologies globally. 

Artificial intelligence corner: Last month, we discussed a study of artificial intelligence (AI)–based chatbots that had a slight tendency to report "hallucinated" and guideline-inconsistent treatment recommendations. In a more recent study in JAMA Oncology, a team based out of Japan investigated the impact of a learning program for physicians and molecular tumor boards on treatment recommendations, especially those with low evidence levels, and used an AI system as a comparison. With 42 eligible participants and 50 simulated cancer cases, the learning program shared methodologies for appropriate treatment recommendations. While the concordance rate of treatment recommendations by tumor increased from 59% to 68% with the learning program, the AI-based system had a much higher concordance rate of 88%. The study finding provides hope for a possible clinical use of AI in treatment recommendations.

For those interested in publishing AI research, the AI in Precision Oncology Journal recently posted a call for papers due in March 2024.

New approvals: On December 8th, the FDA approved two ground-breaking treatments—CasgevyTM (exaglamgogene autotemcel, Vertex Pharmaceuticals) and LyfgeniaTM (lovotibeglogene autotemcel, Bluebird Bio Inc.)—as the first cell-based gene therapy approval for sickle cell disease in individuals 12 years or older. CasgevyTM happens to be the first approved therapy harnessing CRISPR/Cas9, a genome editing technology that can cut a snip of DNA and then accurately edit the area where the DNA was cut. This allows the patients' hematopoietic stem cells to be modified in a way that increases fetal hemoglobin production. LyfgeniaTM works by genetically altering blood stem cells to produce a mimic of hemoglobin A to reduce sickling. Both therapies require a single-dose infusion as part of a hematopoietic stem cell transplant. Europe is poised to approve both drugs early next year after a recommendation for conditional approval at a recent European Medicines Agency meeting.

Global health: Over the last three decades, radiotherapy has witnessed rapid technological advancements and can benefit over half of patients with cancer. A recent review article in Nature Cancer details the difficulties of global access to this technology, calling for a more integrative "diagonal approach" to cancer control. The diagonal approach harmonizes the dichotomy between individual-focused research advancements (such as the gene therapy approval mentioned above) with the general goal of promoting access to cancer treatments across the world. The dichotomy highlights the potential of the diagonal approach in thinking more carefully about global availability in ongoing innovative research and industry endeavors, and integrating a multidisciplinary approach with policy science, economics, and data science.

Taking a diagonal approach to bring radiotherapy to the globe.

About Waqas Haque, MD, MPH

Waqas Haque, MD, MPH, is a third-year Internal Medicine Resident at New York University (NYU) in a Clinical Investigator Track. As a Clinical Investigator Track Resident, Dr. Haque has balanced his patient care work with a variety of research projects. He hopes to begin fellowship training next year in Medical Hematology/Oncology at an academic program with opportunities to further his work in innovative clinical trial design, value-based care delivery to cancer patients, and becoming an early-stage clinical investigator.

For More Information

Sunami K, Naito Y, Saigusa Y, et al (2023). A learning program for treatment recommendations by molecular tumor boards and artificial intelligence. JAMA Oncol. [Epub ahead of print] DOI:10.1001/jamaoncol.2023.5120

Kachaamy T (2023). Call for papers. Special issue on the future of cancer screening: leveraging AI and precision oncology. AI in Precision Oncology. Available at: https://home.liebertpub.com/cfp/special-issue-on-the-future-of-cancer-screening-leveraging-a/491/

US Food & Drug Administration (2023). FDA approves first gene therapies to treat patients with sickle cell disease. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-first-gene-therapies-treat-patients-sickle-cell-disease

DeGroot L (2023). Europe lines up first CRISPR therapy approval. Endpoints News. Available at: https://endpts.com/europe-lines-up-first-crispr-therapy-approval/

Jaffray DA, Knaul F, Baumann M & Gospodarowicz (2023). Harnessing progress in radiotherapy for global cancer control. Nature Cancer, 4:1228-1238. DOI:10.1038/s43018-023-00619-7


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