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MILLTRUST INTERNATIONAL
 

Oncoshot: Cushioning the Cancer Surge in the Elderly

August 1, 2024

BY Milltrust International Group

Cancer is one of the leading causes of death worldwide. The World Health Organisation (WHO) estimated cancer as the first or second leading cause of death in 112 of the 183 countries examined in 2019. In another 23 countries, it was the third or fourth leading cause.

By 2030, we anticipate 26 million new cancer cases and 17 million new cancer deaths per year, largely accounted for by the growth and ageing of populations. One in six people will be aged 60 years or over. That translates into 1.4 billion people, up from 1.2 billion in 2020. By 2050, this number will nearly double to 2.1 billion.

People are living longer; life expectancy beyond 60 is almost guaranteed. This contributes to growth in both the size and proportions of older persons in our populations. While this phenomenon known as population ageing started in high-income countries such as Japan, where 30% of its people are already above 60 years, it is now low- to medium-income countries that are going through this change.

So how do we care for present and future cancer sufferers and the people around them? One Singaporean medical oncologist proposes enhancing the enrolment of patients into cancer clinical trials.

Whilst practising, Dr Huren Sivaraj had trouble understanding the landscape of clinical trial options for his patients at any point during their treatment journey. Trial options were not transparent or visible within the healthcare institution.

He found that when there is poor visibility of trials, oncologists often continue to offer the standard of care treatments instead of considering clinical trials for late-phase developmental cancer therapies that can be implemented alongside the standard ones.

Trial options tend to be offered after patients have exhausted all standard therapy options. By this point, patients are typically deconditioned and symptomatic, let alone fit enough to participate in trials.

When it comes to clinical trial enrolment, doctors typically rely on their register of patients and maybe a few others through doctor-to-doctor referrals. The issue with this is that not enough doctors refer their patients to other doctors and investigators resulting in difficulty when it comes to recruiting eligible patients.

A major reason for this is the lack of a robust communication system able to connect patients, doctors, and the pharmaceutical companies that conduct the clinical trials. It is estimated that 85% of all clinical trials will experience delays, with 94% experiencing delays lasting longer than a month and poor patient recruitment as a significant contributor. The financial consequences of this can cost anywhere between USD $600,000 to USD $8 million per day of delay.

Dr Sivaraj felt that if his patients could access developmental therapies sooner and throughout the entire treatment journey, they would have improved survival outcomes. Hence, Dr Sivaraj founded Oncoshot in 2018 with co-founder Ruslan Enikeev, a data science engineer and creator of Map of the Internet — a popular web traffic data-visualisation tool.

Addressing SDG 3 – Good Health and Well-being, Oncoshot is a health insights exchange platform that leverages its proprietary clinical trial matching artificial intelligence (AI) technology to address the inefficiencies of cancer clinical trials. It targets the rigorous clinical trial enrolment process that requires a careful and meticulous approach to choosing participants that fit strict eligibility criteria.

The Oncoshot platform serves as a bridge between leading regional healthcare institutions, contract research organisations (CROs) and global biotechnology and pharmaceutical companies to facilitate data-driven cancer clinical trials while accelerating enrolment into actively recruiting ones.

When developing a trial, companies traditionally depend on researchers’ approximations and historical data from comparable trials to work out enrolment forecasts. Realistically, the circumstances encompassing each trial differ too inordinately to anticipate based on past experiences. In addition, historical data does not account for patient deaths which may cause an overrepresentation of potentially eligible patients.

The Oncoshot platform generates relevant hospital-approved real-time potential matches for trials in minutes, sorting through over 300,000 de-identified patient profiles spanning its six initial markets. With the traditional approach, this process can take weeks to months.

The clinical trial ecosystem in Singapore has been advancing rapidly with plenty of help and collaboration from the public and private sectors. However, many institutions struggled to find an ideal model for collaboration with data in a manner that meets their security, privacy, and access requirements.

To ensure patient data is secured, only patient data relevant to the specific clinical research is first de-identified and restructured before being transferred to the healthcare institution’s on-premise, Oncoshot platform, where it is analysed to provide population-level insights. The Oncoshot platform can be deployed within the trial site’s server so that patient-level data stays within the institution’s internal cyber security system.

Furthermore, Oncoshot’s platform is appraised by PriceWaterhouseCoopers (PwC), a leader in IT risk consulting and security and the Singapore government’s choice IT consultant for reviewing the National Electronic Health Record system.

Presently, Oncoshot’s partners include pharmaceutical companies such as AstraZeneca and Novartis, CROs, and 13 cancer research organisations spread across Singapore, Australia, India, China, Japan and Taiwan.

This article originally appeared in Impact Entrepreneur Magazine, www.impactentrepreneur.com, https://impactentrepreneur.com/cushioning-the-cancer-surge-in-the-elderly/

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