Identifying oncology clinical trial candidates using artificial intelligence predictions of treatment change: A pilot implementation study Journal Article


Authors: Kehl, K. L.; Mazor, T.; Trukhanov, P.; Lindsay, J.; Galvin, M. R.; Farhat, K. S.; McClure, E.; Giordano, A.; Gandhi, L.; Schrag, D.; Hassett, M. J.; Cerami, E.
Article Title: Identifying oncology clinical trial candidates using artificial intelligence predictions of treatment change: A pilot implementation study
Abstract: PURPOSEPrecision oncology clinical trials often struggle to accrue, partly because it is difficult to find potentially eligible patients at moments when they need new treatment. We piloted deployment of artificial intelligence tools to identify such patients at a large academic cancer center.PATIENTS AND METHODSNeural networks that process radiology reports to identify patients likely to start new systemic therapy were applied prospectively for patients with solid tumors that had undergone next-generation sequencing at our center. Model output was linked to the MatchMiner tool, which matches patients to trials using tumor genomics. Reports listing genomically matched patients, sorted by probability of treatment change, were provided weekly to an oncology nurse navigator (ONN) coordinating recruitment to nine early-phase trials. The ONN contacted treating oncologists when patients likely to change treatment appeared potentially trial-eligible.RESULTSWithin weekly reports to the ONN, 60,199 patient-trial matches were generated for 2,150 patients on the basis of genomics alone. Of these, 3,168 patient-trial matches (5%) corresponding to 525 patients were flagged for ONN review by our model, representing a 95% reduction in review compared with manual review of all patient-trial matches weekly. After ONN review for potential eligibility, treating oncologists for 74 patients were contacted. Common reasons for not contacting treating oncologists included cases where patients had already decided to continue current treatment (21%); the trial had no slots (14%); or the patient was ineligible on ONN review (12%). Of 74 patients whose oncologists were contacted, 10 (14%) had a consult regarding a trial and five (7%) enrolled.CONCLUSIONThis approach facilitated identification of potential patients for clinical trials in real time, but further work to improve accrual must address the many other barriers to trial enrollment in precision oncology research. © 2024 by American Society of Clinical Oncology.
Keywords: adult; controlled study; middle aged; major clinical study; sequence analysis; advanced cancer; cancer growth; systemic therapy; nuclear magnetic resonance imaging; positron emission tomography; computer assisted tomography; oncology; pilot study; artificial intelligence; bone scintiscanning; artificial neural network; random sample; oncologist; high throughput sequencing; human; male; female; article; electronic health record; oncogenomics; mortality risk; solid malignant neoplasm; oncology nurse
Journal Title: JCO Precision Oncology
Volume: 8
ISSN: 2473-4284
Publisher: American Society of Clinical Oncology  
Date Published: 2024-09-01
Start Page: e2300507
Language: English
DOI: 10.1200/po.23.00507
PUBMED: 38513166
PROVIDER: scopus
PMCID: PMC10965204
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Deborah Schrag
    228 Schrag