Evaluation Of The NantHealth GPS Cancer Test In Patients With Advanced Cancers

Study Overview

Evaluation of the NantHealth GPS Cancer Test in Patients With Advanced Cancers

Among patients with advanced (metastatic) cancers, detailed characterizations of the tumor utilizing genomic and proteonomic techniques may help guide treatment. It, however, remains unclear if these new diagnostic technologies truly influence clinical and economic outcomes. This study will evaluate if patients treated according to the results of the NantHealth GPS Cancer test achieve optimal outcomes compared to patients whose treatment are discordant with GPS Cancer recommendations.

Personalized Medicine approaches to cancer management require detailed diagnostic evaluations. Broad genomic profiling,using whole genome (DNA) and whole transcriptome(RNA) sequencing platforms,holds the promise of identifying tumor related mutations that are amenable to targeted therapies, with the potential for improved clinical outcomes and lower toxicities compared to traditional cytotoxic chemotherapy. Proteomic approaches may add additional insights into treatment selection by identifying protein biomarkers known to induce drug resistance or indicate drug sensitivity for chemotherapy, monoclonal antibody therapy, hormonal therapy, targeted therapy and immunotherapy. The full value of these approaches has not been realized in routine clinical cancer care. GPS Cancer™ is a comprehensive test available through NantHealth. GPS Cancer which integrates whole genome (DNA) sequencing, whole transcriptome (RNA) sequencing, and quantitative proteomics through mass spectrometry, provides oncologists with a comprehensive molecular profile of a patient's cancer to inform personalized treatment strategies. GPS Cancer testing is conducted in CLIA-certified and CAP-accredited laboratories. Hypothesis: 1. The addition of proteomics to next generation sequencing (NGS) via the NantHealthGPS Cancer test and the incorporation of whole genome sequencing will identify treatment algorithms with increased likelihood of successful clinical outcomes in patients with advanced cancers. Study Design(summary): 1. The patient population will consist of 160 total individuals with tumor tissue available for NantHealth GPS Cancer testing: (1) pancreatic cancer patients ineligible for curative surgery, (2) metastatic breast cancer, (3) advanced stage (non-resectable/metastatic/incurable) lung cancer, (4) metastatic non-resectable malignant melanoma, (4) metastatic colon cancer not amenable to curative therapy, and (5) metastatic hormone refractory prostate cancer. 2. The treating oncologists will declare any planned treatment strategies before the testing results are obtained.These plans will be compared retrospectively with the actual treatment plans delivered to the patient to determine the Ȭhange rate". 3. The executive steering committee will review the NantHealthGPS Cancer reports and compare the results against the actual delivered therapy. Patients will be segregated into cohorts of "GPS treatment concordant" and "GPS treatment discordant". 4. A cohort of patients with similar diseases(matched via the COTA Nodal Address system) will be drawn at a ratio of 3 to 1 from the COTA database. 5. The time on chosen therapy (time to treatment failure) will be calculated for the cohort of patients with "GPS treatment concordant", "GPS treatment discordant", and "matched controls". The times will be compared using standard statistical analyses. 6. The total cost of care for the three treatment cohorts will also be compared. 7. Subjects must possess medical insurance coverage from Horizon Blue Cross Blue Shield of New Jersey in order to participate. A maximum of 160 patient samples will be tested.

Pancreatic Cancer
Metastatic Breast Cancer
Metastatic Lung Cancer
Metastatic Colon Cancer
Metastatic Melanoma
Metastatic Prostate Cancer

DIAGNOSTIC_TEST: NantHealth GPS Cancer Test

20170327

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates	Results Reporting Dates	Study Record Updates
First Submitted 2017-03-03	Results First Submitted N/A	Last Update Submitted that met QC Criteria 2018-07-19
First Submitted that Met QC Criteria 2017-03-03	Results First Submitted that Met QC Criteria N/A	Last Update Posted (ACTUAL) 2018-07-20
First Posted (ACTUAL) 2017-03-08	Results First Posted N/A	Last Verified 2018-07

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
N/A

Allocation:
N/A

Interventional Model:
N/A

Masking:
N/A

Arms and Interventions

Participant Group/Arm	Intervention/Treatment
: Concordant with GPS Cancer Test Patients with advanced cancer who undergo GPS Cancer testing whose therapy matches the recommendations from the NantHealth GPS Cancer Test.	DIAGNOSTIC_TEST: NantHealth GPS Cancer Test Quantitative targeted proteonomics detected by mass spectrometry with whole genome (DNA) and whole transcriptome (RNA) sequencing.
: Discordant with GPS Cancer Test Patients with advanced cancer who undergo GPS Cancer testing whose therapy does not match the recommendations from the NantHealth GPS Cancer Test.	DIAGNOSTIC_TEST: NantHealth GPS Cancer Test Quantitative targeted proteonomics detected by mass spectrometry with whole genome (DNA) and whole transcriptome (RNA) sequencing.
: CNA controls without testing Retrospective patients in the COTA database matched by similar characteristics (CNA matched).

Participant Group/Arm

Intervention/Treatment

: Concordant with GPS Cancer Test

Patients with advanced cancer who undergo GPS Cancer testing whose therapy matches the recommendations from the NantHealth GPS Cancer Test.

DIAGNOSTIC_TEST: NantHealth GPS Cancer Test

Quantitative targeted proteonomics detected by mass spectrometry with whole genome (DNA) and whole transcriptome (RNA) sequencing.

: Discordant with GPS Cancer Test

Patients with advanced cancer who undergo GPS Cancer testing whose therapy does not match the recommendations from the NantHealth GPS Cancer Test.

DIAGNOSTIC_TEST: NantHealth GPS Cancer Test

Quantitative targeted proteonomics detected by mass spectrometry with whole genome (DNA) and whole transcriptome (RNA) sequencing.

: CNA controls without testing

Retrospective patients in the COTA database matched by similar characteristics (CNA matched).

Primary Outcome Measures	Measure Description	Time Frame
Time on original treatment strategy for advanced cancer	To determine whether patients who are treated with therapies that are concordant with the NantHealth GPS Cancer test are able to stay on their original treatment strategy longer than patients treated with either discordant regimens or a matched Nanthealth GPS untested population.	2 years

Secondary Outcome Measures	Measure Description	Time Frame
Total cost of care	To determine the total 1 year cost of care for patients treated according to the results of the GPS Cancer test compared to discordant regimen treated patients or untested patients.	1 year

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

Pancreatic cancer patients ineligible for curative surgery at time of entry will be eligible for enrollment.
Metastatic breast cancer at any time in their treatment history will be eligible for enrollment.
Advanced stage (non-resectable/metastatic/incurable) lung cancer patients will be eligible for enrollment.
Metastatic colon cancer patients not amenable to curative therapy will be eligible for enrollment.
Metastatic non-resectable malignant melanoma patients will be eligible for enrollment.

Metastatic hormone refractory prostate cancer patients will be eligible for enrollment. Patients must have tumor tissue available prior to the initiation of the current line of treatment available for GPS Cancer testing.
Metastatic bladder cancer
Non-resectable metastatic Renal carcinoma
Non-resectable metastatic Head and Neck cancer
Metastatic Ovarian cancer
Metastatic Cervical cancer
Metastatic Sarcoma
Patients must sign informed consent for this study.
Patients must have private medical insurance coverage through Horizon Blue Cross Blue Shield. This is limited to insured commercial members, including HMO, and excluding, for the avoidance of doubt, members of self-insured customers or Medicare or Medicaid programs.

Pregnancy.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Blue Cross Blue Shield
NantHealth Inc.

Investigators

PRINCIPAL_INVESTIGATOR: Deena Atieh Graham, MD, Hackensack Meridian Health System

Publications

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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