Digital Health Masterclass Challenge 2013: Onco Drug Personalized Medicine (ODPM)
Onco Drug Personalized Medicine (ODPM) recently came third place in the Digital Health Masterclass Challenge held by Janssen Healthcare Innovation and Johnson & Johnson Innovation. ODPM's Linda Rattner Celle shares here details of its entry, a web based calculator to determine the risk of toxicity on cancer patients to be treated with fluoropyrimidines.
(Continued from "Digital Health Masterclass Challenge 2013: DrEd")
Janssen Healthcare Innovation and Johnson & Johnson Innovation held an inaugural Digital Health Masterclass Challenge at the end of last year to help nurture the rising stars of digital health.
Twenty leading digital health start-ups from nine European countries pitched to a panel of experts and investors, and offered an exciting preview of how the latest technology is being used to improve and manage our health. Each of the start-ups has developed an innovative product, service or proposition using the latest technologies such as mobile apps, cloud-based solutions and wireless sensing technologies to addresses a particular healthcare need.
Onco Drug Personalized Medicine (ODPM) came third in the challenge. Linda Rattner Celle of ODPM shares details of its entry here with pharmaphorum's Managing Editor, Rebecca Aris.
Interview summary
RA: Your entry, which achieved third place in this challenge, consisted of web-based calculators to determine the risk of toxicity in cancer patients to be treated with fluoropyrimidines and provides personalised dose adaptation; can you tell me more about how it works and how long they have been under development for?
LRC: The calculators, which are the cornerstone of ODPM's offering have been in clinical use for the last 10 years. They were developed in the cancer hospital (Institute of Cancer of the West) in Angers, France, based on the research of a medical oncologist, a pharmacologist and a molecular biologist. In the early 1990s, they started with the premise that chemotherapy should at best provide the best chance for remission, but even at worst should do the least harm possible to the patient undergoing treatment.
They discovered that certain metabolic and genetic characteristics of each individual patient could predict how they would react to a widely-used cancer drug called 5-fluorouracil (5-FU) and therefore eliminate the early onset toxicities that some experience at the first cycle. They then extrapolated that information to help maintain the proper levels of the drug given intravenously so that patients who metabolize slowly would receive a lighter dose while those who eliminate the drug more quickly would receive a higher dose. This would therefore give every patient the same opportunity for clinical response (remission / cure) based on their individual needs.
RA: What challenges have you faced in developing these calculators and how have you overcome them?
LRC: The technical challenges have been overcome throughout the years of research leading up to the development of the calculators themselves. The analytes measured in the blood for the screening are quite volatile, and are found in only trace amounts; therefore methods for stabilising the samples and validating the analysis techniques were both crucial elements to overcome in order to bring the screening process into clinical practice.
The 10 years that the clinicians have been using the calculators have provided ODPM with abundant clinical data to update and refine the algorithms almost in real-time; a process which continues today.
Another challenge we face even today are the oncologists themselves. They have been using this drug for so long (over 50 years) and they have been trained to treat these severe toxicities and even the deaths as a 'cost of doing business'. We are stepping up to the challenge by maintaining a constant and intense education strategy with these oncologists, to gradually bring more and more of them to the realisation that they no longer have to 'wait and hope' that their patient will tolerate the treatment well – they can know beforehand, and then treat accordingly.
RA: What impact will this have on the quality of life for the patient receiving chemotherapy?
LRC: The patient can be certain that he or she will not experience a severe toxic reaction (even death) when they first receive a powerful cytotoxic drug like 5FU. During the therapy itself, they will receive the proper dose, not too much nor too little, and they are assured to have just enough to have their maximum clinical response (at best, remission) with the least possible chance of severe (Grade 3 and 4) toxicities. This enhanced quality of life is valid for over 60% of the patients who receive 5-FU today. This is why our mission is to bring this decision-support tool to as many clinicians as we possibly can.
RA: How will this reduce hospital costs?
LRC: Using the screening system and the dose-adjustment calculators drastically reduces the number of bed / days for patients being treated for these toxicities. For example, in France, the cost of only one death from 5-FU toxicity far exceeds the cost of screening ALL of the patients to be treated by 5-FU each year. By avoiding these deaths (three in every 1000 patients), as well as the severe toxicities which require days if not weeks of intensive care, hospitals and health systems can save millions of euros/pounds/dollars each year.
RA: What does it mean to you and your team to achieve third place at the Digital Health Masterclass Challenge?
LRC: We are extremely honored to have been chosen by the judging panel as third place winner in the Digital Health Masterclass Challenge, hosted by Janssen Healthcare Innovation and Johnson & Johnson Innovation. Simply being in the company of those 19 other digital health business leaders during the Masterclass was, quite frankly, compensation enough. Since November 20th, we have been able to attract the attention of investors, media outlets and other interested parties, which combined has given a strong boost to our communication strategy. The more people we can get talking about the issue of these avoidable toxicities, the closer we are to changing the way cancers are treated around the world.
RA: What is your hope for your calculators – what do you see on the horizon?
LRC: We see a seamless operation from clinical diagnosis to pre-therapeutic screening to proper first dose of the drug. We see a time when all clinicians as well as all patients will know that there is a safe and secure way to administer these kinds of drugs, and that not all of the parameters are based on the genetics and physiology of the tumor, but also of the patients themselves.
Personalised medicine is somewhat of a buzzword these days, but it IS the future of medicine. More and more diagnostic tools are becoming available in order to give the most effective treatments to each individual, and we are in the forefront of this trend in oncology. We intend to stay there by developing other decision-support tools for oncologists, related to other widely-used cancer treatments.
Further interviews from the Digital Health Masterclass Challenge 2013
• Digital Health Masterclass Challenge 2013: PX healthcare
• Digital Health Masterclass Challenge 2013: DrEd
About the interviewee:
Linda Rattner Celle (Director International Marketing and Operations) is an American living in France for over a decade. As an entrepreneur, she has created businesses in quite varied fields before joining ODPM in 2011. In the field of film and television for over 20 years, she headed up a number of production companies and event management entities. In her adopted country, she identified a high-volume market niche in English language learning for executives, and was able to have an impact on over a thousand students and manage a superb team of trainers. She brings her years of entrepreneurial, organisational and change management experience to this highly promising start-up in order to influence the international growth of the company.
Closing thought: How can we get more people talking about the issue of avoidable toxicities in treating cancers?
