publication date: Jan. 12, 2018

Roche funds effort by Syapse to build software for measuring outcomes in precision oncology

By Matthew Bin Han Ong

Roche has teamed up with the precision medicine company Syapse to develop software for measuring health outcomes and economic impact of precision medicine.

The Syapse-Roche collaboration will focus on developing four specific software analytics solutions that would ultimately be added to the existing Syapse platform to generate insight and data trends.

Formed in 2010, Syapse works with health systems to integrate oncology data from electronic health records with genomic data. (The Cancer Letter, June 24, 2016).

The Syapse platform connects cancer care information across nearly 300 hospitals in 25 states—which collectively manage about one million active cancer cases, about 10 percent of cancer patients in the U.S., the company said.

Neither Syapse nor any other informatics company in oncology is able to use real-world data to provide “clinical decision support,” defined as recommending treatment plans to oncologists.

Syapse, for example, currently functions as a “clinical decision resource,” enabling physicians’ independent clinical judgments based on aggregated patient treatment and outcomes data. 

Other bioinformatics systems, including CancerLinQ, which is operated by the American Society of Clinical Oncology, are working to develop decision support capabilities. Recently, ASCO formed a collaboration with two Big Data firms—Tempus and Precision Health AI to develop commercial uses for CancerLinQ while defraying the costs of operating it (The Cancer Letter, Jan. 5).

Syapse’s collaboration with Roche developed over two years with the goal of expanding Syapse’s suite of interactive tools, which can be adapted to health systems and other health care providers to achieve interoperability.

The Roche-Syapse collaboration is focused on four programs:

  • Developing a “learning health system” based on real-world evidence to enable clinical decision support. This could reduce the need for randomized clinical trials to demonstrate safety and efficacy of precision therapies.

  • Bringing cancer care into the “value-based” era by incorporating cost factors and outcomes into clinical decisions. This is important because more expensive therapies may end up saving resources overall.

  • Using patient-reported outcomes in a consistent manner across therapies. This is important because patient-reported outcomes can differ wildly, depending on therapy.

  • Accelerating enrollment in clinical trials by matching patients with trials. This is important, because patients treated in the community have fewer opportunities to get into clinical trials than patients treated at academic cancer centers.

Under the agreement, Roche will fund the development of these products. The size of Roche’s investment was not disclosed. Roche had invested in Syapse’s Series D financing, which is the fourth stage in a financing cycle for a company that hasn’t gone public.

If these programs are developed, oncologists would be able to receive true clinical decision support—deriving recommendations about testing or treatment plans from the platform instead of only having access to Syapse’s aggregated patient data.

Health system administrators would be able to determine, by studying both economic and patient treatment data, whether hospitals should offer new therapies based on the tradeoffs between outcomes and costs.

Patients would be able to report outcomes over the duration of their treatment and beyond—providing data on response to treatment, quality of life, adverse events, and compliance. For example, if a patient experiences severe side effects and stops following the regimen, a physician would receive a cue to intervene.

Finally, physicians would be able to direct and optimize the enrollment process to ensure that patients are accrued to the clinical trials that they have already been matched with via Syapse’s platform.

“Many of these ideas have been discussed, so it’s not that the idea itself is unique, it’s the execution of it,” Ken Tarkoff, CEO of Syapse, said to The Cancer Letter. “From our perspective, actually being able to execute on these product programs, bringing them to market, bringing the key players together, having the appropriate amount of investment and partnership to make it happen, is really the differentiation.”

The collaboration does not involve selling data to Roche, said Jonathan Hirsch, president and founder of Syapse.

“When you think about typical pharma relationships and what they’re trying to do, there’s been a mentality where the pharma companies have traditionally focused on data access. We decided to take a different approach,” Hirsch said to The Cancer Letter. “What our collaboration with Roche represents is a new type of partnership where a pharmaceutical company is coming in and saying, ‘We need to go beyond the pill and provide additional value to physicians, especially with all the consolidation of oncologists from small independent practices into health system-based practices.’”

A conversation with Tarkoff and Hirsch appears here.

In return for its investment, Roche would get an opportunity to play a role in developing this technology. Roche may also gain access to Syapse’s network, and can develop separate studies and initiatives with the health systems Syapse serves.

“The collaboration with Syapse is a long-term partnership that will strengthen our relationship with a broad network of healthcare systems to advanced personalized healthcare in oncology,” Roche officials said in a statement to The Cancer Letter. “We are aiming at combining Syapse’s pioneering platform with Roche’s oncology expertise and developing solutions that empower providers to practice precision medicine at scale. We hope to contribute to fully realizing the potential of precision medicine for all patients and their physicians. Our partnership with Syapse will allow Roche to do so.”

This collaboration brings together groups that traditionally are unable to cooperate more fully, because of a lack of data access and transparency, said Damon Hostin, CEO of the Precision Medicine Alliance of Catholic Health Initiatives and Dignity Health. The two networks—the nation’s biggest nonprofit health systems—use Syapse to integrate their cancer data (The Cancer Letter, Sept. 30, 2016).

“What really excited me about this is that there is such deep knowledge in health care economics as it relates to the use of advanced therapeutics, and we all know the cost to bear of these therapeutics,” Hostin said to The Cancer Letter. “Roche is really bringing a ground level understanding of that field to the ecosystem and looking to cooperate with it.

“I was very impressed that there is a willingness to be product agnostic, meaning the collaboration is a platform for understanding and it’s a window into the truth of the costs and risks, and that really hasn’t been done before with these types of partners.”

A conversation with Hostin appears here.

The Syapse-Roche collaboration is part of an overall movement in oncology to build learning health systems, said Amy Abernethy, chief medical officer, chief scientific officer, and senior vice president of oncology at Flatiron Health, a cancer informatics company focused on aggregating data for research. Formerly, she ran the Center for Learning Health Care at Duke University.

“What we’re seeing is lots of increasing activity in this space, which tells us it’s an important place.  What gets confusing is that we are all kind of using the same language around learning health systems, but it can mean different things,” Abernethy said to The Cancer Letter. “The concept of a ‘Learning Health System’ can mean everything from improving and accelerating research to improving precision medicine, to improving the value of care delivered, to information back to doctors.

“The learning health systems language that Flatiron is using, CancerLinQ is using, that I used when I was at Duke, and that the Institute of Medicine has used—all of these things are different aspects of this overarching learning health systems philosophy.

“We’re all building parts of the learning health system, and that’s the reason why what Syapse is doing can be complementary to what Flatiron is doing, is because somebody needs to work on clinical decision support, and Syapse and Tempus is saying that that’s what they’re going to work on. Somebody needs to work on accelerating the research side of things, that’s what Flatiron says we’re going to work on.

“We’re all working on different parts of an overall set of tasks that ultimately comes back to how do we improve lives by learning from the care of every cancer patient. You’re just seeing a whole bunch of activity in this space, because I think that not only are the concepts gaining traction, but the business models around it are gaining traction. The efficiency is real. It really does lead to more efficient decision-making and hopefully better patient care.”

In January 2016, Roche led Flatiron’s Series C round of investment, totaling $175 million. At the same time, Roche entered into a multi-year, non-exclusive agreement with Flatiron. The companies also agreed to collaborate on accelerating clinical trials and advancing personalized medicine.

Roche said it chose Syapse because of the company’s deep expertise in precision medicine.

“Their customers include some of the largest health systems and academic systems in the U.S.,” Roche officials said to The Cancer Letter. “Syapse’s expertise in precision medicine software and analytics solutions makes them the ideal partner for this collaboration.

“They have a comprehensive platform to scale precision oncology by integrating previously siloed patient information, providing patient-specific decision support, and matching patients to clinical trials. Syapse is also unique in enabling cancer data sharing for oncology providers to learn from real-world outcomes, which we believe is critical to moving precision medicine forward.

“The collaboration aligns with our long-standing personalized healthcare strategy of tailoring medical treatments to the individual to help prevent, diagnose and treat patients more effectively and quickly.

“As digital healthcare technologies become more sophisticated, personalized healthcare depends increasingly on integrating meaningful data from a variety of data sources and using advanced analytics to generate a complete view of patient health. Syapse is pushing the boundaries in using oncology informatics to improve care; for example, in exploring the use of real-world evidence and analytics to directly improve patient care, today.

“Combining Syapse’s expertise, and its provider-driven network, with Roche’s capabilities will accelerate this work and enable both companies to dramatically increase the number of people who have access to personalized healthcare.”

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