As we move near to the annual meeting of the American Society of Clinical Oncology (ASCO) — which will start at the end of May in Chicago — ASCO has been making a lot of noise about its prototype CancerLinQ™ network. Just how valuable this will be for the future management of prostate cancer will take a while to work out.
So first and foremost let’s make sure readers have a base understanding of the principle behind the CancerLinkQ initiative.
When it is up and running and accessible to members of the oncology community — probably in about 12 to 18 months — this initiative has been developed to track and analyze data on thousands and thousands of cancer patients in real time. The system will be able to use all this information to show your doctor evolving trends on how different types of cancer patients are being treated at a wide variety of institutions around the USA and therefore help him or her to ensure that the patients he or she treats are also being treated in ways that are best aligned with the evolving practices around the country.
According to Sandra Swain, MD, the current president of ASCO,
Today we know very little about the experiences of most people with cancer because their information is locked away in unconnected servers and paper files. Only the 3 percent of patients who participate in clinical trials are able to contribute to advances in treatment. CancerLinQ will transform cancer care by unlocking that wealth of information and enabling every patient to be a cancer knowledge donor.
Now this is all great in theory, but until people have actual experience with the system and start to “work out the kinks” it is hard to really know just how effective and efficient such a system will be. What is certain is that more information will be available to oncologists about how their peers are treating specific types of patients. What is less certain is whether such information will be closely correlated to standard management guidelines like those issued by the National Comprehensive Cancer Network.
The utility of the CancerLinQ system in the management of prostate cancer is also likely to be limited.
Why? Because most patients don’t get referred (or refer themselves) to a medical oncologist until they have metastatic, castration-resistant prostate cancer (mCRPC). Two years from now, this will probably mean that most men with prostate cancer won’t even think about seeing a medical oncologist until they have failed standard androgen deprivation therapy and failed second-line androgen deprivation with drugs like enzalutamide and abiraterone acetate. In other words, the data available to the medical oncology community may only have real utility for the treatment of mCRPC.
Now having access to an expanded range of data on clinical practise in the management of mCRPC is by no means a bad thing … but (at least as of now) what people are really going to need to understand as soon as possible is the optimal sequencing of drugs like LHRH agonists, antiandrogens, sipuleucel-T, enzalutamide, abiraterone acetate, and others still in the pipeline before chemotherapy is necessary. It doesn’t seem (at least to The “New” Prostate Cancer InfoLink) as though there will be a lot of data on this issue getting input into the CancerLinQ system because these treatments will commonly be managed by urologists and urologic oncologists as opposed to medical oncologists.
The development and rollout of the CancerLinQ initiative has been covered in a wide variety of publications over recent days, so here are just a few links to other sources of information that you might to look at:
- “ASCO unveils decision support system” on the MedPage Today web site (March 27, 2013)
- “ASCO harnesses ‘big data’ for cancer care” on the Medscape web site (March 27, 2013)
- “‘Big Data’ For Cancer Care,” on the Wall Street Journal web site (March 27, 2013, but you need to be a subscriber to the Wall Street Journal to read this)
- “Transforming cancer care through big data: ASCO unveils CancerLinQ prototype” lets you see parts of the media event at which ASCO offered details about this initiative.
- “ASCO completes prototype for CancerLinQ™, marking first demonstration of a “learning health system” to transform cancer care” is the actual media release issued by ASCO (on March 27, 2013)
Filed under: Living with Prostate Cancer, Management, Treatment | Tagged: CancerLinQ, clinical, data, Management, outcomes, practise |
THE "NEW" PROSTATE CANCER INFOLINK 
Very interesting. I do not understand why urologic oncologists would not participate just as medical oncologists do. Seems to me they are oncologists who limit their practice to urologic cancers and participate in ASCO.
Some urologic oncologists are members of ASCO … but an awful lot aren’t, just as some medical oncologsist who specialize in treatment urologic cancers are members of the American Urology Association (AUA) … but most aren’t.
If you aren’t an ASCO member I don’t think you will be able to participate in/use the system … but someone please correct me if this is a misperception on my part.
This stirs up the old chestnut of when a medical oncologist should become involved in treatment.
I believe strongly that a urologist should not administer long-term androgen deprivation therapy (ADT or “hormone” therapy) alone. By long term, I mean beyond the 3-9 months often suggested to accompany radiation therapy after surgery, or before and in conjunction with primary radiation treatment.
ADT results in systemic medical issues that are beyond the scope of most urologists, who are trained as surgeons, and even radiation oncologists. A perfect example, that I can speak of from my own diagnosis, is the effect on the liver — not common but a recognized co-morbidity. Fatigue arising from anemia is also very frequent for men on ADT for any longer than 12 months.
Internists rather than surgeons are required to recognize and treat many of these co-morbidities. Unfortunately, the urologists do not want to yield control of the patient, and many medical oncologists in community practice have little knowledge of prostate cancer prior to initiation of chemotherapy.
This CancerLinkQ may help somewhat, but more medical oncologists need to get involved earlier in the care of high-risk prostate cancer.
I just watched the short video our Sitemaster refers to in a concurrent post; it highlights my concern above — that medical oncologists are not part of urology practices, and that “community standard” urologists consider themselves “nimble” enough to administer these new treatments. They need to recognize they are not qualified as internists!