NantHealth and UHS to jointly deliver genomic and transcriptomic sequencing platform and analytics capabilities, incorporating NantHealth’s intelligent clinical operating system (cOS) to transform cancer care coordination

University Hospital Southampton NHS Foundation Trust (UHS) and NantHealth today announced a strategic partnership with the aim of delivering and transforming cancer services using the most advanced molecular genomic and proteomic diagnostics, treatment decision support and unique IT integration capabilities for better informed precision treatment selection and care coordination.

“As an accredited NHS Genomic Medicine Centre, this partnership with NantHealth will allow us to take an important next step in the use of molecular medicine for the benefit of our cancer patients across the Wessex region”

Under the three-year programme, NantHealth will enable UHS to rapidly transport raw data from the sequencing machines to NantHealth’s UK based supercomputing infrastructure through the NantTransporter, and access NantHealth’s automated NantOmics Analytics Platform (NantContraster) for genomics sequencing interpretation and annotation. In addition, NantHealth will generate rapid and timely clinical reporting to support personalised treatment decision making for cancer patients, based on evidence-based outcomes among patients with a similar genetic signature.

With this partnership UHS will integrate advanced genomic and proteomic capabilities into its existing laboratory and with their agreement engage cancer patients to provide genome samples for sequencing. The enormous volumes of data generated will be quickly processed via NantHealth’s hyper secure UK data centre. It will then utilise comprehensive clinical data to identify potential clinical trial participants for recruitment into targeted trials.

Using NantHealth’s intelligent clinical operating system (cOS), the organisations will work to incorporate NantHealth’s technology platforms to capture relevant cancer clinical and outcomes data from the Trust. This strategic collaboration will help identify future patients suitable for clinical trials at the earliest possible stage and will record outcomes delivered as a result of therapy decisions that are made, in this era of targeted therapy and immuno-oncology. By converging molecular science, computer science and real world big data infrastructure capabilities, the cOS platform will empower providers, patients and commissioners to coordinate the best possible care, monitor outcomes and control cost in real-time.

UHS will join a growing number of leading organisations converging as part of a global network of care providers, commissioners and employers supporting the Omics Network, a collaboration to forge a new area of cancer care discovery and enhance the science of care delivery for the benefit of everyone.

“As an accredited NHS Genomic Medicine Centre, this partnership with NantHealth will allow us to take an important next step in the use of molecular medicine for the benefit of our cancer patients across the Wessex region,” said Fiona Dalton, chief executive officer at University Hospital Southampton NHS Foundation Trust (UHS). “We are proud to be amongst the first organisations not just in the UK but globally to deliver precision diagnostics alongside guided cancer decision support to deliver integrated care delivery solutions. We believe this will facilitate an elevated standard-of-care for our patients and will enable UHS to be at the forefront of specialist cancer services and clinical science in the UK.”

“We are excited at the prospect of working closely with University Hospital Southampton, and together taking from ‘bench to bedside’ the use of whole genome sequencing and proteomics for the benefit of cancer patients in the UK,” said Dr. Patrick Soon-Shiong, founder and CEO of NantHealth. “Our advanced technologies will enable the processing of ‘Real World Big Data,’ in the timely workflow of genomic medicine, and at last allow the promise of science to reach the hands of treating clinicians in time of need. The shared goal of UHS and NantHealth is to modernise and drastically improve the delivery of effective cancer care, in this evolutionary era of targeted and immunotherapy.”

Dr Mona Nasser

Dr. Mona Nasser, Clinical Lecturer in Evidence Based Dentistry at Plymouth University Peninsula Schools of Medicine and Dentistry, is to present a lecture at an international conference in Barcelona which links the writings of a 10th century medical philosopher to the use of supercomputer simulation as an alternative to using animals in medical research.

Avicenna Event 5 will take place in Barcelona on the fourth and fifth of June. Avicenna is an international organisation which aims to promote and develop so-call in silico clinical trials, where supercomputer simulation is used in place of animals for clinical research. It is funded by the European Commission and works with the biomedical industry and academic research institutions across Europe to develop the technology, methods, protocols and standards required for in silico clinical trials to become a reality.

Avicenna’s name comes from the Latinised name of Abu Ali al-Husayn ibn Abd Allah ibn Sina, a 10th century physician and philosopher from Persia who wrote the celebrated medical treatise Canon of Medicine. Running to five books, the Canon of Medicine remained the most popular medical textbook in the world for the next six centuries.

Its link to clinical trials may not at first seem obvious, but in her lecture Dr. Nasser points to Ibn Sina’s seven rules for testing the potency of drugs via analogy and experiment. 

It is the seventh rule which has particular resonance with the need to explore alternatives to animal use in research: 

“Experiments should be carried out on the human body. If the experiment is carried out on the bodies of [other animals] it is possible that it might fail … The …reason is that the quality of the medicine might mean that it would affect the human body differently from the animal body …. These are the rules that must be observed in finding out the potency of medicines through experimentation. Take note!”

Said Dr. Nasser: 

“However closely one may identify modern notions about testing drugs in each of Ibn Sina's seven points, his seventh point remains very relevant. One of the few systematic comparisons of drug studies done in animals and humans showed substantial differences between the two, which the authors of the study attributed either to bias or to the failure of animal models to mimic clinical disease adequately.”

She added: 

“Speaking to us from a millennium ago, Ibn Sina’s writings contain key points which are relevant to us today, and which underlie the need to constantly develop new ways of carrying out medical research which directly correlate to human beings. Computer simulation is a new and exciting way forward to change how we design and conduct clinical trials.”

A supercomputer simulation, or "in silico" model, of the body's inflammatory response to traumatic injury accurately replicated known individual outcomes and predicted population results counter to expectations, according to a study recently published in Science Translational Medicine by a University of Pittsburgh research team.

Traumatic injury is a major health care problem worldwide. Trauma induces acute inflammation in the body with the recruitment of many kinds of cells and molecular factors that are crucial for tissue survival, explained senior investigator Yoram Vodovotz, Ph.D., professor of surgery and director of the Center for Inflammation and Regenerative Modeling at the University of Pittsburgh School of Medicine. But if inappropriately sustained, the inflammatory response can compromise healthy tissues and organs.

"Thanks to life-saving surgery and extensive supportive care, most patients who require trauma care are now highly likely to survive," Dr. Vodovotz said. "But along the way, they may experience a variety of complications, such as multiple organ failure, that are difficult to predict in initial assessment. Our current challenge is to identify which patients are vulnerable to certain problems so that we can better implement surveillance and prevention strategies and use resources more effectively."

Building from a model developed for swine, the research team examined blood samples from 33 survivors of car or motorcycle accidents or falls for multiple markers of inflammation, including interleukin-6 (IL-6), and segregated the patients into one of three (low to high) categories of trauma severity. They were able to validate model predictions regarding hospital length of stay in a separate group of nearly 150 trauma patients. They then generated a set of 10,000 "virtual patients" with similar injuries and found the model could replicate outcomes in individuals, such as length of stay and degree of multi-organ dysfunction. Intriguingly, the in silico model also predicted a 3.5 percent death rate, comparable to published values and to the Pitt group's own observations, even though the model did not include patients who didn't survive their injuries.

The in silico model predicted that, on an individual basis, virtual patients who made more IL-6 in response to trauma were less likely to survive. But, as the model predicted, that was not true at the population level: Among nearly 100 real patients whose genetic predisposition to make more or less amounts of IL-6 had been determined, there was little difference in survival between high- and low-IL-6 producers.

"These findings demonstrate the limitations of extrapolating from single mechanisms to outcomes in individuals and populations, which is the typical paradigm used to identify potential treatments," Dr. Vodovotz said. "Instead, dynamic computational models like ours that simulate multiple factors that interact with each other in complex diseases could be a more efficient and accurate way of predicting outcomes for both individuals and populations. Then we can pursue those avenues that have the greatest likelihood of success in clinical trials."

"The potential impact of this work is high because clinical trials are difficult and expensive to carry out, and usually can test only a single dose of a drug," noted co-investigator Timothy Billiar, M.D., George Vance Foster Professor and chair, Pitt Department of Surgery. "Determining the best dose, timing and biomarkers that would characterize patients likely to respond well to therapy is a major thrust of the pharmaceutical and biotechnology companies. This approach could help tailor treatments."

RIT professor Elizabeth Cherry develops virtual heart models for cyber-physical systems

This is not your grandfather's pacemaker.

The National Science Foundation is supporting the early development of medical and cyber-physical systems that fuse software and hardware and go beyond today's embedded medical devices. Rochester Institute of Technology professor Elizabeth Cherry is on the multidisciplinary NSF team, spanning seven universities and centers, developing the "Cyberheart" platform for virtual, patient-specific human heart models and associated device therapies.

Cyberheart represents a starting point for developing and testing cardiac medical devices. Cherry's role on the five-year NSF project will focus on the foundations of modeling, synthesizing and developing medical device software and systems from closed-loop models of the device and organ. The NSF is supporting Cherry's research with a $615,969 grant.

"Our research spans both implantable medical devices, such as cardiac pacemakers, and physiological control systems, such as drug infusion pumps, which have multiple networked medical systems," said Cherry, associate professor in RIT's School of Mathematical Sciences. "These devices are physically connected to the body and exert direct control over the physiology and safety of the patient."

The group will build virtual models of medical devices coupled with virtual heart models for analysis and simulation. In the future, these analytical techniques will detect potential flaws during the design phase and optimize settings on a patient-by-patient basis before implanted. Cyberheart research will build safe and effective software for future medical devices, Cherry said.

In addition to RIT, the project includes Carnegie Mellon University, University of Maryland, Georgia Tech, University of Pennsylvania, the Fraunhofer Center for Experimental Software Engineering, and Stony Brook University.

The University of Louisville and KentuckyOne Health are delivering on their promise of working to make Kentucky a healthier place through a new partnership with Shaping Our Appalachian Region (SOAR).

“We look forward to working with Gov. Beshear, Rep. Rogers and all who are associated with SOAR as we explore how best to meet the challenges of the region in terms of health, economics and general well-being”

UofL and KentuckyOne Health have agreed to become presenting partners of SOAR, providing more than $300,000 in support over the next three years.

SOAR was established in 2013 by Gov. Steve Beshear and Rep. Hal Rogers and is designed to marshal the collective talents and energies of eastern Kentucky communities and citizens to address the most significant challenges confronting Appalachian Kentucky.

“At the University of Louisville, we have a public mandate to improve the lives of the people of Kentucky,” said UofL President James Ramsey. “Working with SOAR is a significant opportunity for us to partner with others throughout the state to achieve that mandate in a region of the Commonwealth that needs the most assistance.”

“We look forward to working with Gov. Beshear, Rep. Rogers and all who are associated with SOAR as we explore how best to meet the challenges of the region in terms of health, economics and general well-being,” said David L. Dunn, M.D., Ph.D., UofL executive vice president for health affairs. “We have worked with leaders in the region on individual projects to alleviate some of the immediate needs, especially in health care. But this is an opportunity to provide lasting solutions.”

“KentuckyOne Health facilities, physicians and care providers have a deep history serving the Appalachian region. Through our hospitals and clinics in Martin, Berea, Mount Sterling and London we are closely tied to the unique health challenges and barriers to care,” said Ruth Brinkley, president and CEO of KentuckyOne Health. “Through our relationship with UofL, now by partnering together with SOAR, we will expand our collaboration with Appalachian communities, utilizing the breadth of our patient services, wellness programs and community resources to truly make a difference.”

UofL and KentuckyOne Health entered into a partnership in 2012 with the mission of creating a healthier population and attacking some of the chronic health problems faced by the citizens of Kentucky. Together they are the largest health system in the Commonwealth of Kentucky.

“If we are to begin to resolve the health issues that the people of the Commonwealth face, everyone must work together,” Beshear said. “It is gratifying to see that two organizations with the stated purpose of improving the lives of people in Kentucky are taking leadership roles in the development of these critical partnerships.”

UofL and KentuckyOne Health already have significant efforts underway in the region. UofL for years has worked with Dataseam to utilize downtime on computers in schools in the region to create a supercomputer grid to speed the design process of potential anti-cancer drugs, while at the same time bringing those computers to the schools. Additionally, UofL has been very active in Remote Area Medicine programs in the region. These programs bring health care providers to underserved areas for large-scale clinics so people are able to receive care not otherwise available. Through the utilization of telemedicine, UofL neurologists have for years been assisting rural physicians with the diagnosis and treatment of strokes. UofL pediatricians are situated throughout the state, helping to fill the gaps in underserved areas.

For nearly 20 years, KentuckyOne Health facilities in Appalachia and surrounding communities have led a community-based program to provide home visits for patients following hospital discharge. Today, the Appalachian Outreach program covers 15 counties in eastern Kentucky, making contacts with more than 12,000 individuals each year. This regionally focused program provides a range of wellness support to help patients, caregivers and their families better understand their health and better manage their ongoing health and well-being.

Targeting health conditions with greatest prevalence in the region, KentuckyOne Health’s Saint Joseph Martin provides focused programs to fight prominent health conditions, notably cancer, diabetes and heart disease. Community programs include smoking prevention and cessation initiatives with local schools, a diabetes management program with Floyd County Health Department and community health fairs to check for heart disease risk factors.

“For years, both of these organizations have been supporting efforts to improve the lives of people in the region,” Rogers said. “Having them join with us so that we can hopefully multiply their individual efforts will only make the region stronger in the future.”

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