Going digital to improve clinical trial enrolment

Clinical trials serve as the mechanism that translates research into standards of care.

However, even though the number of trials has increased exponentially in the past few decades, fewer than 4% of cancer patients worldwide enrol in clinical trials. Higher enrolment in clinical trials has been shown to produce advances in treatment of cancer populations at a faster rate. Furthermore, patients who participate in research are more likely to report positive patient experiences.

Matching patients to trials is a lengthy and complicated process that varies among hospitals and clinicians. With Navify Clinical Trial Match app on the Navify platform, we give clinicians a tool that allows a faster, more standardised and personalised search for trials.

During a tumour board meeting or in preparation for it, multidisciplinary team members can initiate a search with the Navify Clinical Trial Match app based on an individual patient’s data. The app is sponsor-agnostic, integrated with Navify Tumor Board and returns current clinical trials – typically within seconds – from ClinicalTrials.gov, European Medicine Agency, other international trial registries and private institutions; results can be filtered by location.

Using non-identifiable information, patients are matched with trials for which they meet inclusion requirements and have no exclusion conflicts, and local trials are ranked high to encourage enrolment.

The app, therefore, may help raise awareness of relevant clinical trials with the potential to increase participation. By integrating clinical trial match functionality into Navify Tumor Board, clinicians are armed with additional options for patients and time is saved for oncology care teams.

First, it is important for healthcare providers and patients alike that they get unbiased results. Therefore, the Navify Clinical Trial Match app provides sponsor-agnostic search results. Second, often there may be no suitable trials for a particular patient within the institution or close vicinity. To provide global coverage, Clinical Trial Match queries 11 worldwide registries for clinical trials. Third, to optimise the matching given the complexity of trial inclusion and exclusion criteria, the Navify Clinical Trial Match app uses parameters such as age, gender, biomarkers, tumour type, location and stage. Last but not least, to address the increasing number of umbrella and basket trials, the Navify Clinical Trial Match app can search trial databases based on genomic alterations, where applicable.

The Navify Clinical Trial Match is one of the first two clinical decision support apps launched as part of the Navify Decision Support portfolio, a cloud-based platform that hosts workflow products and applications. Further apps from Roche, partners and third parties are to follow and add to the Navify apps eco-system. Currently we offer digital solutions for the oncology space.

The plan is to add workflow products and clinical decision support apps for other clinical fields. A sufficient number of trial registries could be the foundation for a clinical trial matching tool in that respective field.

The content of the Navify Clinical Trial Match apps is provided by MolecularMatch, a clinical informatics company with expertise in precision oncology, immunotherapy and bioinformatics combined with clinical insights. The app leverages MolecularMatch’s KnowledgeBase platform and search engine to globally search clinical trial registries — ClinicalTrials.gov [US], EUCTR [European Union], ANZCTR [Australia] and DRKS [Germany], to name a few.

The solution’s natural language processing [NLP] function recognises 36 million search terms from structured, semi-structured and unstructured clinical data and matches it with unstructured and structured data from thousands of clinical trials in more than 100 countries.

We have involved external clinical collaboration partners throughout the design and development of all of our products, including our apps. It is important to note that key aspects of the user experience – the search and return of results all take place within the Navify Tumor Board, creating an efficient user experience.

Dealing with digital data in healthcare always prompts four questions. How structured is the data? Do you have an unambiguous data model? What’s the quality of the data? How is data secured and kept private?

To address these questions, we partnered with MolecularMatch. MolecularMatch curates and validates clinical trial data and applies machine learning and NLP to improve the matching results. MolecularMatch’s curation process occurs more frequently than the registries on their own. No personally identifiable information is used to match patients to potential clinical trials.

Matching the right patient with the right trial is becoming more and more complex.

Patients trust their healthcare providers to get the most up-to-date information on available therapy options, including clinical trials.

Digital solutions like Navify Tumor Board and Navify Clinical Trial Match are designed to improve transparency to all possible treatment options to personalise treatment to the patient. Having said that, this is a multi-faceted topic. There will always be trials that have difficulty recruiting patients for other reasons.

Artificial intelligence encompasses NLP and machine learning. Navify Clinical Trial Match is on the leading edge of data interpretation and text mining. But we anticipate the growing sophistication of these tools will inform clinical trial development, ensuring not only higher enrolments but refining the objectives of trials so they collect the right information from the right patients at the right time to drive personalised healthcare and improved patient outcomes in an era of value-based care.