George Lundberg, MS, MD, ScD, MASCP, FCAP, Chief Medical Officer and Editor in Chief, CollabRx, a Rennova Health Company; Editor at Large, Medscape; Executive Adviser, Cureus; Consulting Professor of Pathology and Health Research and Policy, Stanford University; President and Chair, The Lundberg Institute; @glundberg
Q: Did the CollabRx vision of 2008-2010 foretell the 2016 Cancer Moonshot?
A: True history is difficult to confirm. Its representation depends in large part on who recorded “his-story.” Even Socrates, who, amazingly, did not himself write, is known mostly because of the extensive writings by his students.
Did Richard Nixon, in declaring “War on Cancer” in 1972, calling for vast research to find a cancer cure foretell the Obama-Biden 2016 “Moonshot”? Perhaps, since it also was a presidential decree.
It takes many threads to weave a tapestry.
Jay Martin (Marty) Tenenbaum PhD, himself both a former Stanford professor and pioneering internet entrepreneur as well as a metastatic melanoma survivor, founded CollabRx as a privately held, for profit company in 2008.
When Marty conceived CollabRx, he envisioned breaking down the silos of process that inhibited movement of positive research results from “the bench to the bedside” to enable a far shorter time than the extant 16 years. Blending-merging the wonders of advanced information technology and the Internet with the increasing wonders of molecular oncology was to be the method.
The goal was always to “defeat cancer, one patient at a time.”
Jeff Shrager, PhD (still with Cancer Commons) and Smruti Vidwans, PhD (still Chief Science Officer of CollabRx) were early hires.
John Wilbanks (an initial CollabRx Editorial Advisory Board member) is credited with founding “Science Commons” in 2006, as a part of the Creative Commons concept.
Wilbanks and Tenenbaum announced/described “Health Commons” in June 2008.
John Niederhuber, MD, Director of the National Cancer Institute, in the March 17, 2010 issue of JAMA, published “Translating Discovery to Patient Care”, nicely summarizing many of these cancer issues and opportunities. He left the NCI Directorship in July 2010.
From 2004-2011 caBIG was an NCI program that was envisioned to accomplish many of the goals described by Niederhuber and envisioned by Tenenbaum. But after spending >$350 000 000 with little to show for the money, caBIG was replaced.
I joined CollabRx on March 2, 2010.
On April 1, 2010, I participated in an Institute of Medicine program in Washington, DC on “The Learning Healthcare System in 2010 and Beyond”. I mentioned the CollabRx and Cancer Commons concept in my lecture and many people expressed interest.
Tenenbaum, Shrager and I announced Cancer Commons in MedPage Today on July 12, 2010. “The goal of Cancer Commons is to provide patients and physicians with the latest information, tools and resources they need to obtain the best possible outcome and to capture and aggregate the results over all studied patients to improve cancer treatment generally.”
The first real product of CollabRx (in addition to appointing dozens of stellar collaborating editorial board members) was the PLOS ONE paper “A Melanoma Molecular Disease Model” (MDM) on March 30, 2011. This paper portrayed a model describing how to envision cancer by genomes, mutations, and pathways. Harvard’s Keith Flaherty and David Fisher teamed with Smruti Vidwans and other CollabRx authors in this groundbreaking effort.
In order to enable utilization of the new MDM, we harked back to the May 5, 1975 beginning of The JAMA series called “Toward Optimal Laboratory Use” (TOLU) which introduced the concept of algorithms and decision trees and tables to physicians that truly did foretell CollabRx “Therapy Finders.”
Following the TOLU model, CollabRx invented “User Guides” for physicians and patients to use as open access interactive web apps at www.collabrx.com, subset Melanoma Therapy Finder
intended to facilitate shared decision making by patients and physicians together at this most difficult time, dealing with advanced cancer. Lung cancer, colorectal cancer and breast cancer web apps followed. The CollabRx Therapy Finder concept incorporated the new biomarkers, recognized practical therapeutic onco-genomics and was based upon cancer site/organ of origin.
On April 1, 2011, The Scientist Magazine (Sarah Green editor) published my “Thought Experiment” called “Medical Publishing for an N of One.” I, an aficionado of large-scale clinical trials as the gold standard for evidence in medicine, had completely acquiesced to the notion that cancer is thousands of different possibly unique diseases with mutational and other …omic designators.
Parallel to these developments, CollabRx science, led by Vidwans, also invented and built a complex, deep, up to date and highly automated Genetic Variant Annotation (GVA) Service that can be agnostic to organ of cancer origin and utilized a “Pan-Cancer” genomic approach, with a different kind of editorial board called “Pan Cancer” headed by Razelle Kurzrock. The GVA is intended to bridge the interpretation-action gap between the NGS laboratory findings and the practicing physician.
In 2012 CollabRx was acquired by Tegal (which adopted the CollabRx name) and moved to San Francisco. New CEO Thomas R. Mika. Cancer Commons by this time had transitioned from a not for profit initiative into a 501c3 corporation and remained in Palo Alto with Tenenbaum.
By 2014, CollabRx announced a new product, CancerRx, as a mobile app extension of the previously exclusively web-based Therapy Finder apps.
There can be little doubt but that the well funded and widely publicized ASCO product called CancerLinQ formally launched in 2016 after years of planning draws heavily in concept from the early thinking of Cancer Commons.
Listening in person to Vice President Joe Biden exhort the ASCO membership in June 2016 to cooperate, collaborate, break down the silos, share, place beating cancer ahead of promoting your institution, company, career, financial gain, etc. sounded a great deal like Marty and me exhorting the IT planning leaders of ASCO in Alexandria, VA in April 2010, and others subsequently, to help us bring the CollabRx and Cancer Commons visions to reality.
We can all hope that the upshot of the Joe and Jill Biden call to double the rate of progress in the fight against cancer (10 years compressed into 5) has a better outcome for many cancer patients, and not only for the American Cancer Industrial Complex, than did the war declared by Richard Nixon in 1971.
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