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Patient History

Andrea Carboni, a 46-year-old woman, is presented on the PrecisionPlan™ clinical dashboard. 

She was diagnosed with triple negative, stage III breast cancer based on a core biopsy that was ordered in response to a positive mammogram and ultrasound. 

A subsequent MRI and CT were negative.

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Tumor Sequencing: MAPK and PTEN

The tumor was also sequenced by Foundation Medicine, resulting in identification of two drivers, MAPK and PTEN.  Results from a Guardant Health test of circulating tumor DNA are pending.


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Comprehensive Treatment Outline

After review of the standard of care options for Stage III triple negative breast cancer, the attending oncologist chose to use the Mastectomy/RT/Dose Dense AC standard of care plan as the baseline therapy for Andrea. 

After choosing this treatment strategy for Andrea, the PrecisionPlan™ platform automatically generated the treatment specifics for Andrea, including the detailed schedule of interventions, doses, tests, toxicity monitoring and patient quality of life assessments including treatment management rules for abnormal and out of range patient responses. 

Based on MAPK and PTEN alterations, the attending oncologist chose to apply PrecisionPlan™’s genomic-based artificial intelligence to Andrea’s case. 

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Treatment Modifications

The OKaaS™ (Oncology Knowledge as a Service) platform performed a comprehensive analysis of Andrea’s treatment options and offered the following major modifications to Andrea’s standard of care plan:

  • Changed the plan to utilize a neo-adjuvant approach using chemotherapy, followed by combined chemotherapy and targeted therapy to address the MAPK and PTEN alterations to shrink the tumor.
  • Changed mastectomy to lumpectomy, followed by standard external beam radiation therapy for local control, based on the chemo and targeted therapies’ ability to shrink the tumor.

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5 Year Wellness Plan

The platform also generated a comprehensive 5 year wellness plan for the patient including all physician visits, tests, cancer screening and lifestyle considerations.

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PrecisionPlan™ Report

Subject to the generation of this comprehensive precision treatment plan, based on standard of care and modified to incorporate known genomic alterations, the physician changed the standard of care anti-emetic to his preferred agent, Kytril.  He then approved the plan and PrecisionPlan™ automatically produced the clinical instructions including relevant orders.

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  • Generate patient-specific precision medicine treatment plans
    • Digitally and in-seconds
    • Per established and internationally-recognized standards
    • Using precision medicine rules
  • Improve clinical decision-making
  • Improve patient flow and through-put
  • Improve clinical efficiencies
  • Generate higher revenue and reduce costs
  • Reduce toxicity and related ER visits and hospitalization

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Precision Medicine Planning Solution for OCM participants

PrecisionPlan™ helps participating cancer treatment providers meet The Center for Medicare and Medicaid Innovation’s (CMMI) new Oncology Care Model (OCM) requirements with its comprehensive pathway and treatment planning platform that includes genomic-based targeted therapies and immunotherapies.

The Viviphi™ platform was designed as a true 21st century clinical virtual peer-to-peer knowledge transfer platform where treating physicians can get immediate access to standards of care and expert knowledge pertaining to genomic-based targeted and immunotherapies personalized to the specific patient being treated.

PrecisionPlan™ provides enhanced cancer care coordination and the right clinical knowledge necessary to generate evidence-based care plans to meet the NCCN, ASCO and IOM standards as well as institutional standards.

The Viviphi™  platform will be available to OCM participants in January 2017 as the 5-year value-based care funding pilot moves from the planning phase to implementation.