OneOncology, Flatiron & Cancer Docs Aim to Boost Community Care

A number of new technologies, from immunotherapy to targeted medicines and diagnostics, have all helped change cancer care the past few years. But not all cutting-edge technologies are available to patients who seek treatment at smaller clinics.

OneOncology, an unusual new startup being launched this morning, aims to help cancer patients in community settings gain access the latest treatments and learn about clinical trials, as they would if they were at a major medical center.

OneOncology is a new healthcare company formed by three of the nation’s largest community-based cancer practices that see 158,000 patients per year: Tennessee Oncology, New York Cancer & Blood Specialists, and West Cancer Center. The company brings together doctors and patients from these three practices and connects them through the cancer-specific electronic health record (EHR) software developed by Flatiron Health.

For Flatiron, a high-flying New York startup that Roche bought for $1.9 billion in February, OneOncology represents a way to acquire more patient data and customers for its EHR system.

The company is starting up with a $200 million investment from private equity firm General Atlantic. Tracy Bahl, a former CVS Health executive, is president and CEO. Each participating practice has an equity stake.

In an e-mail to Xconomy, Robin Shah, a former Flatiron executive who runs OneOncology’s business development efforts, said the goal of the organization is to “ensure patients receive the same best-class care no matter where they live.”

Shah said OneOncology’s solution involves putting a wide array of community practices on Flatiron’s EHR system, so doctors can share data on a cloud-based system, stay up on the latest research, work through changing drug payment and reimbursement models, and learn from one another. Flatiron’s software collects data that, stripped of patient-identifying information, are sold to drug companies and others to use in either research or clinical trial recruitment. It has partnerships with 275 community cancer clinics nationwide.

According to the Community Oncology Alliance, more than half of U.S. cancer patients are treated at community oncology practices—private, physician-owned businesses that aren’t part of the country’s major cancer centers like Memorial Sloan Kettering in New York or Dana-Farber in Boston. But community doctors don’t have the same resources as those at the big medical centers. Many aren’t up to speed on the latest scientific literature, research, or clinical trials.

“No one person has the bandwidth to use this developing, expanding armamentarium [of drugs] in the best possible way for patients unless they are really focused, and are in a setting where they’re always hearing about the latest clinical trials and results,” Drew Pardoll, director of the Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, told Xconomy earlier this year.

For instance, newer diagnostic technologies such as DNA tests that scan for a tumor’s genetic alterations may be underutilized in the community setting, says Jens Reuter, medical director of the private nonprofit Maine Cancer Center Initiative. Even when community doctors use the new diagnostics, the complex reports they generate can be difficult to interpret and act upon. What happens, for example, if a test recommends using a cancer drug that isn’t approved for the patient being tested? There’s been a “lack of comprehensive education” for community oncologists, says Rueter.

Shah said with Flatiron’s help, OneOncology will build a “collective platform” to alert participating doctors about ongoing trials.

“Overall, consortia like this make a lot of sense to me,” Reuter says, noting that with bigger scale, community practices will be better able to learn about patients, share treatment insights, and attract clinical trials.

Still, Reuter notes that OneOncology isn’t championing “a precision medicine approach,” that is, sequencing patients’ tumors for a wide range of genetic alterations and using those insights to find a drug. There is much debate within the scientific community as to the benefits of precision oncology—just a few weeks ago, for example, the Journal of the American Medical Association published a paper showing that broad DNA sequencing of the tumors of lung cancer patients in community practices didn’t lead to a survival benefit.

Shah said OneOncology’s community partners will establish guidelines for the use of all types of diagnostic testing, including broad DNA sequencing tests, and get patients access to the latest treatment options. The goal is to standardize treatment across the participating practices and to be a “driver” in “value-based payment models” that tie a drug’s price to its performance. “We believe this will be the future of oncology and healthcare,” Shah said.