A Comprehensive Cancer Center Designated by the National Cancer Institute

Pathways to Discovery: Winter 2012

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Technology Helps Personalize Cancer Care

As we share data in a more timely, standardized way, it will ... help doctors, nurses, and treatment coordinators provide more effective, personalized care.
Rajan Gopalakrishnan, MS

Rapidly evolving technology plays a role in every aspect of our lives—from how we communicate with family members to how we receive medical treatment.

Technology, which some describe as "impersonal," actually creates more personalized cancer care.

"As users move into the web 2.0 domain and into the mobile domain, we are seeing corresponding changes in how researchers and clinicians interact with clinical trials data and point-of-care decision-making," said UCCCC Director for Informatics Rajan Gopalakrishnan, MS.

Gopalakrishnan and his team work closely with oncologists to ensure that data gathered during clinical trials—such as tumor genetics, treatments used, therapeutic responses, and patient demographics—are anonymized and tracked in a format that can be accessed and understood by collaborators around the world.

One challenge is making sure that all data are entered using integrative technologies and a standardized lexicon to enable varying systems in different medical institutions to process data in the same way.

"As we share data in a more timely, standardized way, it will work its way through the translational pipeline to help doctors, nurses, and treatment coordinators provide more effective, personalized care," said Gopalakrishnan.

Advances in Kidney Cancer Treatment
Because of stricter requirements, technology used in healthcare tends to lag behind technology used in other industries such as banking. That's why UChicago investigators have to be even more innovative in the way they combine established technologies with cutting-edge tools and new interfaces that interoperate with clinical trials databases.

Michael Maitland, MD, PhD, assistant professor of medicine, and colleagues are using an ambulatory blood pressure monitor in kidney cancer patients enrolled in a clinical trial that is testing the efficacy of a new cancer drug.

The blood pressure monitor is a device, about the size of a few iPhones, with an air compressor pump that is connected to a those and blood pressure cuff.

"If you want to precisely measure how a new cancer drug that affects blood vessels is also affecting blood pressure in patients, and subsequently how the measurements differ from patient to patient, this device is the best technology to answer those questions," said Dr. Maitland.

The ambulatory blood pressure monitor can also help identify patients that may be at risk for severe adverse cardiovascular events, such as a heart attack or stroke, if a particular anticancer drug is used. Blood pressure fluctuates through the day and can be affected by everything from caffeine to stress to sitting or standing.

"Capturing blood pressure information over 12-to-24 hours, allows us to get a good idea of what a patient's average blood pressure is," explained Dr. Maitland."We had one patient whose blood pressure seemed normal in the clinic, but the monitor showed us that the patient actually had high blood pressure that needed to be managed before we started her cancer treatment."

Dr. Maitland said that ambulatory blood pressure monitors may one day be used in all patients undergoing a cardiovascular risk profile, with the data added to a patient's electronic medical record.

Another advance in cancer treatment came from combining existing and emerging technologies to measure solid tumors. Dr. Maitland and colleagues used data from clinical trials that led to FDA approval of two new drugs for kidney cancer to develop a mathematical model of the typical growth rate of kidney cancer. By examining tumor measurements obtained by computed tomography (CT) scans of patients who were on placebo, researchers were able to more accurately estimate the effects of a cancer drug. As a result, fewer patients may be required to conduct subsequent clinical trials.

In the future, Dr. Maitland predicts that by adding tumor volume measurements from 3D technology developed by Samuel Armato III, PhD, and colleagues in the Radiology Department, investigators will get an even earlier indication about whether a patient is responding to treatment.

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