P-OMICs-flow: Integrating precision oncology into clinical programs

Problem: Scientific advances continue to revolutionise our understanding of cancer biology, and optimise the way phase 1 and 2 oncology trials are conducted, significantly enriching basic research (T0), translation to humans (T1), and initial translation to patients through clinical trials (T2). However, many innovations become stuck at T2, and struggle to penetrate T3 – “translation to practice” – at scale (T4), generating masses of research waste[1] and missed opportunities for patients[2] – particularly those with hard-to-treat cancers, to engage with potentially lifesaving therapies or risk prevention strategies, due to lack of system support[3].
Solution: Propelling precision medicine into routine cancer care through scalable research-led clinical models can address this bottleneck, by a) strategically matching the "right patient" to the "right trial/treatment"[4], b) harmonising research and clinical care priorities and practices across Australian healthcare contexts[3], and c) using clinical informatics – i.e., capturing data at the clinical encounter and using those data to embed and support knowledge generation
processes for rapid adoption of research and continuous care improvement[5]. Recognising the magnitude of this problem, in partnership with the Garvan Institute of Medical Research (Garvan), Prince of Wales Hospital Sydney (POWH) is developing a novel precision medicine clinic (POMICs-flow) to drive integration of research into routine healthcare, scheduled to launch Dec 2021 (funded by MRFF). This will be the first of its kind in Australia, and a prototype for the integration of precision oncology into clinical programs generally.
Implementation science is intended to support exactly this integration[5]. Capitalising on this opportunity, and in collaboration with the Garvan and POWH, our team of international experts and national healthcare partners will enhance the adoption, implementation, sustainability, of P-OMICsflow to benefit health and health care outcomes. We will combine precision medicine, implementation science, clinical informatics, oncology, health economics, consumer experience,
and patient reported outcomes to lead a world first transformational research program to support the rapid adoption, optimisation, and scale-up of precision medicine research into routine care across multiple health services in Australia. Through this real-world research program we will achieve the following key aims:
• AIM 1: Co-design an implementation platform and suite of outcome measures to optimise
P-OMICs-flow
• AIM 2: Test the effectiveness and cost-effectiveness of P-OMICs-flow
• AIM 3: Develop and pilot test a P-OMICs-flow scale-up model and toolkit