The VA’s National Oncology Program Office is an active participant in the White House’s Cancer Moonshot Initiative. This presentation will summarize efforts underway to provide Veterans with state of the art cancer care in a learning healthcare system. To achieve the goals of the Cancer Moonshot Initiative and Precision Oncology, the VA needs to: Provide all Veterans with timely access to coordinated, interdisciplinary, disease-specific cancer care; identify and facilitate VA medical center participation in compelling clinical trials that are designed to test novel therapeutics targeted at mutations with a high prevalence among Veterans; and, improve the infrastructure and capability for VA clinicians to practice in a learning healthcare system through decision support tool and robust data analytics.
The VA National Program Office has partnered with the National Cancer Institute (NCI) and the White House to implement innovations designed to achieve these objectives. It has received funding to provide Veterans access to next generation sequencing of tumor tissue. Data generated from analysis of the cancer genome will be analyzed by IBM’s Watson computers.
We are also developing a governance structure for national, multisite clinical trials. It will be similar in formatto NCI’s cooperative groups with oncologists leading diseases committees to evaluate which treatment clinical trials should be conducted nationally within the VA. We have developed national contract research agreements with the large pharmaceutical companies to facilitate national clinical trials. We have also developed agreements with VA Central Office and NCI that will allow industry funded studies to be submitted to the VA Centralized Institutional Review Boards (C-IRB) and VAMCs will be able to accept studies that have been approved by NCI’s centralized IRB. We are leveraging Connected/Tele-health technologies to develop Virtual Tumors Boards and Virtual Cancer Centers. These Virtual Cancer Centers are designed to provide access to expedited workup by specialized clinicians using evidence-based guidelines and clinical care pathways.