Leveraging Veterans Health Administration Clinical and Research Resources to Accelerate Discovery and Testing in Precision Oncology
Objective: The promise of precision oncology, which is the ability to choose a treatment specific to the characteristics of the tumor, has arrived. There are targeted therapies based on tumor mutations in multiple cancer types, both approved and in development. The US Department of Veterans Affairs (VA) has embraced precision oncology for the treatment of patients with prostate cancer.
Observations: This article focuses on the efforts to bring precision oncology treatments and trials to veterans with prostate cancer through the Precision Oncology Program for Cancer of Prostate (POPCaP) Centers of Excellence (COE) and the clinical trials consortium inside POPCaP, Prostate Cancer Analysis for Therapy CHoice (PATCH). Through POPCaP, VA has analyzed hundreds of prostate cancer tumors to identify mutations and develop treatment plans for veterans with prostate cancer. PATCH will leverage the genetic data and prostate cancer expertise of POPCaP COEs to develop clinical trials for veterans that take a precision oncology approach to care.
Conclusions: With its extensive resources and capabilities, VA has the ability to advance a precision oncology agenda that provides veterans with the highest standard of care. It has built upon many key elements in clinical, technological and scientific fields of study that would challenge most other health care systems given the extensive costs involved.
Conclusions
VA may have an opportunity to reach out to veterans who may not have immediate access to facilities running clinical trials. As it develops capabilities to bring the trial to the veteran, VA could have more virtual and/or centralized recruitment strategies. This would broaden opportunities for considering novel approaches that may not rely on a more traditional facility-based recruitment approach.
Ultimately, VA can be a critical part of a national effort to fight and, perhaps even, defeat cancers. With its extensive resources and capabilities, VA has the ability to advance a precision oncology agenda that provides veterans with the highest standard of care. It has built upon many key elements in clinical, technological and scientific fields of study that would challenge most health care systems given the extensive costs involved. In addition, creating strong partnerships with organizations such as PCF, NCI, and DoD that are complementary in resources and expertise will help VA to build a national network for cancer care. Putting this all together will support and facilitate a vision for more precise care for any veteran with cancer by more rapidly enabling the testing and approval of medications developed for this purpose.
Acknowledgments
The authors would like to thank Daphne Swancutt for comments and edits on drafts of this article.
