How Digital Health is Bringing Personalized Cancer Care to Veterans

About 40,000 U.S. veterans are diagnosed with cancer each year, according to a U.S. Department of Veterans Affairs (VA) study published in 2012. For the nearly one in four U.S. military veterans who live in rural areas, getting access to timely, quality cancer care may require journeys of 100 miles or more past fields of corn, cattle or cotton. And those trips to the doctor may require time off from work and seeking assistance from caregivers and others.

Veterans living in rural areas face transportation challenges that may discourage or prevent them from joining clinical trials, which usually take place at specialized medical centers in larger cities. This can hamper a veteran’s ability to access experimental treatments and services, such as genomic testing, which may provide an edge in the fight against cancer.

Recognizing the need to improve healthcare access and cancer care for veterans who live in rural and underserved areas, Genentech and the VA are teaming up on a unique research program. Using an emerging approach known as a decentralized, or virtual, clinical study, the aim is to make clinical research more efficient, equitable and cost-effective by bringing some aspects of cancer care into patients’ homes, regardless of where they live. Another benefit of the virtual study is that all 150+ medical centers across the VA health network will become activated simultaneously without the need for independent contracting through each medical center.

“This project is rooted in the power of deploying digital technologies and partnering with key players in the healthcare ecosystem to overcome barriers to treatment and advance personalized health solutions,” said Jamie Freedman, M.D., Ph.D., head of U.S. Medical Affairs at Genentech. “Genentech is committed to recognizing the contributions of veterans to society and to ensuring they can experience the full benefits of personalized healthcare.”

For example, veterans taking part in the study will consent electronically and be equipped with a wearable device to track their overall well-being and health-related activities, such as sleep and activity levels. Together with these tools, as well as the use of telehealth visits and a customized mobile app, Genentech and the VA hope to speed clinical trial recruitment and provide more timely and individualized care to all participants.

“Despite the VA’s large network of hospitals and clinics, the United States is a large country and many of our veterans face challenges accessing care,” said Michael Kelley, M.D., director of the National Oncology Program at the VA. “With technologies like telehealth, we can deliver high-quality care to our veterans wherever they are based.”

This program is being launched against the backdrop of the COVID-19 pandemic, which has reinforced the need to make clinical research more accessible and equitable.The pandemic has highlighted the disparities faced by patients in rural and remote communities trying to access care. Meanwhile, the novel coronavirus disease has had a disproportionate impact on people with chronic conditions or disabilities, on older people, and on racial and ethnic minorities – all groups that are well represented among U.S. veterans.

This project is rooted in the power of deploying digital technologies and partnering with key players in the healthcare ecosystem to overcome barriers to treatment and advance personalized health solutions.

- Dr. Jamie Freedman

“We have an exciting opportunity to improve access for veterans who might otherwise find it difficult or impossible to participate in leading-edge research because of geography or systemic barriers to care,” said Marianne Chacon, M.D., M.B.A., Oncology Portfolio Digital Health Group Medical Director at Genentech. “By addressing these challenges, this partnership could also help ensure that clinical studies – in cancer and beyond – better reflect the diversity of patients who may eventually need the experimental medicines being tested.”

This collaboration between Genentech and the VA will lay the foundation for innovative clinical trials and provide the next level of service and access to patients. In the initial proof-of-concept phase of the study, Genentech and the VA will determine how best to identify, enroll, retain and manage study participants, while also assessing the satisfaction of participants and providers. If the initial phase is successful, in the second phase, the decentralized trial platform will be applied to a more complex study setting in which patients with lung cancer receive treatment.

“Working together with stakeholders such as the VA is an important step toward bringing these benefits to as many patients, in as many settings, as possible,” said Freedman. “The development and testing of this innovative decentralized trial platform not only demonstrates how Genentech is adapting to COVID-19, but also how we envision future drug intervention trials to enable patients to safely and conveniently enter, participate in and complete a study with minimal travel.”