Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2017 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Use of a cognitive computing system for treatment of colon and gastric cancer in South Korea.
Health Services Research, Clinical Informatics, and Quality of Care
2017 ASCO Annual Meeting
J Clin Oncol 35, 2017 (suppl; abstr e18204)
Author(s): Jeong-Heum Baek, Sung-Min Ahn, Alexandra Urman, Young Saing Kim, Hee Kyung Ahn, Park Sung Won, Won-Suk Lee, Sun Jin Sym, Heun Kyu Park, Yong-Soon Chun, Eun Kyung Cho, Woon-Kee Lee, Dongbok Shin, Young-Bo Kim, Irene Dankwa-Mullan, Andrew D Norden, Kyu Rhee, Uhn Lee; Gachon University Gil Medical Center, Incheon, South Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; IBM Watson Health, Somers, NY; Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea; Department of General Surgery, Gachon University Gil Hospital, Incheon, South Korea; Department of Surgery, Breast Cancer Center, Gachon University Gil Hospital, Incheon, South Korea; Department of Surgery, Breast Cancer Center, Gachon University Gil Medical Cente, Incheon, Republic of Korea; Department of General Surgery, Gachon University Gil Medical Center, Incheon, South Korea; Gachon University Gil Medical Center, Incheon, Korea South; IBM Watson Health, Bethesda, MD; IBM Watson Health, Cambridge, MA; IBM Watson Health, Southbury, CT
Background: IBM Watson for Oncology (WFO) is a Memorial Sloan Kettering-trained cognitive computing system that provides oncologists with evidence-based treatment options for cancer. Treatments are presented in three categories: “Recommended”, “For Consideration” and “Not Recommended”. We examined the concordance of treatment options between WFO and the tumor board from Gachon University Gil Medical Centre (GMC), Incheon, South Korea. GMC is an urban center that cares for 50,000 cancer patients annually. Methods: We enrolled 340 patients with stage II, III and IV colon cancer and 185 with chemotherapy-naïve advanced gastric cancer, all treated between 2012 and 2016. Cases were processed using WFO, and the output was compared to blinded tumor board recommendations. Treatment options were considered concordant when the GMC recommendation was included in the “Recommended” or “For Consideration” categories. Results: Treatment recommendations were concordant in 248 (73%) of the 340 evaluated colon cancer cases. Of 250 patients treated in the adjuvant setting, 212 (85%) were concordant. Of 90 patients with metastatic disease, 36 (40%) were concordant. Treatment recommendations were concordant in 90 (49%) of 185 chemotherapy-naïve gastric cancer patients. Low concordance rates in gastric cancer were explained by two observations: (1) The trastzumab/FOLFOX regimen is not covered by the Korean National Health Insurance System, and (2) A regimen known as S-1 (tegafur, gimeracil, and oteracil) plus cisplatin is routinely used in Korea and is not used in the U.S. Conclusions: Treatment options suggested by WFO were concordant with the therapeutic decisions of GMC in the large majority of colon cancer patients treated in the adjuvant setting. Lower degrees of concordance were seen in patients with metastatic colon and gastric cancer, reflecting differences in practice patterns between the United States, where WFO was trained, and GMC, in Korea. Geography-specific customization is available in WFO and should enable physicians and patients to benefit from WFO worldwide. WFO's ability to learn from gastric cancer cases in a part of the world with increased incidence may reveal insights that are applicable elsewhere.