Abstract 4091: Design and adoption of MatchMiner at Dana-Farber Cancer Institute
Authors: Klein Harry , Mazor Tali , Kumari Priti , Ovalle Andrea , Trukhanov Pavel , Hansel Jason , Yu Joyce , Lindsay James , Hassett Michael , Cerami Ethan 
Published: June 2022

Abstract
Precision medicine (PM) drugs targeting alterations such as EGFR mutations and BCR-ABL fusions have provided great clinical benefit to patients. However, with an abundance of tumor sequencing data and trial eligibility criteria available, it can be challenging for clinicians to identify PM trial options for patients. To address this challenge at Dana-Farber Cancer Institute (DFCI), we developed MatchMiner, an open-source platform for computationally matching patients to PM trials. MatchMiner has three modes of use: (1) patient-centric, where clinicians can view all available trial matches for a patient, (2) trial-centric, where clinical trial teams identify patients for their trials based on genomic and clinical criteria, and (3) trial search, where clinicians search for available trials based on clinical and genomic eligibility. Trial matching is performed via the MatchEngine, which computes trial matches based on patient genomic and clinical data and PM trial eligibility criteria. To encode trial eligibility criteria, we developed a structured format called clinical trial markup language (CTML), which uses Boolean logic to encode inclusion and exclusion criteria. Here, we describe our implementation of MatchMiner at DFCI including strategies that were successful and MatchMiner’s impact on trial consent. Since MatchMiner first went live in March 2017, a number of strategies have helped facilitate utilization of MatchMiner. The biggest impact has come from targeted departmental collaborations (Gastrointestinal, Breast, and Center for Cancer Therapeutic Innovation or CCTI), where the MatchMiner team worked directly with key departmental stakeholders to develop customized workflows. To facilitate access to MatchMiner among individual clinicians, we integrated the patient-centric and trial search modes into the Epic electronic health record. Other implementation strategies were piloted, such as weekly emails to clinicians alerting them to potential trial matches, but were less impactful. Overall, departmental collaborations have resulted in several ongoing MatchMiner initiatives. Thus far at DFCI, we have curated 354 PM trials into MatchMiner and facilitated 220 patient consents. For PM trials, 222 genes, 7 mutational signatures and nearly all cancer types were represented, demonstrating that there is a wide range of PM trial options available to patients. We also examined the distribution of trial phases and disease centers running each trial. The majority were Phase I and Phase II trials run out of the CCTI, consistent with the frequency with which novel drugs do not progress to later phase trials. Lastly, we have identified 220 trial consents that benefitted from MatchMiner. Retrospective analysis of a subset of these trial consents (n=166) revealed a significant 22% decrease in time to consent relative to other consents to the same trials, demonstrating the clinical impact of MatchMiner.
Citation Format: Harry Klein, Tali Mazor, Priti Kumari, Andrea Ovalle, Pavel Trukhanov, Jason Hansel, Joyce Yu, James Lindsay, Michael Hassett, Ethan Cerami. Design and adoption of MatchMiner at Dana-Farber Cancer Institute [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 4091.