“The Oxford AHSN has provided us with feedback from medical oncologists and been a gateway into the NHS. Market access has been paramount in the adoption of the personalised dosing app and has enabled us to speak to clinicians we otherwise would not have had access to.”
Jim Millen, Chief Executive Officer, Physiomics
Overview

Physiomics has developed a proprietary model-aided simulation of tumours, Virtual Tumour™, to help pharmaceutical companies improve the success rate of drug development. The company wants to expand the utility of this technology by exploring methods of personalising oncology treatments and dosages for patients.

Physiomics has partnered with Oxford AHSN as well as clinicians at Oxford University Hospitals to explore the utility of the technology in different tumour types. This work was facilitated by two Innovate UK grants. The first (£131,000) was focused on oesophageal cancer, while the second was for prostate cancer (£68,000). Both grants provided funding for Physiomics to develop the VirtualTumourTM technology for the two cancer types. The Oxford AHSN led feasibility studies to determine the utility of the technology in a clinical setting.

In the first study, the Oxford AHSN conducted its Lean Assessment Process into a decision support tool in oesophageal cancer. The second was a stakeholder engagement study for a personalised dosing app for prostate cancer. In both cases stakeholders were interviewed, results analysed and fed back to Physiomics in order to refine their future product development.

Challenge / problem identified

Current treatment guidelines for cancer recommend dosages for patients based on their weight or body surface area, which is then rounded up or down to predetermined standard doses. These dosages aim to be within 6% of a patient’s calculated dose. However, the method of calculating these dosages is not always accurate, which can lead to adverse, sometimes severe, effects for the patient or treatment failure, which means another line of treatment needs to be used. NHS England currently spends roughly £1.5 billion on chemotherapy, and with an ageing population this figure is set to rise.

Physiomics required help from the Oxford AHSN to establish whether its technology could help optimise chemotherapy which will lessen adverse effects for patients (and the associated costs) and reduce the likelihood of patients having to have rounds of treatment that do not work, reducing the waste of expensive drugs and staff time.

How is the AHSN involved?

During 2018 and 2019, the Oxford AHSN conducted two studies in the NHS in England to evaluate the acceptability and potential barriers to adoption for the personalised oncology treatment apps developed out of Virtual Tumour™. In testing the potential scenarios, the current and proposed pathways were developed, and semi-structured interviews conducted to explore the potential use and adoption of the apps in the clinical setting, with medical and clinical oncologists in different trusts.

The key objectives of this study were to help determine initial levels of support for the hypothesis that many patients are on sub-optimal chemotherapy regimens. Additionally, Physiomics wanted to understand how clinicians would view the utility of its tools, once development had been completed and to understand the key drivers and barriers to adoption, allowing for further and more meaningful product development in line with NHS needs.

Impacts / outcomes of AHSN involvement to date

The partnership between the Oxford AHSN and Physiomics helped the company leverage £199,000 through two Innovate UK grants to help to develop its products and test the feasibility of their use in a clinical setting.

The usability feedback given as part of the semi-structured interviews undertaken enabled Physiomics to develop its offering and bring it more in line with clinical needs. It has given them a good understanding of the clinical evidence required to show efficacy and support clinical buy-in. This feedback is crucial for early stage ideas to be progressed in a way that makes them more suitable for NHS use.

As part of the feasibility studies, the Oxford AHSN identified the key stakeholders that will need to be engaged in the development of these innovations, helping to ensure that Physiomics create a product that meets their needs, and increases the likelihood of adoption.

“The Oxford AHSN conducted stakeholder engagement studies on barriers to adoption, by discussions with relevant stakeholders with semi-structured interviews, to gather feedback on products that could potentially introduce better patient experiences and efficiencies into a stretched system.”

Mamta Bajre, Lead Methodologist, Oxford AHSN

Learning to date

The Oxford AHSN identified the key stakeholders who need to be engaged to take these innovations forward, and their suggestions and feedback will be invaluable in developing these apps further. They will need to be contacted on an iterative basis to continue to help guide product development.

Plans / timescales for adoption and spread

Physiomics is currently re-evaluating these projects and looking at future development pathways. No timescales have been set. Going forward, they are looking to partner with NHS trusts to gain more data to test their models further.

Opportunities to get involved

There is potential in the future for data-sharing partnerships, and for clinical trials and real-world evaluations to be conducted.

Start and end dates

December 2017 to April 2019

Contacts

Dr Mamta Bajre, Lead Methodologist, Oxford AHSN
E: [email protected] 

Jim Millen, Chief Executive Officer, Physiomics
E: jmill[email protected]