As the oncology community gathers for this year’s annual meeting of the American Society of Clinical Oncology (ASCO), Komodo is proud to showcase insights from our Healthcare Map™ that shine a light on gaps in care, trends in treatment, and emerging opportunities for innovation, all in line with our mission to reduce the burden of disease. As real-world evidence continues to play a greater role in understanding cancer as a category of diseases, we sat down with Komodo’s VP and Head of Analytics, Dr. Usha Periyanayagam, MD, MPH, to discuss her thoughts on the latest data and technology trends that she’s watching in this therapeutic area. 

What are the “hot topics” or “emerging trends” you expect to dominate conversations at the conference this year?
Usha: It is encouraging and a signal of progress to see a stronger intersection between precision medicine and AI at this year’s event. We know a lot more can be done to improve outcomes and equity in cancer care across diverse healthcare settings, and it would be beneficial to see new research investigating more AI technology approaches to ensure personalized treatment options reach the patients who need them, particularly for clinicals and patients in rural and community-based settings. 

There are also a number of areas within women’s health and oncology that are still far too under-researched, such as disparities in diagnosis and care for pregnant women. With the Biden administration's new Initiative on Women’s Health Research, this is a huge area of opportunity for the cancer community to dive deeper into a range of topics across women’s health. The advances today in real-world data will play a role to help better quantify and study populations that have not previously been targeted for appropriate care and diagnosis.  

What role do you see AI playing at ASCO this year?
Usha: AI has progressed significantly – but it is being underutilized in most of the oncology community (with the exception of radiation oncology workflows). It would be great to see more investment in AI to support the ability of clinicians to stay up to date on the latest targeted treatments, as they work to identify and evaluate patients that are eligible for more personalized therapies based on their individual patient journey. Tying these improvements to patient outcomes would be an exciting next step for these promising technologies. 

What’s the biggest opportunity you see for innovation within the cancer care space?
Usha: Cancer care is delivered across so many different healthcare settings, making it difficult to keep the entire cancer community up to date to ensure the right patients are targeted with the latest therapy or shifts in standards of care. This is particularly important for people in rural and underserved settings. New, valuable diagnostics and treatments are rapidly emerging, but we need a more concerted effort to get these new approaches into the hands of people who need them the most. 

Your team will be showcasing a poster at ASCO 2024 on pregnancy outcomes for patients who have cancer. Why was this study so important?
Usha: Pregnant women are excluded from so many facets of clinical research, which makes it even more important to utilize the real-world data available today to better understand this patient population. Our study described patient characteristics and pregnancy outcomes for pregnant women with cancer. We identified higher rates of pregnancy loss among patients with cancer (31.6%) compared with patients who had no cancer diagnosis (25.8%). We also identified differences in pregnancy outcomes for cancer patients based on race as well as type of insurance coverage. These findings serve as an important starting place for more inquiry into best practices to improve pregnancy outcomes for patients with cancer, particularly within underserved patient populations. 

This study will be featured in a poster presentation on Monday, June 4, at the ASCO 2024 annual meeting. 

Komodo has also published an ASCO abstract on breast cancer trends; can you tell us a bit about those findings? 
Usha: Very little research has looked at the impacts of the COVID-19 pandemic on cancer progression and treatment, particularly breaking down differences in diagnosis and care patterns for different demographics. In a retrospective study of Komodo’s Healthcare Map, our team at Komodo found that the proportion of women with metastatic breast cancer increased significantly across all demographic groups following the COVID-19 pandemic. This likely reflects the drop in routine healthcare screenings experienced nationwide during the height of the pandemic. 

What does this study tell us about disparities in breast cancer care? 
Usha: Breaking this down across racial groups, we found that the incidence of metastatic breast cancer increased from 20.7% to 25.1% among White women, from 17.2% to 22.8% among Asian women, and from 25.5% to 28.0% among Black women. Black women were also the least likely to receive any form of treatment – such as medication, surgery, or radiation – and treatment rates for Black women fell from 84.3% to 80.3%, indicating that nearly 20% of Black women with breast cancer are not being treated for their disease. In contrast, 90.6% of Asian breast cancer patients in the U.S. were being treated in the post-COVID time period. Time to treatment is also slowest for Black women, with a mean wait time of 50 days until treatment (vs. 44 days for White women). These findings underscore the need for systemic approaches to address disparities in cancer care, which were exacerbated by the ripple effects of COVID.