GEARBOx - a multisite clinical trial matching tool for children with relapsed or refractory cancer

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PROJECT SUMMARY / ABSTRACT Despite a steady rise in cure rates, cancer remains deadly for many children, especially those with relapsed or refractory disease. Precision medicine holds great promise for these kids, but matching children to available clinical trials remains a challenge due a lack of up-to-date information and highly complex eligibility criteria based on clinical information and genomic and immunophenotype biomarker data. In collaboration with The Leukemia & Lymphoma Society, the Pediatric Cancer Data Commons (PCDC) team has developed GEARBOx (Genomic Eligibility Algorithm at Relapse for Better Outcomes), a clinical trial matching tool to allow clinicians to quickly find potential matches for their patients with relapsed or refractory acute myelogenous leukemia (AML). We now endeavor to expand GEARBOx to include several more tumor types, including acute lymphoblastic leukemia, neuroblastoma, rhabdomyosarcoma, Ewing sarcoma, and osteosarcoma. Additionally, we will augment the often-manual abstraction of eligibility criteria from clinical trials with new automated methods. The information available to clinicians about trials will be supplemented to include critical data for how to quickly and efficiently enroll a child on a matched study. Finally, the PCDC team will partner with a third-party flow cytometry lab (Hematologics) to create ways to automatically pull and incorporate structured immunophenotype data directly into the GEARBOx tool. These enhancements will greatly enhance the process of finding appropriate clinical trials for patients and then getting them enrolled, thus improving access to critical precision therapy for these children.