Cancer patients often face long and difficult battles against the disease, ranked by the World Health Organization as among the top ten causes of death worldwide. Starting the process of finding appropriate treatment can be a trying, difficult experience as patients navigate traditional chemotherapy, radiation, and surgery treatments, as well as thousands of clinical trials for experimental cancer drugs, and alternative treatment offerings.
Some companies are developing ways to facilitate patients’ efforts to find the right treatment. Using artificial intelligence, machine learning, and automation, they develop matching services and search engines to help patients find an appropriate course of action, especially when it comes to clinical trials through which doctors hope to find and improve on new treatments and drugs for cancer.
Belong, for example, a New York-based company founded by two Israeli entrepreneurs, has built a social network for cancer patients that enables easier access to health professionals and patients with similar conditions. The Belong app serves as a platform through which patients can receive responses by professionals, converse with other patients, and use Belong’s clinical trial matching service.
However, clinical trial matching has proven a particularly complex business. Google searches can easily overwhelm cancer patients seeking the right experimental treatment. Personal physicians and oncologists have limited knowledge about the thousands of options available around the globe. According to a 2007 report in the magazine Applied Clinical Trials, even companies specializing in clinical trial matching can “introduc[e] additional complexity” into patients’ lives and bring with them the “obvious conflict of interest potential with matching services being provided by sponsors.”
Perhaps because of these difficulties, clinical trial enrollment is now declining.
TrialJectory, a startup launched in 2017 with offices in Tel Aviv and New York, has set out to optimize clinical trial matching for cancer patients. CEO and co-founder Tzvia Bader has had extensive experience in the high-tech sector, particularly in big data, and conceived of the idea for TrialJectory after her own struggle with cancer.
“I was lucky enough to have good health insurance and be close to New York, so I was able to go to Memorial Sloan Kettering and I was offered to join a clinical trial,” Bader tells NoCamels. After one failed trial, she enrolled in another that was successful and has been cancer-free since, but she adds, “I wanted to make my own educated decision, so I went online and was shocked to find there was nothing out there about [my trials].”
Moreover, Bader discusses searching for clinical trials when her mother was diagnosed with cancer almost 20 years ago and says her oncologist had to “ask around” while she searched online for “days and days” without finding any information. “I fast forward 19 years, I’m diagnosed with cancer, and nothing has changed,” she adds, “it became like a passion of mine, an obsession for me.”
TrialJectory works through a free-to-use interactive website. Patients can log in to the company website and submit information on their particular situations. Bader points out that one of the difficulties with trial matching is that the criteria are “very specific,” differing on cancer type and phase as well as other features peculiar to each patient. She says TrialJectory is able to achieve such precision: “Based on the patient profile we have, we run an algorithm to find the right trials so instead of a list of a few hundreds, you’ll end up with two, three, [or] five that are right for you.”
The algorithm uses AI to sift through the myriad trials and produce recommendations.
The company then generates revenue from pharmaceutical companies running trials to which TrialJectory refers patients. “As a principle, our mission, part of our values, we don’t charge the patient,” Bader tells NoCamels. After TrialJectory returns trial recommendations on a patient profile, the patient can select one. The company then contacts the pharmaceutical company running the chosen trial to arrange for participation.
“I fast forward 19 years, I’m diagnosed with cancer, and nothing has changed, it became like a passion of mine, an obsession for me.”
Bader says pharmaceutical companies have a strong incentive to pay for such a service. “Right now, 94 percent of clinical trials are behind on their timelines due to patient recruitment,” and they need participants. In addition, “30 percent of phase three trials are being closed due to [lack of] enrollments” despite having shown promise.
According to Bader, this is cause enough for these companies to invest in a service that can provide them with candidates.
According to the startup’s site, there are currently some 18,000 trials in its database in need of approximately 12 million participants.
Bader identifies three types of companies as TrialJectory competitors in the trial matching market: “manual recruiters,” hospital-based matching services, and search engines specializing in trial matching.
Manual recruiters act as brokers by buying access to patient databases or receiving requests from patients and approaching those who fit the criteria for different trials. Bader says that while these recruiters can find tailored trials for specific patients, their method is “low-tech” and “low-scale,” but TrialJectory sees them as potential partners.
Hospital-based services work similarly to manual recruiters, but they use their own databases to match hospital patients to appropriate trials instead of freelancing.
Other companies have built search engines geared toward finding clinical trials. One of the most well-known is the US Food and Drug Administration’s search engine, which private companies have tried to improve upon using their own software. Nonetheless, Bader says search engines yield too many results to meaningfully narrow down a patient’s search for a suitable trial.
Having launched in December of last year, TrialJectory says it has signed up several hundred clients for its services. It is currently focused on matching melanoma patients with trials, and expects to release services for colon cancer patients within the next few weeks, followed by a service for breast cancer patients. The company is also in talks with pharmaceutical companies, but Bader says it is too early to reveal any names.
TrialJectory is currently undergoing its pre-seed investment round and has raised about half a million dollars from private angel investors from the high-tech sector. It is in talks with venture capital firms to secure additional funds.
Digital Health and Patient Empowerment
TrialJectory’s vision is an example of a trend digital health entities have been pushing for: empowerment of individual patients. Emerging technologies in telehealth, AI, social media, and diagnostics, are increasingly allowing patients to manage their health either themselves or on more equal footing with their healthcare professionals. Patients often arrive to a doctor’s office for a “second opinion” following a self-diagnosis with the help of online resources, leading some to re-conceptualize the patient as a “consumer.”
TrialJectory provides patients with free and direct access to resources, they would otherwise have to purchase from a specialist. The system also serves to educate patients on the scope of options available to them, allowing them to make more informed, individual decisions.