Flatiron Health inks RWD partnership with Japanese cancer center to drive international expansion

Flatiron Health, a real-world data company focused on cancer research, inked a partnership with Japan’s National Cancer Center Hospital East (NCCHE), marking a major step in the company's international expansion.

Flatiron, which was acquired by pharmaceutical giant Roche for nearly $2 billion in 2018, plans to work with the NCCHE to build a real-world database of patients with gastrointestinal cancers. 

The collaboration marks a major milestone for Flatiron as it lays the groundwork for more RWD partnerships with hospitals and health networks in Asia and Europe.

The announcement also marks the opening of Flatiron's Asia office with more international locations to be announced in the coming months.

Founded by ex-Google employees Nat Turner and Zach Weinberg in 2012, Flatiron built its business around oncology-focused EHR software and a repository of real-world cancer evidence. The company, which operates as an independent affiliate of Roche Group, now works with more than 280 community cancer centers and seven major academic cancer centers across the U.S. as well as more than 20 of the top global developers of oncology therapeutics.

Flatiron's database contains more than 3 million patient records available for research, with 75% from community practices and 25% of the data from academic cancer centers.

The company is strategically focused on growing its real-world evidence business for oncology research and development and recently hired former Veradigm executive Stephanie Reisinger as its senior vice president and general manager, RWE, to lead that unit.

"I'm really proud of Flatiron's accomplishments over our first decade. We've pioneered maximizing the use of RWD from routine care and cancer care, which has led to label expansions and dosing adjustments and a better understanding of safety profiles for cancer patients around the world," Carolyn Starrett, Flatiron CEO, told Fierce Healthcare in an exclusive interview.

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"I think that's a really incredible track record to build on. What we're doing now is starting to make long-term bets to shape the future of evidence generation," said Starrett, who took the reins as Flatiron's new CEO in March 2021.

The company is aiming to integrate additional RWD from more sources, including medical claims, imaging data and social determinants of health data, Starrett said.

Through the collaboration with NCCHE in Japan, Flatiron will de-identify, aggregate and curate the experiences of approximately 2,000 patients with gastrointestinal cancer to create data sets to support NCCHE's research and treatment decisions and for use by other researchers and regulatory decision-makers, Nathan Hubbard, vice president and head of business development of Flatiron International, told Fierce Healthcare.

The cancer center also will have access to Flatiron's U.S.-derived data sets.

"There are 2 million cancer patients diagnosed every year, and 750,000 of those, unfortunately, still lose their battle with cancer annually,” she said, referencing the number of cancer patients in Japan, Germany and the U.K. “There are just so many more patients to learn from in the countries where we are growing our operations," Starrett said.

Flatiron is expanding its reach through Flatiron International subsidiaries in Japan, Germany and the U.K. to partner with hospitals and health networks in RWD collaborations. Those curated data sets will be available to those hospitals and, under license, to biopharma companies to accelerate cancer research, according to the company.

"I think there's enormous potential to broaden the application and use of real-world evidence in regulatory decision-making, in clinical trial design and in understanding the availability of important treatments. And in understanding what are the right treatments for which patients in an increasingly complex oncology landscape," Starrett said.

As part of its international expansion strategy, the company focuses on countries engaged in cutting-edge research that have widely deployed electronic medical records systems, expressed receptivity to RWD and have large populations of cancer patients, Hubbard said.

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"[Japan, Germany and the U.K.] rose to the top of the list as places that hit that sweet spot for us," he said.

The COVID-19 pandemic accelerated the demand for and interest in real-world evidence, Starrett said, noting that she believes RWE will become a central strategy for biopharma companies and drug developers going forward.

"COVID proved that it's not enough to use the strategies that we've historically used. We have to make greater use of the data that's available across the spectrum of care and use it more quickly to find faster and better solutions," she noted.

Most of what the industry knows about which drugs work for which cancer patients comes from the relatively few patients who enroll in clinical trials, according to Starrett.

"It's not enough to only source clinical trials from major research centers where the patient population that we're learning from tends to be more affluent, more educated, with fewer comorbidities and healthier than the broader population that will need to take advantage of those medicines and those therapies," she said. "We think the opportunity and the role that Flatiron can play is to create access to a much broader patient population and enable the sites that we partner with around the world to open up those trials, find patients and manage them in a much more efficient way."