Known for coloring outside the lines when it comes to face-to-face care for patients with cancer, Jeanne Kowalski-Muegge, Ph.D., professor in Dell Medical School’s Department of Oncology, is applying this same philosophy on a molecular level.
For cancer patients whose tumors lack an “actionable target” — a molecular change that can be targeted by drugs — determining the next steps in their treatment remains a challenge for physicians. Kowalski-Muegge, who also serves as associate director of cancer clinical genomics and co-program leader of quantitative oncology at Dell Med’s Livestrong Cancer Institutes, leads a lab that is creating a precise way to pinpoint actionable targets. Their solution? A computational platform called “W3: Whole Data, Whole Profile for Whole Patient Care.”
When a patient’s cancer is unresponsive to standard treatment options, their oncologist will often recommend molecular tumor testing. These tests, although they identify key treatments that “match” targeted cancer cells, are often daunting and require cross-discipline expertise. For this reason, experts from fields ranging from oncology to computational research come together to review test results in groups called molecular tumor boards. However, when molecular tumor boards review test results and make a recommendation, the patient has often already tried the suggested treatment option and found it ineffective.
In September of 2020, the Livestrong Cancer Institutes launched a molecular tumor board, developed and led by Kowalski-Muegge, with the unique goal of enabling its members to immerse themselves in experiential cancer genomics learning. Known as TOMWAY: Total Molecular Profiles With Actionable Targets, the board doesn’t just look at test results and make recommendations. Instead, TOMWAY develops hypotheses about why a tumor isn’t responding to treatment and uses computational simulations to test its theories.
Looking at the Big Picture
To ensure TOMWAY’s recommendations won’t result in treatment plans that patients have already tried, the team looks at molecular tumor test results holistically. Their comprehensive analysis, using the W3 platform developed by Kowalski-Muegge’s lab, deconstructs the entire data set, including data points that are often unused in standard analyses. Then, the W3 algorithms analyze a patient’s health profile in the context of the molecular test report, linking it to evolving, real-world biology research. The end result is a visual understanding of a patient’s cancer genome that can uncover hidden patterns and novel treatments.
This next-generation technology was presented as part of the 2021 Demo Day for Texas Health Catalyst, a cross-campus collaboration and part of the Dell Med CoLab, that fosters innovation in health care. Along with undergraduate student Qi Xu, Kowalski-Muegge and her team presented W3’s concept and won best presentation in the digital health category. With support from Texas Health Catalyst, the lab’s next step is to put W3 through beta testing and ensure technical feasibility.
“When we entered Demo Day, we were just applying for just a consulting award. In the end, what we received was so much more,” Kowalski-Muegge says. Through Texas Health Catalyst and their assigned advisor, Greg Stein, M.D., the team learned about the importance of patent filing with UT’s Office of Commercialization Technology, customer discovery and how to devise an effective pitch. They also received motivation and encouragement to persist through the common challenges that come with advancing any innovation. “We went on a journey that made us want to be better at research, better at communicating our ideas to a wide audience and better at engaging with others for investment to realize their impact.”