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A Comprehensive Ontology of
Hematology/Oncology Regimens
Jeremy L. Warner MD, MSJune 12, 2018
NAACCR Annual Meeting
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Chemotherapy regimens
• Systemic cancer treatment is context specific, with complex multidrug regimens in many cases.
• We have been building a comprehensive, freely available website containing such information, HemOnc.org, since 2011.
• 84% of the distinct regimens on HemOnc.org have more than one antineoplastic component.
• While some chemotherapy regimen information is captured in standard ontologies (e.g., the NCI Thesaurus, SEER*Rx), this area of oncology is mostly non-standardized.
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HemOnc.org
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The case for a new ontology derived from HemOnc.org
NCI Thesaurus:
Incomplete: many other treatment settings
Underspecified: • Context for accepted use• Supportive medications• Substitutions (e.g., prednisolone)• Supportive evidence (i.e., references)
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Are these the same?
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HemOnc.org Ontology version 2018-05-08
• 171,865 axioms• 25,406 individuals (drugs, regimens, authors, etc.)
o 1,275 distinct treatment regimenso 2,827 referenceso 20,778 authors
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Availability
http://ascopubs.org/doi/abs/10.1200/CCI.17.00142
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Anti-CD20 antibodies
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Drug example: Rituximab
29 classifications16 alias concepts1 standard mapping (to RxNorm)
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Published in: Andrew M. Malty; Sandeep K. Jain; Peter C. Yang; Krysten Harvey; Jeremy L. Warner; JCO Clinical Cancer Informatics 2018, 2, 1-11.Copyright © 2018 American Society of Clinical Oncology
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Regimen example: R-CHOP
4 alias concepts16 classifications20 treatment components42 references
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Published in: Andrew M. Malty; Sandeep K. Jain; Peter C. Yang; Krysten Harvey; Jeremy L. Warner; JCO Clinical Cancer Informatics 2018, 2, 1-11.Copyright © 2018 American Society of Clinical Oncology
Even a concept as seeminglysimple as R-CHOP is quitecomplex!
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Regimens by class(May 2018)
Class of regimen No. of distinct regimensChemotherapy 1,029Chemoimmunotherapy 26Chemoradiotherapy 79Endocrine therapy 37Growth factor therapy 10Immunosuppressive therapy 25Immunotherapy 29Radiotherapy 31Other 103
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Drug annotations(May 2018)
Annotation Number of instancesRxNorm 343Drug_Code_Name 253Drug_Generic_Name 283Drug_Brand_Name 1,107Drug_Brand_Name_Preferred 246Drug_Alias 2,796
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Regimen annotations(May 2018)
Annotation Number of instancesregimen 1,275biomarker 102empty 97historical 126Regimen_Alias 418
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Next steps
• Complete the elimination of duplicative regimen names
• Classify “other regimens” to the extent possible
• Add a preferred name term to all individual entities
• Add expected duration of treatment property
• Add an annotation for regimens that are not stand-alone (i.e., they’re a component of a multipart treatment protocol under certain circumstances)
• Store cooperative group information separately, when it occurs (e.g., ECOG, CALGB, Intergroup, etc.)
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Acknowledgements
18
• Collaborators– Krysten Harvey, BS– Sandeep Jain, MD– Andrew Malty– Peter Yang, MD
• DeepPhe and CLAMP teams– Hua Xu, PhD (MPI)– Ergin Soysal, PhD– Liwei Wang, MD PhD– Elizabeth Sigworth, BS– Chenjie Zeng, PhD
• Licensees– Boston Children’s– Dana-Farber– EMBL-EBI– Mayo Clinic– Northwestern Univ.– OHDSI– UAMS– Univ. of Illinois– Univ. of Pennsylvania
• Grant Funding– L30 CA171123– U24 CA184407– U24 CA194215– GM10331601