Ep. 22: Miruna Sasu, PhD, MBA, Chief Strategy Officer at COTA. Topic: Advanced Analytics for Cancer Research
Kathy: Welcome to Episode 22 of the Smarter Healthcare Podcast. Our guest is Miruna Sasu, Chief Strategy Officer at COTA, a company that uses technology and advanced analytics to organize complex data for cancer care and research.
In this episode, Miruna and I talk about how COTA is innovating in cancer care, her motivations for undertaking this work, and what she sees as the future of cancer research.
I hope you enjoy listening!
Kathy: Thank you Miruna for joining us today. Could you start by providing us with an overview of what COTA does?
Miruna: Absolutely. Thanks, Kathy, for having me. COTA, Inc. is the premiere hematology oncology real-world data company that provides real-world data in terms of electronic medical records and also services around that. So we curate electronic medical records so you think about when the doctor writes what is going on with the patient in their record, we actually go in and we take data from the doctor’s notes, and we structure it. And we provide that data back to our healthcare providers, which we have academic institutions, for example, healthcare providers, and then we also facilitate research with life science companies, as well as patient advocacies, and back-door healthcare providers, so that they can make decisions about what they’re going to treat their patients with based on data.
Kathy: And how did you come to the company, and what was your personal motivation to focus on cancer innovation?
Miruna: This is a very personal story for me. My mission started when my grandfather was diagnosed with Stage IV lung cancer. I actually grew up in Romania where my mother was working a whole lot, so my grandfather and my grandmother basically raised me. They were like my parents. So when he was diagnosed the doctor told us he had at most three months to live, and the tumor had taken over both of his lungs and was spreading. So I was barely 12 years old when that happened and I’m sure you can imagine I was absolutely devastated. It was – he was a cornerstone of our family. So at the time our financial situation was quite tight, so we couldn’t afford some of the best treatments, and the doctors weren’t really giving him a great prognosis anyway. But luckily, we were able to get him on a clinical trial that was at the time run by Bristol-Meyers Squibb, and after several rounds of treatment he actually went into remission, believe it or not. And that was the moment that I said, ‘I want to do that for other people.’ So I went through my education with the goal to conduct clinical trials to help other people get the same sort of benefit, basically, get access to innovative medicines and cure cancer. So I, unfortunately, my grandmother was later diagnosed with non-Hodgkin’s leukemia, or lymphoma, and lost that battle. So that sort of made me even more determined, and that’s how I ended up working for Bristol-Meyers Squibb, then for Johnson and Johnson in clinical trials, and then more recently here at COTA as chief strategy officer, and as I mentioned, COTA is an oncology real-world data company focusing on figuring out how to try to cure cancer by bringing the environment between regulators and providers and life science companies all together.
Kathy: Your story resonates so much with me. I lost my own father to cancer about five years ago, he had leukemia, and a big part of why I am involved in healthcare right now is because of him and that experience. So I appreciate you sharing that story with us.
Miruna: Yeah, thank you. I am so sorry to hear that, it’s really, really touching and completely gets me every time we talk about it.
Kathy: Can you provide some real-world examples as to how COTA is innovating in cancer care?
Miruna: Yeah, sure. I can name so many. So COTA was actually built on the premise of innovative cancer care and improving outcomes. Our founder’s vision was to at some point connect the whole ecosystem that I mentioned before, between health carers and drug developers and actually payers as well. We got really really good at data curation, which is sort of this extraction of information that is in the doctor’s notes, and structuring it for utilization in analytics. The reason that actually happened is because you can’t really, if you don’t understand the patient, you can’t really do much. So you have to understand the patient utilizing their data, and then you analyze that data at the whole population level to figure out what works best. So we actually do this through tech-assisted medical curation, where each medical record is looked at as the patient’s story. We utilized proprietary technology to do this and to put it in front of our abstractors, things like machine learning, and we also have this really phenomenal elite medical team that performs research on the data along with healthcare providers, so doctors that are actually looking to figure this out for their patients, patient advocacies that are looking a little bit higher at population levels, health authorities that are looking at how do they keep people safe as drug developers continue to put drugs in front of them. And then of course drug developers, because they are trying to get the most innovative medicines to the market fastest. So our mission is to utilize some of these capabilities that we have internally to understand oncology diseases better, help drug developers build treatments for the right patient at the right time, and then make essentially every story like mine, with my grandfather’s, right? So this is – the ecosystem that we are working in, between the data and the technology that we have, we are trying to innovate, and help drug developers innovate within cancer care, and we’re also trying to help healthcare providers make better decisions for their patients by utilizing the data at their fingertips.
Kathy: And are there specific technology advancements over the last several years that have really helped with this process?
Miruna: Yes. Definitely. But I think first it’s really important to define what technology means. So there are software platforms, there’s data science, there are algorithms, there are hardware pieces like CT scan machines and innovations there and so on and so forth. Now, the software platforms that I mentioned help healthcare providers understand their own patients’ data better. These algorithms that I’m talking about – there are different kinds of algorithms. A lot of people talk about data science and AI. Well, AI can be utilized in a lot of places. And the way Coda utilizes AI, I would say, is more in the machine learning space. Where we are taking this data and we’re learning on not only how to better curate the data, but also how to better analyze the data so we can get the best outcomes. And so we are really building a robust and very flexible platform to help healthcare providers make these decisions. And we also employ data science technologies to structure the data and create meaningful insights. COTA actually has an additional piece of technology called the COTA Nodal Address, which is a more in-depth way to characterize patient populations. You can imagine sort of ICD-9 and -10 codes, but to a much more sophisticated degree. So this is a patented technology that COTA has that has been helping figure out not only what treatments best provide the best outcomes in patients, but also to figure out what payment - or how can we essentially pay for innovation? How can we actually say the value of this medicine is greater because it improves a patient’s life or extends the patient’s life as well. There are many other examples of this, these are just kind of the ones that COTA has that we are employing today. But of course, you might think about other technology pieces, like I said, wearables, and hardware, like for example, there are treatments through radiation, guided radiation, utilizing maybe linear accelerators. That is something that just came about in the last 15 years or so. Which is really trying to improve cancer research but also improving the care of the patient and extending lives.
Kathy: Now with this way that you are organizing and analyzing the data, have certain cancers benefitted from this method more than others? I’m just thinking about – is it the cancers that have a lot of people who have them just because you can extract a lot more from the data or are rare cancers benefitting as well?
Miruna: So I would say all cancers are benefitting. The reason I say that is because there’s a really great focus on understanding the patient. And understanding the patient’s journey. The reason that’s important is because if you don’t know what you need to do for that patient and in what direction that patient’s disease might develop, then you really can’t understand how to treat them. So in a lot of ways over the past ten years or so, as the real-world data revolution is happening, and more and more companies are getting into this space and utilizing real-world data to make decisions and to develop treatments, all cancers are benefitting. So what you’re seeing is an extension of life, and a bettering of quality of life for these patients, because more drugs are getting to the market. But specifically about COTA, we focus heavily in hematologic oncology. So I’d say multiple myeloma, diffuse large B cell lymphoma – which we call DLBCL – and maybe acute myeloid leukemia are just a few to mention that have really benefitted from this. Because now we have really large data sets in these patient populations that we can interrogate to look for signals about what treatments might work better and what treatments might be needed for these patients. We include things like biomarkers and genetic tests with this data, so you might be able to say this patient with this genetic makeup or this biomarker makeup may benefit from, say, a multiple treatment regimen that may look in a very specific way for that person. So I’d say one of the things I wanted to say to you when we started is we are one of two companies whose data was used on an approved regulatory decision. And that decision was in a transformational therapy in multiple myeloma. We hope to have many, many more of these wins, but at this point hematologic malignancies – or patients that have hematologic malignancies are starting to see a lot of benefits from aggregating this data and looking at their medical data to see how we can improve their lives and extend their lives.
Kathy: Now over the last couple of years we have focused so many of our healthcare resources on the pandemic. How was cancer care and research affected during this time?
Miruna: Oh goodness, there is so much I can say here, even though we have so much more to learn. There has been some research out there looking at cancer patient experience during the pandemic, as you know. But unfortunately, these – a lot of cancer patients are immuno-compromised, so they needed to take extra precautions during the pandemic. Which means that some of them may have missed treatments, or some of their diseases advanced a bit faster than we would like. But the pandemic also brought new ways to be seen by a doctor, and to push to sort of decentralize medicine and bring the treatment to the patient. Some patients have benefitted from this, because they can be seen by a physician with some sort of virtual environment like telemedicine. And someone can come to their home and draw blood or do their labs in their home. I would say overall we definitely need to figure out how to ensure that these treatments, and maybe not treatments – maybe interventions as a whole. Maybe it’s not all treatments, sometimes it can be, again like I just mentioned, a blood draw or a panel that needs to be done or some other intervention that may not be a treatment but also is looking at how is this patient doing overall? To bring that to the patient, especially as these patients can get pretty sick, so that they don’t have to travel to an academic medical center to do this. And I think through the COVID pandemic we’ve seen more of that because life had to go on. And these patients had to get treated. They had to get their bloodwork done. And they had to get these interventions. And unfortunately, because everything is slowed down some of them didn’t benefit from that, but the virtual environment which we’re forced into is really starting to hopefully develop a bit better so that we can treat these folks even when they’re really, really sick at home.
Kathy: And what are some of the lessons learned from the pandemic that you think will drive cancer innovation moving forward?
Miruna: So one thing that I think is really important is that as we saw things shut down, everything actually needed to continue. In the U.S. we’re actually really privileged in so many ways, and we had to open our minds to electronic means of everything. But the bottom line in cancer innovation is that we need to develop drugs for unmet needs, and we need to ensure that those treatments can be delivered to the patient. Not just through large institutions, but in any geography. And that goes in the U.S. and outside of the U.S. as well. Other countries are not as privileged as we are, so the fact that we’ve had access to digital everything is something that not everyone can say in the world. And some people don’t even have a phone or a computer and so on. So we have to figure out how do we get to those people? But I do think that this ecosystem we were talking about before can be worked to imbibe all aspects of what we’re learning from the pandemic to get to those patients. And that is the following: Real-world data, in terms of electronic medical records, and medical records in general, can help figure out where medical intervention is needed, and exactly what is needed. Then once that is known, there are new technologies that are helping drug developers and retailers figure out how to deploy their workforces to get these interventions to the patients ASAP. Now one element that we also need to talk about in terms of lessons is: our regulatory ecosystem is slow. They’re trying very hard to start looking at drugs that come to market sooner, and they are very much working on their process to push for faster approvals. So we need to continue that, but there’s not just the need from the regulatory system to do this, there’s also a need from the payer side to be able to adopt this. And that is to get that drug on formulary ASAP. And again, this can be done with data. So I do think, in terms of lessons that we have learned, is well – we said we can’t do it faster, we can’t do it faster. Yes, we can. We absolutely can. We proved it. And I can say that – with a million thanks to my colleagues at J and J, because when I was at J and J, we were developing the COVID-19 vaccine. And I’ve seen it happen, it’s gone through my hands – we didn’t sleep for almost a year, but it happened. So now why not apply it to cancer as well?
Kathy: That’s great. Now, let’s look ahead five years. What do you think will be the biggest change or step forward in cancer research?
Miruna: This is a really good question. Five years is one that I haven’t gotten before. I’ve had ten years, I’ve had twenty years…if I take a 20,000-foot view, I do think it’s worth stressing that in order to change cancer patient lives, we will have to continue to lean on innovative treatments to lengthen their lives, and improve their quality of life. To do that, I think we need to understand what they’re going through, through the data, as we’ve been talking about. And really not just data for the sake of data, but analyzing what they’re going through, what their medical journey is. What their story is. And if we have the ability to put that data into the hands of these decision-makers, medical decision-makers, as well as patients – patients need to decide what to do, right? And to really help them compare and contrast what other patients are benefitting from, I would say the adoption of data-driven strategies for the patient will be a huge win for everyone. But certainly most beneficial to the patient. So if I were to tell you the biggest change – if we could have everyone – even without regulatory pushes – adopt the idea that they need to rely on data to help them make decisions about how to treat a patient, and how to extend a patient’s life, I think that’s the number one thing that we can do in the next five years. Because the data is here. We can do this. And now it’s a matter of, do we want to?
Kathy: Well, great. Thank you, Miruna, this was a great conversation, and I think that the work that COTA is doing is so impactful. So thank you for coming on the podcast.
Miruna: Thank you so much, Kathy, it has been a pleasure.
Kathy: Thank you for joining me for this episode of the Smarter Healthcare Podcast. If you’d like to learn more about Miruna, you can follow her on Twitter @MirunaSasu. You can follow me on Twitter @ksucich or @smarthcpodcast. Feel free to get in touch with comments or guest suggestions.
To listen to more episodes, visit our website at www.smarthcpodcast.com or find us on your favorite podcast app. I’d appreciate if you would subscribe, rate, and review. Thanks for listening!
