A Conversation With
George A. Komatsoulis, Ph.D.
NCI Cancer Biomedical Informatics Grid® (caBIG®)
Q: What is caBIG® and what is your role in this NCI program?
NCI’s Cancer Biomedical Informatics Grid® (caBIG®)(https://cabig.nci.nih. gov/) enables the implementation of molecular medicine by creating a world wide web of cancer research; a virtual network of interconnected data, individuals, and organizations that redefines how research is conducted, care is provided, and patients/participants interact with the biomedical research enterprise. The caBIG program brings cancer researchers together by supporting communities, providing access to content and enabling connectivity. caBIG® is a federation; data is managed by the organizations that generate it with the caBIG® interoperability infrastructure (called caGrid) enabling data sharing to authorized individuals both within and between organizations.
We build caBIG® tools to support the needs of cancer researchers. These needs were identified through a series of outreach activities in the cancer research community that began in 2003. We continue to engage the community through a series of “workspaces”- groups that meet regularly by teleconference and face-to-face to discuss needs in particular research domains. There are four of these “domain” workspaces: Integrative Cancer Research, Tissue Banks and Pathology Tools, Clinical Trials Management Systems and in vivo Imaging. In addition we have what are known as “cross cutting” and “strategic” workspaces that deal with semantics, interoperability infrastructure, training and data sharing and intellectual capital.
To date, we have built 78 tools to support various areas of research including microarray management and analysis, proteomics, nanotechnology, storage, annotation and analysis of images, and biobanking software. We’ve also made investments in the area of clinical trials software by developing a Clinical Trials Management Suite that includes a patient registration module, an adverse event module, a laboratory integration hub and a study calendar. All of these tools are designed to be interoperable using caBIG® infrastructure.
The director of caBIG® is Kenneth Buetow, Ph.D., who is also director of the NCI Center for Bioinformatics and Information Technology (CBIIT). I support Dr. Buetow as the Deputy Director of CBIIT. In this role, I have fairly broad management responsibilities over the caBIG® program and represent it in a variety of settings.
Q: Do you think cancer research on complementary and alternative medicine (CAM) is different than conventional medicine research and does it have different data sharing needs?
I don’t think that CAM research is fundamentally different than conventional medical research. All of the caBIG tools are as applicable to CAM investigations, and I believe that CAM researchers have the same needs to integrate information or collaborate with others.
The difference between CAM and more conventional researchers is that a big part of caBIG® is usage of data standards, controlled biomedical terminologies and data elements to describe the data you’re collecting. For the more conventional clinical trials, we have many standards, data elements and terminologies already available to support research in those areas.
One of the things we hope to do in working with CAM partners is to help them devise the standards and terminologies that are needed in CAM research. For example, we are in the process of registering the questions from the Ayurveda extension to our registration module; once there, they are available to other trials.
With that said, many of the assessments that are going to be done in a CAM clinical trial are ultimately going to be the same as for conventional treatments. The same laboratory values, outcomes measures, and patient demographic data are going to need to be collected. Where we’re catching up in is in the area of getting good descriptors for the CAM treatment regimens and getting the CAM compounds appropriately characterized. Ultimately, after the first CAM trial is done using caBIG® tools, the next CAM study will be able to use the content from the first trial.
We’re looking to engage the CAM community so that what we build and create for caBIG® is usable and accessible to them as much as it is for conventional cancer research. For any CAM researchers who have questions about caBIG®, we’re happy to sit down and talk to them about the capabilities that we can create, so they can make a decision as to whether or not caBIG® technology is something that is useful for them and their work.
Q: Could you provide an example of some CAM research studies using caBIG® tools?
A private company in India, BioMantra, that supports research from the Department of AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopath) of the Indian Ministry of Health and Family Welfare, has taken some caBIG® technologies and adapted them to support research into traditional Ayurvedic medicine. They used the caBIG® Clinical Trials Suite and found that when they register patients into these trials, there was some additional information they wanted to have in the caBIG® patient registration module. They therefore took the module and extended it to support a set of questions that support the kinds of information you would want on a patient treated with Aryuvedic medicine.
This modified caBIG® system is now being offered to participant institutions in India for use as they perform clinical trials. It is quite exciting because we have wanted researchers to take caBIG® technology, modify it for their own specific purposes – in this case for CAM trials – and then move forward to provide those capabilities to their research communities. Further, this is another step toward assessing traditional products and practices in a manner consistent with the standards used to assess standard medical practice.
We’re hoping to see other groups take our technology and where it makes sense, turn it into a commercial or non-commercial product supports specialized communities. Because the caBIG® tools start out as free, open source software, these groups can develop tools that they can more easily offer free, or at a reduced price.
Q: Have you received specific requests and inquiries about caBIG® from CAM researchers?
In addition to the projects in India I mentioned, we have some early phase discussions going on with some groups in China, and we’re also working with OCCAM right now to identify opportunities for use of caBIG® technologies for CAM research projects. Frankly, one of the reasons we’ve been having discussions with the CAM community is because we think that caBIG® tools have a particular value for CAM research. CAM researchers may not have the same level of funding as industrysponsored studies and because caBIG® software is free, it represents an opportunity for researchers to gain access to a world-class, productiongrade clinical trial and genomics research infrastructure.