IC3

Background

Colon and rectal cancers (CRCs) are the third leading cause of cancer-related deaths in the United States and the third most common cancer in men and in women17. Worldwide, more than a million cases are diagnosed each year. Although these cancers have historically been common in western countries, they now are increasing rapidly in Asia and the Middle East. The recent rapid increase in rates of CRC in patients under 50 years of age is also alarming. With advancement in communication platforms, data sharing networks and advanced analytics now available, it is possible to study international patterns of cancer occurrence and treatment. Using multinational resources, superfast computing, artificial intelligence (AI), and a dedicated team of professionals with expert skills and intimate patient contact, the disease outcomes can be improved in treatment and care of CRC patients.

With this in mind, an international team of healthcare professionals formed a study group in 2016, dedicated to examining colon cancer on a global scale. The International Cooperative of Colorectal Cancer (IC3) pursues improvements in the prevention, treatment, and cure of colon and rectal cancers by studying the similarities and differences in therapies around the world and aims to lower health care costs in colorectal cancer therapies. Collaborators at Weill Cornell Medicine and MDEpiNet Coordinating Center are leading this effort to bring talents from multiple disciplines together. Since its founding, the IC3 collaborative has grown in number of researchers, nations, and continents represented. Currently, the IC3 team include participants from specialty hospitals in China, France, India, Japan, the Netherlands, Saudi Arabia, South Korea, Tanzania, Tunisia and the United States that form a consortium for multicenter prospective observational study comparing oncologic and clinical outcomes in surgery for colon cancer.

Objectives

The main objective of IC3 is to investigate and compare outcomes of cancer and use of technology in existing databases from each participating country. The secondary objective is to initiate primary data collection from leading institutions within each country to evaluate the devices, treatment methods, and outcomes. The third objective is to plan basic science research as well as cost-analysis studies that have the potential to improve outcomes and advance towards a cure for colon and rectal cancer.

Partnerships structure

The IC3 is an international collaborative that partners with the MDEpiNet Coordinating Center. IC3 is led by Jeffrey W. Milsom (Weill Cornell Medicine) with input from Art Sedrakyan and his team from the MDEpiNet Coordinating Center.

Existing Agreements
MDEpiNet Coordinating Center and IC3 have subcontract agreements with all entities under the protocol titled “Multicenter Prospective Observational Study Comparing Oncologic and Clinical Outcomes in Surgery for Colon Cancer in Specialty Hospitals”.

Data Infrastructure

Patient population
The patient population includes colorectal cancers patients from various countries around the world, including China, India, Tanzania, Japan, Tunisia, France, The Netherlands, Saudi Arabia, and South Korea.

Data sources
IC3 utilizes EHRs and registry data for its research projects, including records from its international partners like Japanese Society for Cancer of the Colon and Rectum (JSCCR) and the aforementioned hospital systems. Data-sharing agreements are underway for countries such as Korea University Anam Hospital and NIIT Medical Center in Tokyo.

Current Projects and Plans

IC3’s main ongoing studies include evaluating survival following CRC surgery in the US and Japan. The first three studies evaluated the 5-year survival after CRC surgery using US SEER cancer registry and Japanese registry data. US-based claims analysis was performed to evaluate the use and outcomes of bowel stenting in colorectal cancer patients as palliative treatment and as a bridge to surgery.

IC3’s current plan is to expand data infrastructure and data-sharing platforms internationally, using Research Electronic Data Capture (REDCap) or High-Performance Integrated Virtual environment (HIVE) for data capture. A meeting was held in May 2019 that trained coordinators and surgeons to use the REDCap app. The priority is to finalize REDCap data collection forms and finalize data sharing agreements.

The IC3 team is working to advance the international efforts and explore funding opportunities. The Cornell team is planning to run a survey among partner institutions to collect background information on colorectal cancer treatment in order to create an information sheet to be used for potential fundraising for IC3.