Memorial Sloan Kettering Cancer Center, IBM to Collaborate in

Applying Watson Technology to Help Oncologists

New York, NY, Thursday, March 22, 2012
https://www.mskcc.org/news-releases/mskcc-ibm-collaborate-applying-watson-technology-
help-oncologists

A team of physicians and analysts at Memorial Sloan Kettering has been “training” IBM Watson
for more than a year to develop a tool that can help medical professionals choose the best
treatment plans for individual cancer patients.
Video Details 

Memorial Sloan Kettering Cancer Center (MSKCC) and IBM (NYSE: IBM) have agreed to
collaborate on the development of a powerful tool built upon IBM Watson in order to
provide  medical professionals with improved access to current and comprehensive cancer
data and practices. The resulting decision support tool will help doctors everywhere create
individualized cancer diagnostic and treatment and recommendations for their patients based
on current evidence.

The initiative will combine the computational power of IBM Watson and its natural language
processing ability with MSKCC’s clinical knowledge, existing molecular and genomic data
and vast repository of cancer case histories, in order to create an outcome and evidence-based
decision support system. The goal is to give oncologists located anywhere the ability to
obtain detailed diagnostic and treatment options based on updated research that will help
them decide how best to care for an individual patient.

The IBM Watson system gained fame by beating human contestants on the television quiz
show Jeopardy! It can interpret queries in natural language and uses statistical analysis,
advanced analytics and a powerful array of processors to search millions of pages in seconds
and deliver evidence-based statistically-ranked responses.

MSKCC’s world-renowned oncologists will assist in developing IBM Watson to use a

patient’s medical information and synthesize a vast array of continuously updated and vetted
treatment guidelines, published research and insights gleaned from the deep experience of
MSKCC clinicians to provide an individualized recommendation to physicians. The tool will
also provide users with a detailed record of the data and evidence used to reach the
recommendations.

The need for such an advanced technology arises from the steadily increasing complexity of
oncology treatment. Cancers are the second most common cause of death in the U.S., second
only to heart disease, and the American Cancer Society projects that 1.6 million new cancer
cases will be diagnosed in the U.S. this year* with outcomes varying widely across the
country. Cancer is not one disease but some hundreds of sub-types, each with a different
genetic fingerprint. Significant discoveries in molecular biology and genetics in the past two
decades have delivered new insights into cancer biology and strategies for targeting specific
molecular alterations in tumors, but these advances have also ratcheted up the complexity of
diagnosing and treating each case. Oncologists and physicians who do not specialize in
specific sub-types of cancer face a significant challenge in keeping up with the magnitude of
rapidly changing information.
 “The combination of transformational technologies found in Watson with our cancer
analytics and decision-making process has the potential to revolutionize the accessibility of
information for the treatment of cancer in communities across the country and around the
world,” said MSKCC President and CEO Craig B. Thompson. “Consistent with our mission,
the vision is to help better identify and personalize cancer therapies for each individual
patient, no matter where that patient may be receiving care. We also expect tremendous new
research opportunities to emerge from this collaboration.”

Infographic: Advancing the Future of Personalized Cancer Care

“Memorial Sloan Kettering’s evidence-based clinical approach, scientific acumen, and vast
database make it the ideal partner in this ambitious project,” said Dr. Martin Kohn, chief
medical scientist, IBM. “Cancer care is profoundly complex with continuous clinical and
scientific advancements to consider. This field of clinical information, given its importance
on both a human and economic level, is exactly the type of grand challenge IBM Watson can
help address.”

“This comprehensive, evidence-based approach will profoundly enhance cancer care by

accelerating the dissemination of practice-changing research at an unprecedented pace,”
said Dr. Mark G. Kris, Chief, Thoracic Oncology Service at MSKCC and one of the
clinicians leading the development effort. He noted that 85% of patients with cancer are not
treated at specialized medical centers and it can take years for the latest developments in
oncology to reach all practice settings.

Development work is already underway for the first applications, which include lung, breast
and prostate cancers. The objective is to begin piloting the solutions to a select group of
oncologists in late 2012, with wider distribution planned for late 2013. This collaboration
complements an earlier announcement by IBM and WellPoint that the parties will focus on
putting Watson to work on oncology solutions.
The future of cancer treatment and research: What IBM
Watson means for our patients
BY LAURA NATHAN-GARNER

HTTPS://WWW.MDANDERSON.ORG/CANCERWISE/WHAT-IBM-WATSON-MEANS-FOR-OUR-
PATIENTS.H00-158834379.HTML

At MD Anderson, we're constantly looking for innovative new ways to provide the best
possible cancer treatment options for our patients as we work toward our mission of
Making Cancer History®.

To help with this, we've enlisted a cognitive computing system powered by IBM Watson.
This technology, known as Oncology Expert Advisor™ (OEA), will soon be used by our
doctors and researchers as part of our Moon Shots Program, starting with our fight
against leukemia.

Ultimately, we hope to use the OEA in all of our clinics to help our patients regardless of
their cancer type. By pulling together and analyzing vast amounts of information from
patient and research databases, the OEA is expected to help our care teams identify and
fine-tune the best possible cancer treatments for our patients, while also alerting them to
problems that arise during a patient's care.

The OEA is also expected to help our researchers advance new discoveries in our fight
against cancer.

We recently spoke with Courtney DiNardo, M.D., assistant professor in Leukemia, who's

been testing the OEA before it debuts in our leukemia clinic. Here's what she had to say.

What are the benefits of using the OEA to organize and collect data about our
patients?
The OEA can extract patient information from various data sources and synthesize all
available medical records into a clear, concise and accurate synopsis. It can analyze
clinical information, medical history, as well as leukemia-related information, such as
specific genetic and molecular features, and look at all available information in the
context of published evidence-based guidelines and available clinical trials.

The OEA also allows us to look at changes in a patient's condition over time, enabling us
to learn a wealth of information within seconds and answer complex medical questions
with speed, accuracy and confidence. This has an enormous potential to help us make
the best cancer treatment decisions for our patients and the best research decisions that
can help us make progress in our fight against cancer.

What does the use of the OEA mean for the future of personalized medicine?
The OEA enables us to provide better, more personalized care through accurate and
evidence-based treatment recommendations based upon a specific patient's
characteristics as well as his or her leukemia-specific characteristics. The OEA also can
help doctors identify the best cancer treatment for a particular patient by identifying both
the standard treatment options and clinical trials for which a patient is eligible. 

Additionally, by following a patient over time along with the physician, the OEA helps
minimize potential adverse events and optimize management of the patient's care at all
times.

How - and how soon - will the OEA change cancer treatment here at MD
Anderson?
The OEA is currently in the testing and evaluation stage in MD Anderson's Department
of Leukemia. The actual timeline of when this will be available to our leukemia patients
and then expanded to patients with other types of cancer is not currently known.

We're hoping that soon, various medical providers, including physicians, mid-level
providers and research teams, will soon be able to use it to assimilate complex and ever-
expanding genomic data and published scientific research. The OEA then integrates this
information with patient data to provide insights and helps us select the best cancer
treatment for each and every patient.

What does the OEA mean for cancer care beyond MD Anderson?
The OEA has the potential to "democratize" cancer care, meaning that any physician
with Internet access will be able to access the latest scientific knowledge and MD
Anderson's expertise.

For physicians who aren't leukemia experts, the OEA can function as an expert second
opinion, allowing them to access the same knowledge and information we have here.
This will enable doctors even in remote areas to provide the highest standard of care to
patients who can't travel to Houston for their cancer treatment.

As a doctor, what do you consider the OEA's greatest potential?

The ability to integrate patient level data such as additional medical history, medications, 
alongside cancer genomics, as well as cancer therapy received and responses, side
effects, etc., will provide an unparalleled research platform that can be used to generate
questions, explore hypotheses and provide answers to critical research questions.

For example, the OEA will also enable us to analyze why certain patients respond to
certain cancer treatments and why particular patients experience certain side effects,
using a research platform that is currently not available. This gives us the potential to
really learn from the vast amount of information we currently have, and use it to advance
cancer research and to benefit each individual patient. I'm excited about the possibilities
for accelerating new research and providing the most effective treatments and cures for
our patients.
IBM Struggles to Turn Watson Computer Into Big
Business
Revenue Is Far From Company's Ambitious Targets
 

Spencer E. Ante
Updated Jan. 7, 2014 9:16 pm ET
https://www.wsj.com/articles/SB10001424052702304887104579306881917668654
Three years after International Business Machines Corp. IBM   -4.64%   began trying to turn
its "Jeopardy"-winning computer into a big business, revenue from Watson is far from the
company's ambitious targets.
IBM Chief Executive Virginia "Ginni" Rometty has told executives she hopes Watson will
generate $10 billion in annual revenue within 10 years, according to an October 2013
conference-call transcript reviewed by The Wall Street Journal. She set that target after the
executive in charge of Watson said its business plan would bring in $1 billion of revenue a
year by 2018. That would make Watson the fastest IBM business unit to reach the $1 billion
milestone.
But Watson had total revenue of less than $100 million as of late October, according to the
transcript. One of its first big projects, with the University of Texas M.D. Anderson Cancer
Center, was "in a ditch" in early 2013, said Manoj Saxena, the executive overseeing Watson.
IBM executives still believe Watson could become one of the biggest innovations in the
company's 103-year history, alongside the mainframe and personal computer. In a sign of
Watson's potential, IBM plans a major announcement about the business Thursday, said a
person familiar with the matter.
"Watson has rapidly moved from an industry-first research initiative to a commercial reality"
that tackles business and social problems, an IBM spokesman said. "IBM is making excellent
progress with clients and with partners in advancing Watson, and we are excited about
Watson's future as a cloud service and as technology that will change lives." Watson also
helps IBM sell other technology as customers prepare to use the supercomputer.
During an internal conference call in May, Mr. Saxena said he would "probably" give the
Watson team a grade of B+.
Watson's key distinction from other analytical software is its ability to "learn." Feed it
medical cases, and Watson will rank possible treatments by "confidence score." During
training, doctors tell Watson when it makes a bad recommendation, and the supercomputer
learns from its mistakes.
IBM is developing versions of Watson that can match cancer patients to clinical drug trials or
recommend an investment strategy after reviewing a customer's portfolio.
Watson is having more trouble solving real-life problems than "Jeopardy" questions,
according to a review of internal IBM documents and interviews with Watson's first
customers.
For example, Watson's basic learning process requires IBM engineers to master the
technicalities of a customer's business—and translate those requirements into usable
software. The process has been arduous.
In addition, Watson doesn't work with the data-center technology offered by SoftLayer
Technologies Inc., the cloud-computing provider IBM acquired for $2 billion. IBM also
hasn't figured out how to generate a reliable revenue stream from Watson, according to the
October conference call.
Citigroup Inc. has been collaborating with IBM since March 2012 to develop a version of
Watson that can recommend financial products to consumers. It hasn't been launched yet. A
Citigroup spokeswoman said the bank is "continuing to identify and test uses for Watson."
So far, just a handful of customers are using Watson in their daily business. With the
supercomputer's help, health insurer WellPoint Inc. determines if doctors' requested
treatments meet company guidelines and a patient's insurance policy. Elizabeth Bigham, a
WellPoint vice president, said Watson initially took too long to "learn" WellPoint's policies.
Ms. Rometty, IBM's chief executive, met with WellPoint CEO Joseph Swedish to help
resolve the problems. IBM reworked Watson's training regimen at WellPoint's request, and
the system improved. "It has become part of the way we do business," Ms. Bigham said.
Two years ago, doctors at M.D. Anderson began working with IBM to build a version of
Watson that would recommend leukemia treatments by mining medical literature.
After the initial stumbles, Anderson and IBM officials said the project is back on track.
Lynda Chin, M.D. Anderson's chairwoman of genomic medicine, says the leukemia-
treatment adviser could be used later this year. It might be two more years before Watson
could handle other types of cancer.
IBM began exploring Watson's commercial potential before the computer beat two
"Jeopardy" champions on live television in 2011. The company is looking to revive growth
and modernize an aging technology portfolio.
Under former CEO Samuel Palmisano, IBM routinely met Wall Street's financial
expectations. Since Ms. Rometty took over in early 2012, IBM has stumbled more often as
new technologies threaten some of its lucrative franchises. IBM shares have lagged behind
the overall stock market.
"They need to have something special and they are hoping [Watson] is it," says Stephen
Baker, author of "Final Jeopardy," a book about the making of Watson. Rivals like Google
Inc. could threaten IBM with "tools within shouting range" of Watson that give customers
most of what they need at much lower cost, he added.
IBM's biggest bets are in health care, where it believes Watson can improve care and lower
costs by identifying the best treatment option from thousands of academic studies and
millions of patient records.
In 2012, Memorial Sloan-Kettering Cancer Center in New York began work on an adviser to
recommend cancer treatments. Dr. Mark Kris, a Sloan-Kettering oncologist, said an early
version of the Watson tool could be used on patients later this year if it passes tests.
At his office, he pulled out an iPad and showed a screen from Watson that listed three
potential treatments. Watson was less than 32% confident that any of them were correct. "Just
like cancer, it is much more complex than we thought," Dr. Kris said.
IBM's deal with M.D. Anderson last year is the largest Watson deal, valued at nearly $15
million. IBM executives hope it could grow to $100 million.
The project initially ran awry because IBM's engineers and Anderson's doctors didn't
understand each other. IBM's developers worked elsewhere and only visited Houston every
few weeks to talk to doctors.
Last spring, Dr. Chin and Watson's chief technology officer, began to meet at least once a
week. IBM developers now meet with doctors several times a week. "We all found it painful,
but the product is much better now," said Dr. Chin.
M.D. Anderson is working on its broader version of Watson and hopes to have it done within
18 to 24 months.