科技是否萬能 大數據能夠戰勝癌症嗎

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There are more than 13 million people living with cancer in the United States, according to the National Cancer Institute, but researchers and doctors hoping to develop better treatments can only learn from a tiny percentage of them, according to Nat Turner.

據美國國家癌症研究所（National Cancer Institute）稱，全美癌症患者共有1300多萬人。但據奈特o特納說，那些希望能開發出更好治療方案的研究人員和醫生卻只能針對其中很小一部分人開展研究。

Along with Zach Weinberg, Turner is a co-founder ofFlatiron Health, a two-year-old healthcare technology company based in New York and best known for recently raising $130 million in an investment round led by Google Ventures GOOG -1.34% . Turner believes that his company’s “cloud-based data platform” for oncology can help gather data on a disease that affects 1 in 2 men and 1 in 3 women. Despite more than a million cancer diagnoses in the U.S. each year, the field lacks sufficient data to improve treatment of it, he said.

特納和扎克o維恩伯格都是Flatiron Health公司的聯合創始人。這家醫療保健技術公司位於紐約，成立纔剛兩年。最近它剛拿到谷歌風投（Google Ventures）領銜投資的1.3億美元，名噪一時。特納相信，他們公司打造的腫瘤學“雲數據平臺”可以幫助收集那些影響一半男性及三分之一女性的癌症相關數據。他說，儘管美國每年確診的癌症有上百萬例，但卻一直缺乏足夠的相關數據去改進癌症治療方案。

“In America, most of the learning that occurs in healthcare is in clinical trials,” Turner said. Yet a full 96 percent of patients do not participate. “It’s a huge problem: If 100 patients walk in the door, we’re only learning from four of them.”

他說：“在美國，絕大多數癌症治療經驗都來自於臨牀試驗。”但是高達96%的病人並不參加這類試驗。“這是個大問題，也就是說，100個進醫院的病人中只有4個人可以供我們深入研究。”

Information is certainly collected on the other 96%—but it is typically trapped in electronic medical records (EMR) systems and doctors’ notes, Turner said. “Our vision is to aggregate the data on that 96 percent, organize it, and make it usable by physicians, patients, and any of the stakeholders here,” he said. “Ultimately, we want to improve cancer care.”

另外96%的病人信息其實也有人收集——但特納稱，它們往往沉澱在電子病歷（EMR）系統和醫生筆記裏。“我們的目標就是收集這96%的病人的數據，重新整理，讓它們可以爲醫生、病人和其他利益相關者所用。說到底，我們是希望能提高癌症的治療水平。”

‘Their concern is longevity’

“谷歌想要的就是長生不老”

Flatiron’s OncologyCloud platform includes an analytics section, an EMR piece that comes courtesy of the company’s recent acquisition of Altos Solutions, a patient portal, and a billing portion. Together, the technologies provide what the company calls the world’s largest single source of structured real-world oncology data and intelligence. By enabling that data to be shared in HIPAA-compliant ways, Flatiron hopes it will accelerate personalized medicine and research.

Flatiron公司的腫瘤學雲平臺含有一個分析模塊，一個電子病歷模塊，這兩者是這家公司近期收購電子病歷系統公司Altos Solutions的成果。此外，它還有一個病人入口和計費系統。這些板塊和技術加起來就能提供這家公司所稱的全球最大的結構化真實腫瘤學數據和信息的單一來源。Flatiron希望，通過讓這些數據以符合健康保險便利及責任法案（HIPAA）的方式分享傳播，能促進個體化的用藥和研究。

The technology is now being used by between 1,500 and 2,000 clinicians and administrators at more than 200 cancer centers, Turner said.

特納表示，目前有200多家癌症中心的1,500到2,000位臨牀醫生和管理人員已經在使用這一技術。

With $138 million raised so far, the company clearly has clearly captured investors’ attention. Flatiron’s $130 million Series B is the fourth-largest round in which Google Ventures has participated and is its largest medical software deal to date. (The firm also participated in Flatiron’s Series A round.)

這家公司迄今已經募得1.38億美元，顯然早已成爲投資者追捧的對象。它的1.3億美元B輪融資是谷歌風投第四大參投項目，也是其迄今爲止規模最大的醫藥軟件投資（谷歌風投也參投了Flatiron的A輪融資。）

Google’s interest in a healthcare company is not that surprising. Last fall, it announced Calico, an effort focused on health and well-being, and its venture arm has investments in Foundation Medicine andDNAnexus. (Google Ventures did not respond to a request for comment.)

谷歌公司對醫療保健公司的投資興趣完全在人們意料之中。這家公司去年秋天宣佈成立Calico公司，致力於拓展健康領域的研究；同時，它的風投部門也已投資了Foundation Medicine和DNAnexus（對此谷歌風投沒有迴應置評的要求）。

“Google’s concern is longevity,” said Skip Snow, a senior analyst for healthcare with Forrester Research. “They believe the relationship they want to have with healthcare is a longevity play—how do we help people live longer, healthier lives?”

弗雷斯特研究公司（Forrester Research）資深分析師斯基普o斯諾說：“谷歌想要的是長生不老。他們深信自己介入醫療保健領域就是爲了追求長壽——怎麼幫助人們活得更長久、更健康？”

‘How are you possibly going to keep up?’

“怎麼可能與時俱進？”

“We have worked with Nat and Zach before, having funded their last company Invite Media, and given their track record, we wanted to be involved in their next venture,” said Josh Kopelman, a partner withFirst Round Capital, which also participated in both of Flatiron Health’s funding rounds.

首輪資本公司（First Round Capital）合夥人喬什o科普曼說：“我們以前就和奈特及扎克合作過，也投資了他們上一個公司Invite Media。正是考慮到他們的一貫表現，我們決定投資他們現在的企業。”它也參與了Flatiron Health的兩輪融資。

“The fact that they’re going after solving a problem that will have major impact in cancer care is hugely important and made it even more compelling for us to be involved,” Kopelman added. “It’s pretty rare to have a team like the one they’re building go after this kind of idea.”

科普曼補充說：“他們致力要解決的問題將對癌症治療產生重大影響，這一點十分重要，也讓我們產生了更強烈的投資興趣。他們目前組建起來攻克這個難題的團隊十分少有。”

There is a “seismic shift” happening toward evidence-based medicine, Snow said. “The number of possibilities for what a doctor should do about a health problem is getting unmanageable, he said, “especially in cancer, which is very complex.”

斯諾稱，循證醫學目前正發生着翻天覆地的變化。他說：“一個醫生現在針對某個健康問題所能採取的治療方案太多了，數量之大變得難以管理，尤其是癌症，因爲這個領域十分複雜。”

Further complicating the process is the fact that so many cancer drugs in the pipeline are biomarked, Snow added, meaning that they are tailored to physiologically impact only certain groups of people, rather than the entire population.

斯諾還稱，使治療更趨複雜的問題是，目前渠道在售的很多癌症治療藥物都做過生物標記。這就意味着，它們都是度身定製，只對特定人羣、而不是所有人有效。

“If you’re an oncologist practicing in a community hospital in Nebraska, how are you possibly going to keep up with all that?” Snow said.

斯諾說：“如果你只是個內布拉斯加州社區醫院的腫瘤醫生，怎麼可能跟得上這些發展呢？”

On the other hand, Flatiron’s “96 percent” statistic is “very deceiving,” Snow said. Most clinical trials won’t accept patients in the early stages of cancer, and even if they do, they typically are looking for a relatively uncommon form of the disease, he said.

而另一方面，斯諾表示，Flatiron公司所謂的“96%”數據也“很唬人”。因爲絕大多數臨牀試驗都不會接受早期癌症病人，就算接受，一般也是找那些不太常見的癌症。

“Not every cancer victim is a candidate for clinical trials,” Snow said. “The fact that four percent participate is not a very meaningful statistic.”

斯諾說：“不是每位癌症患者都適合參加臨牀試驗。所謂的4%參與率不是個很有意義的統計數據。”

Compounding the problem: Cancer victims typically don’t know which trials they’re eligible to be in, Snow said. “Even a doctor at Memorial Sloan Kettering may not know what’s going on at Stanford,” he said.

使問題更趨複雜的是：癌症患者一般並不知道自己適合參加哪些臨牀試驗，斯諾稱。“就算是斯隆o凱特靈紀念中心（Memorial Sloan Kettering，紐約著名癌症治療中心——譯註）的醫生可能也不知道斯坦福大學（Stanford）的研究進展。”

Flatiron’s technology alerts physicians when their patients are eligible for a particular trial, Turner said.

而特納稱，Flatiron的技術可以在病人適合參加特定試驗時通知主治醫師。

‘The Lexis-Nexis of cancer’

“癌症領域的超級數據庫”

Large cancer institutes such as Sloan Kettering and Mt. Sinai’s Icahn Institute are in many ways trying to do the same thing as Flatiron with their own sets of data. Those institutions are considered to have more expertise to deal with the data; Flatiron’s fundamental position is that the use of only one institution’s data, however large, is insufficient to fully address the problem.

像斯隆o凱特靈和西奈山伊坎研究院（Mt. Sinai’s Icahn Institute）這樣的大型癌症研究機構也在很多方面想利用自己的數據積累開展和Flatiron一樣的業務。人們認爲這類機構有更多懂得數據處理的專家，而Flatiron的主要問題是它只能用一個機構的數據。不管這個數據量有多大，都不足以解決問題。

It’s the same issue at hand with exploiting electronic medical records overall, said Alan Louie, research director with IDC’s Health Insights group.

IDC公司Health Insights集團的研究總監阿蘭o路易稱，要深入研究所有電子病歷也存在這個問題。

“The fact that you have the data all in one place is one thing, but whether you can make it usable effectively is another,” Louie said. “You have to really combine the bioinformatics with a knowledge of cancer and the manifestation of the disease.”

路易稱：“把所有數據集中到一起是一回事，能否有效利用它們卻是另外一回事。必須能把生物信息學和對癌症及症狀的深入瞭解結合起來才行。”

The large cancer institutes may have more limited data sets, given that they don’t aggregate data from a variety of sources the way Flatiron does, “but I’d argue the researchers there may be more aware of the subtleties of genomics and probably can analyze the data more effectively,” he said.

大型癌症研究機構可能數據量相對有限，因爲它們沒法像Flatiron那樣從多種渠道收集數據，他說：“但我認爲這些機構的研究人員可能更懂得深奧的基因組學，也可能更有效地分析數據。”

There are other EMR systems that Flatiron competes with, Turner says, such as Epic. But for analytics, “I honestly haven’t seen too many,” he said. “Maybe Microsoft Excel.”

特納稱，在電子病歷系統上Flatiron公司也是有對手的，如Epic。但就這些病歷的分析來說，他表示：“我還真沒看到多少對手，也許微軟公司（Microsoft）的Excel算一個。”

IBM is also a player, but “they’re very geared toward the top one percent and focused on decision support,” Turner said. The American Society of Clinical Oncology’s CancerLinQ is another.

IBM公司同樣也是對手之一，但“它們主要致力於爲1%的客戶服務，並專攻決策支持，”特納稱。而美國臨牀腫瘤協會（American Society of Clinical Oncology）的CancerLinQ算另一個。

Forrester’s Snow saw it differently. “Flatiron is more like an information service provider and less like a Sloan Kettering or Icahn,” he said. “The Sloan Ketterings and Icahns are saying, ‘We are the centers of excellence, the creators of the protocols and the content, and we will sell you the license to have access to our model of excellence.’ “

不過斯諾的看法有所不同。他說：“Flatiron更像是個信息服務提供商，而不像斯隆o凱特靈和伊坎這類專業研究機構。而斯隆o凱特靈和伊坎會說‘我們是專業卓越的中心，行業標準的起草者，我們爲您提供授權，使您也能用上我們的卓越模式。’”

Flatiron, on the other hand, “wants to be the Lexis-Nexis of cancer,” Snow said. “Aggregate the data, store it, and license it to the community with tools so you can ask the questions you need to ask.”

而另一方面，斯諾表示，Flatiron的目標是“在癌症研究領域成爲像Lexis-Nexis（美國頂級商業與法律數據庫——譯註）一樣的頂級數據庫。它主要業務就是收集數據、存儲數據，再將數據和相關工具授權給相關研究機構，使其能諮詢相關問題。”

Which means the company is better suited to compete with Bloomberg, Lexis-Nexis (owned by Reed Elsevier), IMS Health, and Thompson-Reuters rather than organizations trusted on the subject on cancer like Sloan Kettering.

這意味着這家公司更覈實的競爭對手是彭博社（Bloomberg）、Lexis-Nexis【隸屬於裏德愛思唯爾集團（Reed Elsevier）】，IMS Health和湯普森路透（Thompson-Reuters），而不是斯隆o凱特靈這類專攻癌症研究的機構。

“I think they absolutely can succeed against those who sell information as a service,” Snow said. “That’s the landscape they can prevail in, and that’s the landscape where the incumbents are moving slowly, especially in health.”

斯諾稱：“我想該公司肯定能勝過那些信息銷售服務商。這將是他們能縱橫馳騁的領域，而目前這個領域的巨頭進展緩慢，尤其是在醫療健康領域。”

“Flatiron’s trick is they’re little, nimble, and smart,” he said, “and with $100 million, they can probably recruit good talent.” Which is exactly what Turner said he plans to do.

他說：“Flatiron的優勢在於他們規模不大，聰明靈活。有了這一個億，他們可能還能招到更出色的人才。”而這正是特納的計劃。