AI enabled intervention increased real-world guideline compliant care: Improving genomic testing and cascade genetics for women with ovarian cancer (OC)

BackgroundNavya-AI is a clinically validated digital intervention that outputs patient-specific, evidence-based information; with 97% concordance between Navya-AI output and expert recommendations, and 80% adoption of recommendations by patients. Given high financial toxicity of suboptimal maintenance treatments in OC, use of AI to encourage optimal treatment has potential benefit. This study assesses the impact of Navya-AI in improving compliance to guidelines for genomic testing for women with OC in India; especially since generics for genomic testing and PARP inhibitors are cost effectively accessible in India.MethodsSince March 2022, genomic testing for BRCA1/2 and HRD has been a recommended guideline for stage III & IV OC by NCCN, ESMO, and NCG India. From March 2022 to March 2024, all women with OC who received a Navya-AI enabled review of their treatment plan were prospectively analyzed for concordance on genomic testing and precision care. Intervention with Navya AI was used to close any identified care gaps.ResultsOf 260 OC patients who received a Navya-AI review, 80% [209/260] met guideline criteria for genomic testing. Stage I/II [47], and rare histologies [4] were excluded. Women were diverse with respect to age (years) [0-35: 6%, 35-50: 30%, 51-65: 49%, >65: 15%]; stage [III 42%, IV: 58%]; family history of cancer: 24%. Genomic testing and precision care was planned for only 30% [63/209] of the patients. In the remaining 70% [146/209], digital intervention by Navya-AI including information on the risks/benefits of genomic testing, potential use of PARP inhibitors, importance of cascade genetics, and patient navigation to their treating oncologists enabled guidelines compliance.ConclusionsGuideline compliant care is a useful metric in tracking quality of care in gynecologic cancers, where wide care disparities exist. Positive findings on genomic testing in OC has a significant impact on progression-free survival and decreasing cancer burden. More than 60% of patients presenting to a nationally used digital health expert opinion service in India would have missed such critical testing. Through AI driven technologies, this disparity can be identified and closed, globally.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.