In Data Race, Flatiron Health Touts Tripling of Global Oncology Research Network

Flatiron Health, a leading provider of cancer technology and data services, today shared data on the explosive growth of its international oncology research network over the past year, with partnerships now numbering more than 30 in 3 countries outside the US.

The international network has taken off, tripling its growth "both in terms of the number of partners and the volume of patient records available for research across the UK, Germany, and Japan," officials said in an email to The American Journal of Managed Care. Flatiron has increased the number of partnerships by 23 just in the last year, they said. Partners include academic medical centers, hospitals, universities, and community sites.

"In each country, our teams have established new partnerships that reflect their unique oncology landscape—bringing together leading academic medical centers, national cancer centers, and community hospitals and clinics," officials said.

New partnerships include some of the largest university hospitals and national cancer centers in their respective countries, with German partnerships covering 20 community sites and hospitals.

"This expansion enables us to generate more robust, representative real-world data across a diverse range of care settings and patient populations, furthering our mission to transform cancer care globally," they said.

The growth brings the total number of patient records in Flatiron's database above 5 million, of which 3 million are from the United States, according to information from Flatiron officials and the company website.

Founded in 2012 and acquired by Roche in 2018, Flatiron uses deidentified patient data to create tools for investigators and oncology practices to aid clinical decision-making, measure quality, and understand patient outcomes. Well known in the US for its oncology-focused electronic health record (EHR) system, OncoEMR, the company has more than 280 partners in community oncology and 8 in academia in its US database; 75% of patient records from the US are from community oncology practices, according to the website.

Over the past 5 years, company officials said, Flatiron has lined up international partners that include:

• In the UK, Leeds Teaching Hospitals NHS Trust, University Hospitals of Leicester NHS Trust, and Newcastle Hospitals NHS Foundation Trust
• In Germany, Klinikum Stuttgart
• In Japan, the National Cancer Center Hospital East, National Cancer Center Hospital, Nagoya University Hospital, and Aichi Cancer Center Hospital.

"The unprecedented expansion of our global network has supported improvements to local cancer patients’ care and novel multinational research—fundamentally changing what’s possible for our partners and the patients they serve," said Nathan Hubbard, MBA, chief business officer at Flatiron Health, in a statement. “Our partners are already unlocking answers to complex research questions—answers that traditional data sources can’t support. By leveraging this expanded real-world evidence, which spans from understanding standards of care and treatment patterns to informing [health technology assessment] and regulatory decisions, this momentum is improving cancer care for patients worldwide.”

Today’s announcement comes as health care technology companies—including Flatiron—embrace the potential of artificial intelligence (AI) to bring the use of real-world data to a new level. Growth of AI is creating new predictive possibilities in both cancer research and bedside precision medicine; in the future, physicians will use technology to predict how individual patients will respond to different treatment options. Just this month, Flatiron investigators presented research on the use of large language models (LLMs) to extract real-world cancer progression events at a special conference on AI presented by the American Association for Cancer Research in Montreal, Canada.

Flatiron data are regularly the centerpiece or a component of abstracts at major oncology conferences. In today’s announcement, the company touted 7 recent studies using multinational real-world data on its Trusted Research Environment (TRE), described as “a secure platform that enables access to patient-level data at scale.”

Development of a Global Dataset

Over the past decade, both regulators and pharma companies have expressed concerns that early data sets used in research were generated with patient data that did not represent the diverse nature of cancer globally. In particular, patients of color and those from impoverished countries were not well represented. This problem meant that precision medicine strategies, including use of therapies that target specific mutations, might not be as effective in some patients. In June 2024, the FDA released a draft guidance calling on pharma companies to develop “Diversity Action Plans” to address this challenge in future clinical trials.

With this in mind, Flatiron began pursuing international partners to broaden the diversity of its data. A paper published in March by ESMO Real-World Data and Digital Oncology, a journal of the European Society for Medical Oncology, outlined Flatiron’s development of its dataset with disease-specific information from the US, UK, Germany, and Japan, using a “robust process for curating structured and unstructured EHR-derived data.”¹

Today's statement notes that “many countries outside the UK, Germany, and Japan still lack access to locally available oncology datasets that are representative, methodologically sound, and recent enough for research needs.”

In response, the company created the Flatiron FORUM (Fostering Oncology RWE Uses and Methods), a consortium of members from both academia and pharma to share oncology EHR data globally. In their statement, company officials said partners in the Flatiron FORUM “co-develop concrete use cases, apply new methodologies, and rigorously validate the transportability of outcomes between regions and diverse healthcare systems—including countries beyond the UK, Germany, Japan.”

Global partners from the UK and Japan praised efforts to generate more diverse datasets.

“Flatiron is committed to building research cohorts that are reflective and representative of the real-world oncology populations and local care standards,” Hideaki Bando, MD, chief, Division of Drug and Diagnostic Development Promotion at National Cancer Center Hospital East, said in the statement. “Increased understanding of how different cancers impact different geographical areas is critical to generate robust evidence to inform targeted treatment strategies worldwide.”

“Flatiron’s real-world data is a powerful complement to the UK’s cancer registries, adding new clinical depth and recency that help fill critical evidence gaps,” said Geoff Hall, professor of Cancer Medicine & Digital Health and consultant oncologist at Leeds Teaching Hospitals NHS Trust. “Through the combined strength of Flatiron's global oncology research network and Flatiron FORUM, we are unlocking richer insights for both local innovation and multinational research—ultimately supporting more informed clinical breakthroughs, regulatory decisions, and better outcomes for patients across the UK and worldwide.”

Reference

Adamson B, Horne E, Xu C, et al. Characterisation of oncology EHR-derived real-world data in the UK, Germany, and Japan. ESMO Real World Data Digital Oncol. 2025;7:100113. doi:10.1016/j.esmorw.2025.100113