Flatiron Health announced that its international oncology research network has tripled in size across the UK, Germany, and Japan over the past year, marking what the company describes as "an unprecedented acceleration in global cancer research collaboration." The expansion brings the total number of partnerships to more than 30 across three countries outside the United States, with 23 new partnerships added in the last year alone.
The growth has pushed Flatiron's total patient database above 5 million records, of which 3 million are from the United States. The international expansion specifically targets the need for more diverse and representative real-world oncology data across different patient populations and healthcare systems.
Major Academic and Medical Center Partnerships
New partnerships include some of the largest university hospitals and national cancer centers in their respective countries. In the UK, Flatiron has partnered with Leeds Teaching Hospitals NHS Trust, University Hospitals of Leicester NHS Trust, and Newcastle Hospitals NHS Foundation Trust. German partnerships include Klinikum Stuttgart and cover 20 community sites and hospitals. Japanese collaborations encompass the National Cancer Center Hospital East, National Cancer Center Hospital, Nagoya University Hospital, Aichi Cancer Center Hospital, and Institute of Science Tokyo Hospital.
"The unprecedented expansion of our global network will continue to support 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, Chief Business Officer at Flatiron Health.
Addressing Global Data Diversity Challenges
The expansion addresses longstanding concerns from regulators and pharmaceutical companies about the lack of diverse representation in early cancer research datasets. Patients of color and those from impoverished countries were historically underrepresented, potentially limiting the effectiveness of precision medicine strategies across different populations. The FDA released draft guidance in June 2024 calling for "Diversity Action Plans" to address these challenges in future clinical trials.
Flatiron began pursuing international partners specifically to broaden the diversity of its data. A paper published in March by ESMO Real-World Data and Digital Oncology outlined the company's development of disease-specific datasets from the US, UK, Germany, and Japan using "a robust process for curating structured and unstructured EHR-derived data."
Research Platform and Methodology
Flatiron has completed seven research studies incorporating multinational real-world data within the past two years, powered by the company's Trusted Research Environment (TRE). The platform enables access to patient-level data at scale while maintaining local data control and compliance requirements.
"Flatiron is committed to building research cohorts that are reflective and representative of the real-world oncology populations and local care standards," said Hideaki Bando, MD, Chief of the Division of Drug and Diagnostic Development Promotion at National Cancer Center Hospital East. "Increased understanding of how different cancers impact different geographical areas is critical to generate robust evidence to inform targeted treatment strategies worldwide."
Global Consortium for Data Transportability
To address remaining gaps in global oncology data access, Flatiron established Flatiron FORUM (Fostering Oncology RWE Uses and Methods), a consortium bringing together biopharma and academic partners. The initiative focuses on validating the transportability of oncology data across borders and diverse healthcare systems, including countries beyond the current UK, Germany, and Japan network.
Through Flatiron FORUM, participants "co-develop concrete use cases, apply new methodologies, and rigorously validate the transportability of outcomes between regions and diverse healthcare systems," according to company officials. This collaborative approach aims to address critical challenges in regulatory science and access.
Clinical Impact and Future Applications
Prof. Geoff Hall, Professor of Cancer Medicine & Digital Health and Consultant Oncologist at Leeds Teaching Hospitals NHS Trust, noted that "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."
The expanded network supports research spanning from understanding standards of care and treatment patterns to informing health technology assessments and regulatory decisions. Company officials indicate that many countries outside the current network still lack access to locally available oncology datasets that are representative, methodologically sound, and recent enough for research needs.
Founded in 2012 and acquired by Roche in 2018, Flatiron Health uses deidentified patient data to create tools for investigators and oncology practices. The company maintains more than 280 partners in community oncology and 8 in academia in its US database, with 75% of US patient records coming from community oncology practices.
