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4. Metabolic Dysregulation Explains the Diverse Impacts of Obesity in Males and Females with Gastrointestinal Cancers.

Author

Rosario, Spencer, Dong, Bowen, Zhang, Yali, Hsiao, Hua-Hsin, Isenhart, Emily, Wang, Jianmin, Siegel, Erin, Owen, Dwight, Dey, Prasenjit, Tabung, Fred, Spakowicz, Daniel, Edge, Stephen, Yendamuri, Sai, Ibrahimi, Sami, Kolesar, Jill, McDonald, Patsy, Vadehra, Deepak, Churchman, Michelle, Liu, Song, Kalinski, Pawel, Mukherjee, Sarbajit, Monjazeb, Arta, and Murphy, William

Subjects
cancer, gender disparity, immunity, metabolism, obesity, omics, Male, Female, Humans, Kynurenine, Tryptophan, Leukocytes, Mononuclear, Obesity, Gastrointestinal Neoplasms, Adenocarcinoma
Abstract

The prevalence of obesity, defined as the body mass index (BMI) ≥ 30 kg/m2, has reached epidemic levels. Obesity is associated with an increased risk of various cancers, including gastrointestinal ones. Recent evidence has suggested that obesity disproportionately impacts males and females with cancer, resulting in varied transcriptional and metabolic dysregulation. This study aimed to elucidate the differences in the metabolic milieu of adenocarcinomas of the gastrointestinal (GI) tract both related and unrelated to sex in obesity. To demonstrate these obesity and sex-related effects, we utilized three primary data sources: serum metabolomics from obese and non-obese patients assessed via the Biocrates MxP Quant 500 mass spectrometry-based kit, the ORIEN tumor RNA-sequencing data for all adenocarcinoma cases to assess the impacts of obesity, and publicly available TCGA transcriptional analysis to assess GI cancers and sex-related differences in GI cancers specifically. We applied and integrated our unique transcriptional metabolic pipeline in combination with our metabolomics data to reveal how obesity and sex can dictate differential metabolism in patients. Differentially expressed genes (DEG) analysis of ORIEN obese adenocarcinoma as compared to normal-weight adenocarcinoma patients resulted in large-scale transcriptional reprogramming (4029 DEGs, adj. p < 0.05 and |logFC| > 0.58). Gene Set Enrichment and metabolic pipeline analysis showed genes enriched for pathways relating to immunity (inflammation, and CD40 signaling, among others) and metabolism. Specifically, we found alterations to steroid metabolism and tryptophan/kynurenine metabolism in obese patients, both of which are highly associated with disease severity and immune cell dysfunction. These findings were further confirmed using the TCGA colorectal adenocarcinoma (CRC) and esophageal adenocarcinoma (ESCA) data, which showed similar patterns of increased tryptophan catabolism for kynurenine production in obese patients. These patients further showed disparate alterations between males and females when comparing obese to non-obese patient populations. Alterations to immune and metabolic pathways were validated in six patients (two obese and four normal weight) via CD8+/CD4+ peripheral blood mononuclear cell RNA-sequencing and paired serum metabolomics, which showed differential kynurenine and lipid metabolism, which corresponded with altered T-cell transcriptome in obese populations. Overall, obesity is associated with differential transcriptional and metabolic programs in various disease sites. Further, these alterations, such as kynurenine and tryptophan metabolism, which impact both metabolism and immune phenotype, vary with sex and obesity together. This study warrants further in-depth investigation into obesity and sex-related alterations in cancers that may better define biomarkers of response to immunotherapy.

Published
2023

7. ESR1 and p53 interactome alteration defines mechanisms of tamoxifen response in luminal breast cancer

Author

Oturkar, Chetan C., Rosario, Spencer R., Hutson, Alan D., Groman, Adrianne, Edge, Stephen B., Morrison, Carl D., Swetzig, Wendy M., Wang, Jianmin, Park, Jun Hyoung, Kaipparettu, Benny Abraham, Singh, Prashant K., Kumar, Shicha, Cappuccino, Helen H., Ranjan, Manish, Adjei, Araba, Ghasemi, Mohammad, Goey, Andrew K.L., Kulkarni, Swati, and Das, Gokul M.

Published
2024
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8. Inherited Germline Variants in Urinary Tract Cancer: A Multicenter Whole-Exome Sequencing Analysis and Correlation With Clinical Features and Tumor Genomics

Author

Kohlmann, Wendy, Nix, David A., Pauley, Kristen, Greenberg, Samantha, Atkinson, Aaron, Boucher, Kenneth M., Kolesar, Jill, Singer, Eric A., Edge, Stephen B., Churchman, Michelle L., Graham, Laura, Salhia, Bodour, Sanchez, Alejandro, Zakharia, Yousef, Nepple, Kenneth G., Schneider, Bryan P., Byrne, Lindsey, Jain, Rohit K., Chahoud, Jad, Feng, Bing-Jian, and Gupta, Sumati

Published
2024
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9. Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: a multicentre pooled analysis of 5161 patients.

Author

Yau, Christina, Osdoit, Marie, van der Noordaa, Marieke, Shad, Sonal, Wei, Jane, de Croze, Diane, Hamy, Anne-Sophie, Laé, Marick, Reyal, Fabien, Sonke, Gabe S, Steenbruggen, Tessa G, van Seijen, Maartje, Wesseling, Jelle, Martín, Miguel, Del Monte-Millán, Maria, López-Tarruella, Sara, I-SPY 2 Trial Consortium, Boughey, Judy C, Goetz, Matthew P, Hoskin, Tanya, Gould, Rebekah, Valero, Vicente, Edge, Stephen B, Abraham, Jean E, Bartlett, John MS, Caldas, Carlos, Dunn, Janet, Earl, Helena, Hayward, Larry, Hiller, Louise, Provenzano, Elena, Sammut, Stephen-John, Thomas, Jeremy S, Cameron, David, Graham, Ashley, Hall, Peter, Mackintosh, Lorna, Fan, Fang, Godwin, Andrew K, Schwensen, Kelsey, Sharma, Priyanka, DeMichele, Angela M, Cole, Kimberly, Pusztai, Lajos, Kim, Mi-Ok, van 't Veer, Laura J, Esserman, Laura J, and Symmans, W Fraser

Subjects
I-SPY 2 Trial Consortium, Humans, Breast Neoplasms, Neoplasm, Residual, Receptor, erbB-2, Chemotherapy, Adjuvant, Neoadjuvant Therapy, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Young Adult, Receptor, ErbB-2, Breast Cancer, Patient Safety, Clinical Research, Cancer, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundPrevious studies have independently validated the prognostic relevance of residual cancer burden (RCB) after neoadjuvant chemotherapy. We used results from several independent cohorts in a pooled patient-level analysis to evaluate the relationship of RCB with long-term prognosis across different phenotypic subtypes of breast cancer, to assess generalisability in a broad range of practice settings.MethodsIn this pooled analysis, 12 institutes and trials in Europe and the USA were identified by personal communications with site investigators. We obtained participant-level RCB results, and data on clinical and pathological stage, tumour subtype and grade, and treatment and follow-up in November, 2019, from patients (aged ≥18 years) with primary stage I-III breast cancer treated with neoadjuvant chemotherapy followed by surgery. We assessed the association between the continuous RCB score and the primary study outcome, event-free survival, using mixed-effects Cox models with the incorporation of random RCB and cohort effects to account for between-study heterogeneity, and stratification to account for differences in baseline hazard across cancer subtypes defined by hormone receptor status and HER2 status. The association was further evaluated within each breast cancer subtype in multivariable analyses incorporating random RCB and cohort effects and adjustments for age and pretreatment clinical T category, nodal status, and tumour grade. Kaplan-Meier estimates of event-free survival at 3, 5, and 10 years were computed for each RCB class within each subtype.FindingsWe analysed participant-level data from 5161 patients treated with neoadjuvant chemotherapy between Sept 12, 1994, and Feb 11, 2019. Median age was 49 years (IQR 20-80). 1164 event-free survival events occurred during follow-up (median follow-up 56 months [IQR 0-186]). RCB score was prognostic within each breast cancer subtype, with higher RCB score significantly associated with worse event-free survival. The univariable hazard ratio (HR) associated with one unit increase in RCB ranged from 1·55 (95% CI 1·41-1·71) for hormone receptor-positive, HER2-negative patients to 2·16 (1·79-2·61) for the hormone receptor-negative, HER2-positive group (with or without HER2-targeted therapy; p

Published
2022

12. Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: a multicentre pooled analysis of 5161 patients

Author

Adamson, Kathi, Albain, Kathy S., Asare, Adam L., Asare, Smita M., Balassanian, Ron, Beckwith, Heather, Berry, Scott M., Berry, Donald A., Boughey, Judy C., Buxton, Meredith B., Chen, Yunn-Yi, Chen, Beiyun, Chien, A. Jo, Chui, Stephen Y., Clark, Amy S., Clennell, Julia L., Datnow, Brian, DeMichele, Angela M., Duan, Xiuzhen, Edmiston, Kirsten K., Elias, Anthony D., Ellis, Erin D., Esserman, Laura L., Euhus, David M., Fadare, Oluwole, Fan, Fang, Feldman, Michael D, Forero-Torres, Andres, Haley, Barbara B., Han, Hyo S., Harada, Shuko, Haugen, Patricia, Helsten, Teresa, Hirst, Gillian L., Hylton, Nola M., Isaacs, Claudine, Kemmer, Kathleen, Khan, Qamar J., Khazai, Laila, Klein, Molly E., Krings, Gregor, Lang, Julie E., LeBeau, Lauren G., Leyland-Jones, Brian, Liu, Minetta C., Lo, Shelly, Lu, Janice, Magliocco, Anthony, Matthews, Jeffrey B., Melisko, Michelle E., Mhawech-Fauceglia, Paulette, Moulder, Stacy L., Murthy, Rashmi K., Nanda, Rita, Northfelt, Donald W., Ocal, Idris T., Olopade, Olufunmilayo, Pambuccian, Stefan, Paoloni, Melissa, Park, John W., Parker, Barbara A., Perlmutter, Jane, Peterson, Garry, Pusztai, Lajos, Rendi, Mara, Rugo, Hope S., Sahoo, Sunati, Sams, Sharon, Sanil, Ashish, Sattar, Husain, Schwab, Richard B., Singhrao, Ruby, Steeg, Katherine, Stringer-Reasor, Erica, Symmans, W. Fraser, Tawfik, Ossama, Tripathy, Debasish, Troxell, Megan L., van't Veer, Laura J., Venters, Sara J., Vinh, Tuyethoa, Viscusi, Rebecca K., Wallace, Anne M., Wei, Shi, Wilson, Amy, Yau, Christina, Yee, Douglas, Zeck, Jay C., Osdoit, Marie, van der Noordaa, Marieke, Shad, Sonal, Wei, Jane, de Croze, Diane, Hamy, Anne-Sophie, Laé, Marick, Reyal, Fabien, Sonke, Gabe S, Steenbruggen, Tessa G, van Seijen, Maartje, Wesseling, Jelle, Martín, Miguel, del Monte-Millán, Maria, López-Tarruella, Sara, Boughey, Judy C, Goetz, Matthew P, Hoskin, Tanya, Gould, Rebekah, Valero, Vicente, Edge, Stephen B, Abraham, Jean E, Bartlett, John M S, Caldas, Carlos, Dunn, Janet, Earl, Helena, Hayward, Larry, Hiller, Louise, Provenzano, Elena, Sammut, Stephen-John, Thomas, Jeremy S, Cameron, David, Graham, Ashley, Hall, Peter, Mackintosh, Lorna, Godwin, Andrew K, Schwensen, Kelsey, Sharma, Priyanka, DeMichele, Angela M, Cole, Kimberly, Kim, Mi-Ok, van 't Veer, Laura J, Esserman, Laura J, and Symmans, W Fraser

Published
2022
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16. Pan-cancer Landscape of Programmed Death Ligand-1 and Programmed Death Ligand-2 Structural Variations

Author

Hoskins, Emily L., Samorodnitsky, Eric, Wing, Michele R., Reeser, Julie W., Hopkins, Julia F., Murugesan, Karthikeyan, Kuang, Zheng, Vella, Raven, Stein, Leah, Risch, Zachary, Yu, Lianbo, Adebola, Serifat, Paruchuri, Anoosha, Carpten, John, Chahoud, Jad, Edge, Stephen, Kolesar, Jill, McCarter, Martin, Nepple, Kenneth G., Reilley, Matthew, Scaife, Courtney, Tripathi, Abhishek, Single, Nancy, Huang, Richard S.P., Albacker, Lee A., and Roychowdhury, Sameek

Published
2023
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17. Variation in type of adjuvant chemotherapy received among patients with stage I breast cancer: A multi‐institutional study

Author

Vaz-Luis, Ines, Hughes, Melissa E, Cronin, Angel M, Rugo, Hope S, Edge, Stephen B, Moy, Beverly, Theriault, Richard L, Hassett, Michael J, Winer, Eric P, and Lin, Nancy U

Subjects
Cancer, Breast Cancer, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Aged, Breast Neoplasms, Chemotherapy, Adjuvant, Cohort Studies, Female, Humans, Logistic Models, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prospective Studies, Receptor, ErbB-2, chemotherapy, stage I, breast cancer, institutional variation, cost, Receptor, erbB-2, Oncology and Carcinogenesis, Public Health and Health Services, Oncology & Carcinogenesis
Abstract

BackgroundAmong patients with stage I breast cancer, there is significant uncertainty concerning the optimal threshold at which to consider chemotherapy, and when considered, there is controversy regarding whether to consider non-intensive versus intensive regimens. The authors examined the types and costs of adjuvant chemotherapy received among patients with stage I breast cancer.MethodsThe current study was a prospective cohort study including patients with stage I breast cancer who were treated at a National Comprehensive Cancer Network center from 2000 through 2009. Stage was defined according to the version of the American Joint Committee on Cancer Staging Manual applicable at the time of diagnosis. Stratifying by human epidermal growth factor receptor 2 (HER2), the authors examined the percentage of patients receiving intensive versus non-intensive chemotherapy regimens and the factors associated with type of chemotherapy administered using multivariable logistic regression. Costs of the most common regimens were estimated.ResultsOf 8907 patients, 33% received adjuvant chemotherapy. Among those individuals, there was an increase in the use of intensive chemotherapy within the last decade, from 31% in 2000 through 2005 to 63% in 2008 through 2009 (including an increase in the use of the combination of docetaxel, carboplatin, and trastuzumab) among patients with HER2-positive disease and from 15% in 2000 through 2005 to 41% in 2008 through 2009 among patients with HER2-negative disease (32% of patients with hormone receptor-positive and 59% of patients with triple-negative disease). Among patients treated with non-intensive regimens, there was an increase in the use of the combination of docetaxel and cyclophosphamide noted, with a decrease in the use of the doxorubicin and cyclophosphamide combination. The choice of regimen varied significantly by institution. The major drivers of cost variation were the incorporation of biologics (eg, trastuzumab) and growth factors, with significant variation even within non-intensive and intensive regimens.ConclusionsOver time, there was an increase in use of intensive regimens among Stage I breast cancer, with striking institutional and cost variations.

Published
2015

20. Outcomes by Tumor Subtype and Treatment Pattern in Women With Small, Node-Negative Breast Cancer: A Multi-Institutional Study

Author

Vaz-Luis, Ines, Ottesen, Rebecca A, Hughes, Melissa E, Mamet, Rizvan, Burstein, Harold J, Edge, Stephen B, Gonzalez-Angulo, Ana M, Moy, Beverly, Rugo, Hope S, Theriault, Richard L, Weeks, Jane C, Winer, Eric P, and Lin, Nancy U

Subjects
Cancer, Breast Cancer, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Adult, Aged, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols, Biomarkers, Tumor, Breast Neoplasms, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Follow-Up Studies, Humans, Mastectomy, Segmental, Middle Aged, Neoplasm Staging, Prognosis, Prospective Studies, Receptor, ErbB-2, Receptors, Estrogen, Receptors, Progesterone, Trastuzumab, Treatment Outcome, Triple Negative Breast Neoplasms, United States, Receptor, erbB-2, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

PurposeTreatment decisions for patients with T1a,bN0M0 breast cancer are challenging. We studied the time trends in use of adjuvant chemotherapy and survival outcomes among these patients.Patients and methodsThis was a prospective cohort study within the National Comprehensive Cancer Network Database that included 4,113 women with T1a,bN0M0 breast cancer treated between 2000 and 2009. Tumors were grouped by size (T1a, T1b), biologic subtype defined by hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status, and receipt of chemotherapy with or without trastuzumab.ResultsMedian follow-up time was 5.5 years. Eight percent of patients with HR-positive/HER2-negative tumors were treated with chemotherapy. Fifty-two percent of those with HER2-positive or HR-negative/HER2-negative breast cancers received chemotherapy, with an increase over the last decade. Survival outcomes diverged by subtype and size, but the 5-year distant relapse-free survival (DRFS) did not exceed 10% in any subgroup. The 5-year DRFS for patients with T1a tumors untreated with chemotherapy ranged from 93% to 98% (n = 49 to 972), and for patients with T1b tumors, it ranged from 90% to 96% (n = 17 to 2,005). Patients with HR-positive/HER2-negative disease had the best DRFS estimates, and patients with HR-negative/HER2-negative tumors had the lowest. In this observational, nonrandomized cohort study, the 5-year DRFS for treated patients with T1a tumors was 100% for all subgroups (n = 12 to 33), and for patients with T1b tumors, it ranged from 94% to 96% (n = 88 to 241).ConclusionWomen with T1a,b tumors have an excellent prognosis without chemotherapy. Size and tumor subtype may identify patients in whom the rate of recurrence justifies consideration of chemotherapy. These patients represent an optimal group for evaluating less toxic adjuvant regimens to maintain efficacy while minimizing short- and long-term risks.

Published
2014

23. Time to Adjuvant Chemotherapy for Breast Cancer in National Comprehensive Cancer Network Institutions

Author

Vandergrift, Jonathan L, Niland, Joyce C, Theriault, Richard L, Edge, Stephen B, Wong, Yu-Ning, Loftus, Loretta S, Breslin, Tara M, Hudis, Clifford A, Javid, Sara H, Rugo, Hope S, Silver, Samuel M, Lepisto, Eva M, and Weeks, Jane C

Subjects
Cancer, Breast Cancer, Clinical Research, Adult, African Americans, Aged, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Cancer Care Facilities, Chemotherapy, Adjuvant, Confounding Factors, Epidemiologic, Drug Administration Schedule, Female, Healthcare Disparities, Humans, Insurance, Health, Lymph Node Excision, Magnetic Resonance Imaging, Mammaplasty, Mastectomy, Medicaid, Medicare, Middle Aged, Neoplasm Staging, Referral and Consultation, Time Factors, United States, Whites, White People, Black or African American, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundHigh-quality care must be not only appropriate but also timely. We assessed time to initiation of adjuvant chemotherapy for breast cancer as well as factors associated with delay to help identify targets for future efforts to reduce unnecessary delays.MethodsUsing data from the National Comprehensive Cancer Network (NCCN) Outcomes Database, we assessed the time from pathological diagnosis to initiation of chemotherapy (TTC) among 6622 women with stage I to stage III breast cancer diagnosed from 2003 through 2009 and treated with adjuvant chemotherapy in nine NCCN centers. Multivariable models were constructed to examine factors associated with TTC. All statistical tests were two-sided.ResultsMean TTC was 12.0 weeks overall and increased over the study period. A number of factors were associated with a longer TTC. The largest effects were associated with therapeutic factors, including immediate postmastectomy reconstruction (2.7 weeks; P < .001), re-excision (2.1 weeks; P < .001), and use of the 21-gene reverse-transcription polymerase chain reaction assay (2.2 weeks; P < .001). In comparison with white women, a longer TTC was observed among black (1.5 weeks; P < .001) and Hispanic (0.8 weeks; P < .001) women. For black women, the observed disparity was greater among women who transferred their care to the NCCN center after diagnosis (P (interaction) = .008) and among women with Medicare vs commercial insurance (P (interaction) < .001).ConclusionsMost observed variation in TTC was related to use of appropriate therapeutic interventions. This suggests the importance of targeted efforts to minimize potentially preventable causes of delay, including inefficient transfers in care or prolonged appointment wait times.

Published
2013

28. A National Study of the Use of Asymptomatic Systemic Imaging for Surveillance Following Breast Cancer Treatment (AFT-01)

Author

Schumacher, Jessica R., Neuman, Heather B., Chang, George J., Kozower, Benjamin D., Edge, Stephen B., Yu, Menggang, Vanness, David J., Si, Yajuan, Jacobs, Elizabeth A., Francescatti, Amanda B., Spears, Patricia A., Havlena, Jeffrey, Adesoye, Taiwo, McKellar, Daniel, Winchester, David, Burnside, Elizabeth S., Greenberg, Caprice C., and the Alliance ACS-CRP CCDR Breast Cancer Surveillance Working Group

Published
2018
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30. Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update

Author

Recht, Abram, Comen, Elizabeth A., Fine, Richard E., Fleming, Gini F., Hardenbergh, Patricia H., Ho, Alice Y., Hudis, Clifford A., Hwang, E. Shelley, Kirshner, Jeffrey J., Morrow, Monica, Salerno, Kilian E., Sledge, George W., Jr, Solin, Lawrence J., Spears, Patricia A., Whelan, Timothy J., Somerfield, Mark R., and Edge, Stephen B.

Published
2016
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31. Treatment recommendations to cancer patients in the context of FDA guidance for next generation sequencing

Author

Dy, Grace K., Nesline, Mary K., Papanicolau-Sengos, Antonios, DePietro, Paul, LeVea, Charles M., Early, Amy, Chen, Hongbin, Grand’Maison, Anne, Boland, Patrick, Ernstoff, Marc S., Edge, Stephen, Akers, Stacey, Opyrchal, Mateusz, Chatta, Gurkamal, Odunsi, Kunle, Pabla, Sarabjot, Conroy, Jeffrey M., Glenn, Sean T., DeFedericis, Hanchun T., Burgher, Blake, Andreas, Jonathan, Giamo, Vincent, Qin, Maochun, Wang, Yirong, Kanehira, Kazunori, Lenzo, Felicia L., Frederick, Peter, Lele, Shashikant, Galluzzi, Lorenzo, Kuvshinoff, Boris, and Morrison, Carl

Published
2019
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32. Climate Change and Cancer Care: A Policy Statement From ASCO.

Author

Bernicker, Eric, Averbuch, Steve D., Edge, Stephen, Kamboj, Jasmine, Khuri, Fadlo R., Pierce, Jennifer Young, Schiller, Joan, Sirohi, Bhawna, Thomas, Alexandra, Moushey, Allyn, Phillips, Jonathan, and Hendricks, Carolyn

Subjects
TUMOR prevention, TUMOR risk factors, TUMOR treatment, MEETINGS, HEALTH policy, RESEARCH evaluation, PRIORITY (Philosophy), UNIVERSAL healthcare, CONFERENCES & conventions, ORGANIZATIONAL goals, RISK assessment, QUALITY assurance, DECISION making, HEALTH equity, MANAGEMENT, CLIMATE change, CANCER patient medical care, TELEMEDICINE
Abstract

The article focuses on ASCO's commitment to addressing the impact of climate change on cancer, emphasizing specific actions guided by its mission pillars of research, education, and quality. Topics include ASCO's endorsement of climate change as a public health crisis, its support for evidence-based policies to reduce the health burden from climate change, and its collaboration with the Medical Society Consortium on Climate and Health.

Published
2024
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37. Defining Priorities in Value-Based Cancer Care: Insights From the Alliance for Clinical Trials in Oncology National Cooperative Group Survey.

Author

Allen, Casey J., Snyder, Rebecca A., Horn, Danea Marie, Hudson, Matthew F., Barber, Anne, Smieliauskas, Fabrice, Spears, Patty A., Edge, Stephen, and Greenup, Rachel A.

Subjects
EVALUATION of medical care, ONCOLOGY nursing, MEDICAL radiology, CLINICAL trials, HEALTH services accessibility, PATIENT advocacy, ACADEMIC medical centers, HEALTH outcome assessment, MEDICAL care costs, EVIDENCE-based medicine, EXECUTIVES, PATIENT-centered care, VALUE-based healthcare, SURVEYS, SCALE analysis (Psychology), QUALITY of life, NURSES, RESEARCH funding, ECONOMIC aspects of diseases, CANCER patient medical care, ONCOLOGY, OVERALL survival, DIFFUSION of innovations, ONCOLOGISTS
Abstract

PURPOSE: We determine how stakeholders prioritize the importance of oncologic outcomes, patient-reported outcomes (PROs), and cancer-related health care costs. METHODS: A survey was distributed to the National Clinical Trials Network Alliance for Clinical Trials in Oncology cooperative group membership from May 14 to June 30, 2022. Respondents were asked to rate (5-point Likert scale) and rank (1-9) evidence-based value domains: overall survival, treatment toxicities/complications, quality of life (QOL), financial toxicity, access to care, compliance with evidence-based care, health system performance, scientific discovery and innovation, and cost to the health care system. RESULTS:A total of 514 members responded, including researchers (24.7%), nurses (19.5%), medical oncologists (17.9%), administrators (9.3%), surgical and radiation oncologists (9.1%), patient advocates (3.1%), and nonphysician providers (16.4%). Participants represented various practice settings including National Cancer Institute–designated cancer centers (29.8%), university-affiliated academic cancer centers (21%), hospital-owned oncology practices (21.8%), and others (27.4%). There was agreement in how respondents prioritized value domains (W = 0.39, P = 001). Respondents ranked patient QOL (mean rank: 2.6 ± 1.9) as most important above all other metrics including survival (mean rank: 3.5 ± 0.3) and access to care (mean rank: 3.5 ± 2.1; P = .001). Members engaged in direct patient care also ranked access to care of higher importance than nonclinicians (P = 026). Cost to the health care system (mean rank: 7.5 ± 2.1) and health system performance (mean rank: 7 ± 2) were ranked as least important (P < 001). Inclusion of PROs into therapeutic assessment (59.3%) was the most frequently selected priority of future cooperative group initiatives. CONCLUSION: Oncology community stakeholders deemed patient-centered value domains as most important and considered patient QOL the highest priority. Inclusion of PROs into clinical trials was endorsed as an important component of therapeutic assessment. These findings can be taken into consideration when creating a value framework for inclusion in cancer clinical trials. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Focused Guideline Update

Author

Recht, Abram, Comen, Elizabeth A., Fine, Richard E., Fleming, Gini F., Hardenbergh, Patricia H., Ho, Alice Y., Hudis, Clifford A., Hwang, E. Shelley, Kirshner, Jeffrey J., Morrow, Monica, Salerno, Kilian E., Sledge, Jr, George W., Solin, Lawrence J., Spears, Patricia A., Whelan, Timothy J., Somerfield, Mark R., and Edge, Stephen B.

Published
2017
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42. Pregnancy-related characteristics and breast cancer risk

Author

Brasky, Theodore M., Li, Yanli, Jaworowicz, David J., Potischman, Nancy, Ambrosone, Christine B., Hutson, Alan D., Nie, Jing, Shields, Peter G., Trevisan, Maurizio, Rudra, Carole B., Edge, Stephen B., and Freudenheim, Jo L.

Published
2013

46. Toolbox to Reduce Lumpectomy Reoperations and Improve Cosmetic Outcome in Breast Cancer Patients: The American Society of Breast Surgeons Consensus Conference

Author

Landercasper, Jeffrey, Attai, Deanna, Atisha, Dunya, Beitsch, Peter, Bosserman, Linda, Boughey, Judy, Carter, Jodi, Edge, Stephen, Feldman, Sheldon, Froman, Joshua, Greenberg, Caprice, Kaufman, Cary, Morrow, Monica, Pockaj, Barbara, Silverstein, Melvin, Solin, Lawrence, Staley, Alicia, Vicini, Frank, Wilke, Lee, Yang, Wei, and Cody, III, Hiram

Published
2015
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