The Challenge of Individualizing Treatments for Patients with Breast Cancer

乳腺癌患者个体化治疗的挑战

• 批准号: 8726338
• 负责人: Steven J. Katz
• 金额: $ 291.47万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8726338
• 关键词: Address; Attitude; Breast; Breast Cancer Treatment; Cancer Patient; Caring; Catchment Area; Clinical; Communication; Data; Data Collection; Decision Making; Diagnosis; Disease; Disease-Free Survival; Effectiveness; Evaluation; Face; Goals; Individual; Interdisciplinary Study; Internet; Intervention; Knowledge; Left; Malignant Neoplasms; Medical Oncologist; Medicine; Methodology; Methods; Mission; Morbidity - disease rate; New Jersey; Newly Diagnosed; Observational Study; Outcome; Outcomes Research; Pain; Patient Rights; Patients; Physicians; Population; Population Sciences; Process; Public Health; Randomized Controlled Trials; Registries; Reporting; Research; Resource Sharing; Sampling; Seasons; Strategic Planning; Surgeon; Surveys; Systemic Therapy; Testing; Translational Research; Woman; Work; base; cancer care; cancer therapy; design; evidence base; improved; innovation; malignant breast neoplasm; metropolitan; oncology; outcome forecast; population based; population health; preference; programs; screening; tool; treatment strategy

DESCRIPTION (provided by applicant): Treatments for cancer impose substantial burden and morbidity but net survival benefit of different strategies is often small and virtually always uncertain. Thus, clinicians may do more harm than good if treatment is too aggressive. There are a number of management strategies for breast cancer aimed at reducing unnecessary morbidity and burden on patients with favorable disease. A key barrier to advancing these initiatives is the need for a better understanding of the challenges of individualizing cancer care The goal of this program is to improve population health by helping clinicians and their patients address the challenges of individualizing treatment of breast cancer for patients with favorable prognosis. Objective 1: To examine the challenges of individualizing treatment for women with breast cancer. Two projects will each undertake an observational study of patients newly diagnosed with breast cancer (including their attending clinicians) who were reported to the SEER registries of Georgia and New Jersey during an 18 month period to examine patient and clinician factors associated with key evaluative tests, treatments, and patient appraisal of decision quality. Project 1 will focus on challenges for surgeons and their patients with regard to locoregional therapy. Project 2 will focus on challenges for medical oncologists and their patients with regard to systemic therapy. Objective 2: To improve treatment decision quality. Project 3 will perform a randomized controlled trial of a practice based online decision tool for patients newly diagnosed with breast cancer in the Detroit and Atlanta SEER regions intended to improve decision quality. Objective 3: To accelerate the dissemination of SEER-based research findings by implementing and evaluating a tailored online portal aimed at all surgeons and medical oncologists who treated the patient samples in P1 and P2 to evaluate whether our research findings can more directly and promptly inform clinicians knowledge and attitudes about individualizing treatment. Objective 4: To advance methods in SEER population translational research focused on quality of cancer care. We propose four shared resource cores that will support program project activities, advance innovative methods in oncology population sciences, and advance team mission and long-term strategic planning.

描述（由申请人提供）：癌症治疗会带来巨大的负担和发病率，但不同策略的净生存获益通常很小，而且几乎总是不确定的。因此，如果治疗过于激进，临床医生可能弊大于利。乳腺癌有多种治疗策略，旨在减少不必要的发病率和患有有利疾病的患者的负担。推进这些举措的一个关键障碍是需要更好地了解个体化癌症护理的挑战。该计划的目标是通过帮助临床医生及其患者应对预后良好的乳腺癌个体化治疗的挑战来改善人口健康。目标 1：探讨女性乳腺癌个体化治疗面临的挑战。两个项目将分别对新诊断的乳腺癌患者（包括其主治临床医生）进行观察性研究，这些患者在 18 个月期间向佐治亚州和新泽西州的 SEER 登记处报告，以检查与关键评估测试、治疗和患者决策质量评估相关的患者和临床医生因素。项目 1 将重点关注外科医生及其患者在局部治疗方面面临的挑战。项目 2 将重点关注肿瘤内科医师及其患者在全身治疗方面面临的挑战。目标 2：提高治疗决策质量。项目 3 将对底特律和亚特兰大 SEER 地区新诊断出乳腺癌的患者进行基于实践的在线决策工具的随机对照试验，旨在提高决策质量。目标3：通过实施和评估针对所有治疗P1和P2患者样本的外科医生和肿瘤内科医生的定制在线门户，加速基于SEER的研究结果的传播，以评估我们的研究结果是否可以更直接、更迅速地告知临床医生关于个体化治疗的知识和态度。目标 4：推进以癌症护理质量为重点的 SEER 群体转化​​研究方法。我们提出了四个共享资源核心，以支持计划项目活动，推进肿瘤学人口科学的创新方法，并推进团队使命和长期战略规划。