Optimizing Supportive Care for Patients with Metastatic Lung Cancer in the Era of Precision Oncology

在精准肿瘤学时代优化转移性肺癌患者的支持护理

• 批准号: 10448560
• 负责人: Laura Anne Petrillo
• 金额: $ 27.19万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10448560
• 关键词: Active Learning; Address; Adenocarcinoma; Advanced Malignant Neoplasm; Advisory Committees; Advocate; Area; Award; Awareness; Behavior Therapy; Behavioral; Behavioral Research; Cancer Etiology; Cancer Survivor; Cancer Survivorship; Caring; Cessation of life; Chronic; Chronic Disease; Clinical Research; Clinical Trials; Clinical Trials Design; Communication; Data Analyses; Decision Making; Disseminated Malignant Neoplasm; Distress; Documentation; Elements; Enrollment; Epidermal Growth Factor; Feedback; Five-Year Plans; Foundations; Funding; Future; Goals; Grant; Health; Intervention; Intervention Studies; Interview; Knowledge; Malignant Neoplasms; Malignant neoplasm of lung; Medical; Mentors; Mentorship; Modeling; Mutation; Non-Small-Cell Lung Carcinoma; Nonmetastatic; Oncogenes; Oncogenic; Oncologist; Oncology; Palliative Care; Patient Care; Patients; Physicians; Pilot Projects; Population; Positioning Attribute; Prognosis; Protocols documentation; Psychology; Public Health Schools; Quality of life; Randomized Clinical Trials; Randomized Controlled Trials; Research; Research Methodology; Research Personnel; Self Efficacy; Specialist; Supportive care; Surveys; Survivors; Symptoms; Training; Treatment/Psychosocial Effects; Uncertainty; United States; United States National Institutes of Health; acceptability and feasibility; base; care delivery; care preference; career; career development; coping; disease prognostic; driver mutation; end of life; end of life care; experience; follow-up; improved; innovation; intervention effect; life-limiting cancer; medical specialties; novel; novel therapeutics; patient population; patient subsets; pilot test; precision medicine; precision oncology; preference; prognostic; programs; research and development; response; side effect; skills; survivorship; symposium; targeted treatment; therapy development; treatment as usual; treatment trial; trial comparing

PROJECT SUMMARY Lung cancer is the leading cause of cancer-related death in the United States, yet precision oncology discoveries have substantially improved survival and quality of life for a subset of patients. Patients with lung cancer with targetable oncogenic driver mutations represent an emerging population of patients living with chronic, life-limiting cancer. Such patients struggle with uncertainty about when their cancer will progress and how to make decisions about their personal lives and medical care. They also infrequently discuss their prognosis and preferences for end-of-life care with their clinicians. This proposal details a five-year plan to develop and pilot test a palliative care intervention that incorporates elements of survivorship care to address the unmet needs of patients with oncogene-driven lung cancer. Specifically, the aims of this project are to 1) refine a population-specific palliative care intervention informed by survivorship care for patients with oncogene-driven lung cancer with feedback from stakeholders (N=15) and an open pilot (N=10); 2) evaluate the feasibility and acceptability of the intervention in a randomized controlled trial compared to usual care (N=80), and estimate the preliminary effects of the intervention on patients’ distress related to prognostic uncertainty, self-efficacy for managing chronic disease, prognostic awareness, and discussions about goals and values to inform future decision making. This proposal also details the plans of the candidate, Dr. Laura Petrillo, a palliative care physician-investigator, to gain mentorship, didactic training, and career development to facilitate her transition to research independence. Dr. Petrillo’s long-term career goal is to become a leader in supportive care in oncology, specializing in developing and evaluating supportive care interventions tailored to the needs of patients receiving novel therapies. This proposal includes Dr. Petrillo’s plans for gaining expertise in 1) behavioral intervention development; 2) approach to cancer survivorship research and practice; and 3) clinical trial design and conduct. She will achieve this training through experiential learning leading the proposed project with guidance from mentors Dr. Jennifer Temel and Joseph Greer, leading experts in palliative care research, and a scientific advisory team with expertise in oncogene-driven lung cancer, behavioral psychology, palliative care and survivorship research. She will gain additional skills through coursework in behavioral research methods, clinical trial design and conduct, and longitudinal data analysis. This project will position Dr. Petrillo to compete for R01-level funding and launch an independent career leading a research program at the interface of supportive care and oncology.

项目总结 肺癌是美国癌症相关死亡的主要原因，但精确肿瘤学 这些发现极大地改善了一部分患者的生存和生活质量。肺病患者 具有靶向致癌驱动基因突变的癌症代表了一种新的患者群体 慢性、限制生命的癌症。这些患者在不确定的情况下挣扎，不知道他们的癌症何时会恶化和 如何对他们的个人生活和医疗保健做出决定。他们也很少讨论他们的 预后和临床医生对临终关怀的偏好。这项提案详细说明了一个五年计划，以 开发和试点包含生存护理要素的姑息护理干预措施以解决 癌基因驱动的肺癌患者未得到满足的需求。具体地说，本项目的目标是1) 完善针对特定人群的姑息治疗干预措施，为患者提供生存护理信息 癌基因驱动的肺癌，来自利益相关者的反馈(N=15)和开放试验(N=10)；2)评估 随机对照试验与常规护理干预的可行性和可接受性 (n=80)，并评估干预对患者预后相关苦恼的初步效果 不确定性、慢性病管理的自我效能感、预后意识和对目标的讨论 和价值观，为未来的决策提供信息。 这项提案还详细介绍了候选人劳拉·彼得里洛博士的计划，她是一名姑息治疗医生兼研究员， 获得指导、授课培训和职业发展，以促进她向研究的过渡 独立。彼得里洛博士的长期职业目标是成为肿瘤学支持性护理领域的领导者， 专门开发和评估为患者量身定做的支持性护理干预措施 接受新的治疗方法。这项提案包括彼得里洛博士获得行为学专业知识的计划 干预发展；2)癌症生存研究和实践的方法；3)临床试验设计 以及行为举止。她将通过体验式学习来实现这一培训，该项目将与 导师詹妮弗·特梅尔博士和约瑟夫·格里尔博士，姑息治疗研究的领先专家，以及 在癌基因驱动的肺癌、行为心理学、姑息治疗方面拥有专业知识的科学顾问团队 以及生存研究。她将通过行为研究方法的课程学习获得额外的技能， 临床试验设计和实施，以及纵向数据分析。这个项目将使Petrillo博士有资格参加 获得R01级别的资金，并在以下接口启动领导研究计划的独立职业生涯 支持性护理和肿瘤学。