A Patient-Oriented Research Program in Geriatric Oncology

项目摘要 该K24更新提案的主要研究者（PI）Supriya Mohile博士领导了一个独立资助的 罗切斯特大学威尔莫特癌症研究所的以患者为导向的老年肿瘤学研究项目。 在过去的K24资助期间，Mohile博士完成了两项大型多中心集群随机试验， 评估老年评估和管理（GAM）是否改善老年患者的结局， 晚期癌症GAM是一种有效的以患者为中心的健康状况评估方法， 有不良后果风险的癌症患者，并指导癌症治疗和 与老化有关的条件。这两项试验首次证明，GAM干预可以改善患者的 以结果为中心（沟通和患者/护理者满意度）和临床结果（治疗 毒性、福尔斯和多药疗法）。罗切斯特大学的学员参与了这项研究， 并通过癌症和衰老研究小组（CARG）利用GAM试验的数据， 成功地竞争自己的职业发展和独立奖项。在10个早期职业生涯中， Mohile博士目前在罗切斯特大学指导的科学家中，有八位是女性，四位是 在医学界的代表性不足。学员已收到20多份赠款，并出版了80多份手稿 和莫希勒医生一起Mohile博士目前是七个职业发展奖项的主要导师或共同导师。 此外，在上一个K24资助期内，Mohile博士作为PI成功竞争了三个新的R级奖项 来自以患者为中心的结果研究和美国国立卫生研究院，以评估 在肿瘤学实践中实施GAM，并扩大对癌症治疗耐受性的理解， 老年人最初的K24使Mohile博士和她的学员能够提高沟通技能 研究;更新将使他们能够与专家一起学习实施科学和领导力 罗切斯特大学和CARG的顾问。本提案的总体目标是：1） 制定和评估GAM在肿瘤学实践中的实施策略; 2）检查治疗 晚期癌症和衰老相关疾病的老年患者开始新的高风险癌症的耐受性 治疗方案。本研究将通过提供语用信息产生积极的影响 在肿瘤护理中实施GAM的机制。重要的是，这项提案将允许职业生涯 发展学员追求以患者为导向的研究，重点是老年肿瘤学，一个研究不足 领域通过资助的研究，来自威尔莫特癌症研究所的捐赠，以及美国国立卫生研究院资助的CARG (MPI：Mohile），Mohile博士有资源继续培养感兴趣的研究人员的职业生涯， 老年肿瘤学研究贯穿学术生涯轨迹。K24奖的更新将使 博士Mohile将扩大指导，以促进老年肿瘤学中以患者为导向的研究的发展。

PROJECT SUMMARY The principal investigator (PI), Dr. Supriya Mohile, of this K24 renewal proposal leads an independently funded patient-oriented geriatric oncology research program at the University of Rochester Wilmot Cancer Institute. Over the last K24 funding period, Dr. Mohile completed two large multi-site cluster-randomized trials that evaluated whether geriatric assessment and management (GAM) improves outcomes of older patients with advanced cancer. GAM, a validated patient-centered approach for assessing health status, identifies older patients with cancer who are at risk of adverse outcomes and guides management for cancer treatment and for aging-related conditions. Both trials demonstrated, for the first time, that a GAM intervention improves patient- centered outcomes (communication and patient/caregiver satisfaction) and clinical outcomes (treatment toxicity, falls, and polypharmacy). Integrally involved in this research, mentees at the University of Rochester and through the Cancer and Aging Research Group (CARG) have utilized data from the GAM trials to successfully compete for their own career development and independent awards. Of the ten early career scientists that Dr. Mohile currently mentors at the University of Rochester, eight are women and four identify as underrepresented in medicine. Mentees have received over 20 grants and have published over 80 manuscripts with Dr. Mohile. Dr. Mohile is currently a primary mentor or co-mentor on seven career development awards. Further, over the last K24 funding period, Dr. Mohile successfully competed for three new R-level awards as PI from the Patient Centered Outcomes Research and the National Institutes of Health to evaluate strategies for implementing GAM in oncology practices and to expand understanding about cancer treatment tolerability in older adults. The original K24 allowed Dr. Mohile and her mentees to enhance skills in communication research; the renewal will allow them to learn about implementation science and leadership with expert consultants at the University of Rochester and in CARG. The overarching aims of this proposal are: 1) to develop and evaluate implementation strategies for GAM in oncology practices; and 2) to examine treatment tolerability in older patients with advanced cancer and aging-related conditions starting a new high-risk cancer treatment regimen. This research will have a positive impact by providing information on pragmatic mechanisms for implementing GAM in oncology care. Importantly, this proposal will allow for the career development of mentees pursuing patient-oriented research focused on geriatric oncology, an understudied field. Through funded research, an endowment from the Wilmot Cancer Institute, and the NIA-funded CARG (MPI: Mohile), Dr. Mohile has the resources to continue to foster the careers of investigators interested in geriatric oncology research across the academic career trajectory. The renewal of this K24 Award will enable Dr. Mohile to expand mentoring to enhance the growth of patient-oriented research in geriatric oncology.