Walking forward - American Indian Participation in Cancer Clinical Trials

这一倡议的主要目标是解决并有望降低癌症的高发病率和不祥的增加。 南达科他州西部美洲印第安人(AL)的死亡率，与 这是美国总人口的数字。该项目的具体目标是： (1)利用病人导航(PN)服务的综合模式，改善以下与癌症有关的 我们目标人群的健康结果：提高癌症筛查率；减少 异常发现、癌症诊断和癌症治疗的开始，以降低 癌症的存在，以提高癌症存活率，并增加获得姑息治疗和其他服务的机会 管理我们客户的复杂疾病状态。对这些努力的评估将采用“以利用为重点” 记录进展和指导未来工作的方法。 (2)进一步扩大癌症临床试验的范围，招募更多的AI患者，以及所有医学 我们农村地区服务不足的患者，到NCI赞助的更常见癌症地点的临床试验。 除了参加合作小组试验(如NCCTG、RTOG、GOG)外，调查员还发起试验 例如调强放射治疗和近距离放射治疗的研究将开放。参加威斯康星州肿瘤学网络 (韩元)也将启动，以扩大对更常见的肿瘤的研究 这片区域。 (3)扩大目前的转译研究范围，以包括将允许进行研究的放射基因组学 通过识别基因研究禽流感患者与辐射毒性相关的遗传风险 通过DNA微阵列可以预测治疗反应，并最终指导治疗。这将会 包括比较发生不良反应患者的淋巴细胞对辐射的遗传反应 对那些没有接受过辐射的人来说。然后可以开发出一种基因签名来识别 易受影响的患者在接受放射治疗前。

The primary goal ofthis initiative is to address and hopefully reduce the high, and ominously increasing, cancer mortality rates among American Indians (Als) in western South Dakota, which is 30% higher as compared to that ofthe overall US population. The specific aims ofthis project are: (1) to utilize a comprehensive model of patient navigation (PN) services to improve the following cancer-related health outcomes in our target population: to increase cancer screening rates; to decrease delays between abnormal finding, cancer diagnosis and initiation of cancer treatment, to decrease the average stage at which cancer presents, to increase cancer survival rates, and to increase access to palliative care and other services to manage the complex disease states of our clients. Evaluation of these efforts will employ a "utilization -focused" methodology to document progress and guide future efforts. (2) to further expand the scope of chnical cancer trials and to enroll more AI patients, as well as all medically underserved patients in our rural area, to NCI sponsored clinical trials for the more common cancer disease sites. In addition to participation in Cooperative Group trials (e.g. NCCTG, RTOG, GOG), Investigator initiated trials such as IMRT and brachytherapy studies will be opened. Participation in the Wisconsin Oncology Network (WON) will also be initiated to broaden the availability of studies for the more common tumors that are seen in this area. (3) to expand the scope of current translational research to include radiogenomics that will allow investigating the genetic risk profiles specifically related to radiation induced toxicities among AI patients by identifying genes through DNA microarrays that might predict response to treatment and ultimately guide therapy. This would include comparing lymphocytic genetic responses to irradiation from patients who had adverse reactions following irradiation to those who have not. A genetic signature could then be developed that would identify susceptible patients prior to radiation therapy.