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: 8539482
• 负责人: Steven J. Katz
• 金额: $ 276.42万
• 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/8539482
• 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）：癌症治疗造成了重大负担和发病率，但是不同策略的净生存益处通常很小，而且几乎总是不确定。因此，如果治疗太侵略性，临床医生可能弊大于利。有许多乳腺癌的管理策略旨在减轻有利疾病的患者的不必要的发病率和负担。推进这些举措的关键障碍是需要更好地理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解决对有利预后患者对乳腺癌的个性化治疗的挑战来改善人口健康。目标1：检查对乳腺癌女性个性化治疗的挑战。两个项目将对新诊断为乳腺癌的患者（包括他们的临床医生）进行一项观察性研究，这些患者在18个月的时间内已报告给格鲁吉亚和新泽西州的SEER注册机构，以检查与关键评估，治疗，治疗方法以及患者决策质量评估相关的患者和临床因素。项目1将关注外科医生及其患者在局部疗法方面的挑战。项目2将关注医学肿瘤学家及其患者在全身治疗方面的挑战。目标2：提高治疗决策质量。项目3将对底特律和亚特兰大先知地区新诊断为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针对所有外科医生和医学肿瘤学家的量身定制的在线门户，他们对P1和P2中的患者样本进行了量身定制的在线门户，以评估我们的研究结果是否可以更直接，迅速地为临床医生了解个性化治疗的知识和态度，以加速基于SEER的研究结果。目标4：推进SEER人群翻译研究的方法，重点是癌症护理的质量。我们提出了四个共享的资源核心，这些核心将支持计划项目活动，推进肿瘤学人群科学的创新方法以及提前团队的使命和长期战略计划。