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.

项目摘要 肺癌是美国与癌症相关的主要原因，但精确的肿瘤学 对于一部分患者，发现的生存率和生活质量大大改善了。肺患者 具有针对性的致癌驱动器突变的癌症代表了有新兴的患者人群 慢性生命癌症。这样的患者在不确定性方面挣扎 如何决定他们的个人生活和医疗服务。他们也很少讨论他们的 与临床医生对临终关怀的预后和偏好。该建议详细介绍了一个五年计划 开发和飞行员测试姑息治疗干预措施，结合了生存护理要素以解决 致癌基因驱动的肺癌患者的未满足需求。具体而言，该项目的目的是1） 完善人群特异性的姑息治疗干预措施 癌基因驱动的肺癌，利益相关者的反馈（n = 15）和开放式飞行员（n = 10）； 2）评估 与通常的护理相比，在随机对照试验中干预的可行性和可接受性 （n = 80），并估计干预对患者痛苦与预后有关的初步影响 不确定性，管理慢性疾病，预后意识的自我效能以及对目标的讨论 和价值观，以告知未来的决策。 该建议还详细介绍了候选人劳拉·佩特里洛（Laura Petrillo）博士的计划。 获得心态，教学培训和职业发展，以促进她向研究的过渡 独立。 Petrillo博士的长期职业目标是成为肿瘤学支持护理的领导者， 专门研究和评估满足患者需求的支持性护理干预措施 接受新颖的疗法。该建议包括Petrillo博士在1）行为中获得专业知识的计划 干预发展； 2）癌症生存研究和实践的方法； 3）临床试验设计 和行为。她将通过经验丰富的学习来实现这一培训 导师詹妮弗·特雷尔（Jennifer Temel）和约瑟夫·格里尔（Joseph Greer）的指导 科学咨询团队具有致癌基因驱动的肺癌，行为心理学，姑息治疗方面的专业知识 和生存研究。她将通过行为研究方法的课程获得更多的技能， 临床试验设计和行为以及纵向数据分析。该项目将定位Petrillo博士参加比赛 对于R01级资助，并启动独立职业领导研究计划 支持护理和肿瘤学。