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: 10626937
• 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/10626937
• 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; Collaborations; Communication; Data Analyses; Decision Making; Disseminated Malignant Neoplasm; Distress; Documentation; Elements; Eligibility Determination; Enrollment; Epidermal Growth Factor; Exclusion; Feedback; Five-Year Plans; Foundations; Funding; Future; Goals; Grant; Health; Intervention; Interview; Knowledge; Malignant Neoplasms; Malignant neoplasm of lung; Medical; Mentors; Mentorship; Modeling; Mutation; Non-Small-Cell Lung Carcinoma; Oncogenes; Oncogenic; Oncologist; Oncology; Palliative Care; Patient Care; Patients; Physicians; Pilot Projects; Population; Population Intervention; Positioning Attribute; Prognosis; Protocols documentation; Psychology; Public Health Schools; Quality of life; 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; care delivery; care preference; career; career development; coping; driver mutation; end of life care; end-of-life communication; experience; follow-up; improved; innovation; intervention effect; life-limiting cancer; medical specialties; novel; novel therapeutics; participant enrollment; patient oriented; patient population; patient subsets; pilot test; precision medicine; precision oncology; preference; prognostic; programs; randomized, clinical trials; 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.

项目概要 肺癌是美国癌症相关死亡的主要原因，但精准肿瘤学 这些发现极大地改善了一部分患者的生存率和生活质量。 具有靶向致癌驱动突变的癌症代表了一个新兴的患者群体 慢性、限制生命的癌症患者与癌症何时进展的不确定性作斗争。 他们也很少讨论如何做出有关个人生活和医疗保健的决定。 该提案详细介绍了一项五年计划。 开发并试点测试一种姑息治疗干预措施，其中包含幸存者护理的要素，以解决 具体而言，该项目的目标是：1) 以生存护理为基础，完善针对特定人群的姑息治疗干预措施 致癌基因驱动的肺癌，并听取利益相关者 (N=15) 和开放试点 (N=10) 的反馈；2) 评估 与常规护理相比，随机对照试验中干预措施的可行性和可接受性 (N=80)，并估计干预措施对患者预后相关痛苦的初步影响 不确定性、管理慢性病的自我效能、预后意识和目标讨论 和价值观为未来的决策提供信息。 该提案还详细介绍了候选人 Laura Petrillo 博士的计划，她是一位姑息治疗医师兼研究员， 获得指导、教学培训和职业发展，以促进她向研究的过渡 Petrillo 博士的长期职业目标是成为肿瘤学支持护理领域的领导者， 专门开发和评估适合患者需求的支持性护理干预措施 该提案包括 Petrillo 博士获得以下方面专业知识的计划。 干预措施的制定；2) 癌症生存研究和实践的方法；3) 临床试验设计； 她将通过领导拟议项目的体验式学习来实现这一培训。 导师 Jennifer Temel 博士和 Joseph Greer 博士（姑息治疗研究领域的顶尖专家）的指导，以及 科学咨询团队在致癌基因驱动的肺癌、行为心理学、姑息治疗方面拥有专业知识 她将通过行为研究方法课程获得额外的技能， 该项目将使 Petrillo 博士能够参与临床试验的设计和实施以及纵向数据分析。 获得 R01 级资助并启动独立职业生涯，领导一个研究项目 支持护理和肿瘤学。