Survivorship and Cancer Care Delivery Research and Clinical Trials

Reducing Delays in Starting Radiation Therapy after Head and Neck Cancer Surgery

ENDURE Trial
PI: Evan Graboyes, M.D., MPH

For patients with locally advanced head and neck cancer, clinical practice guidelines recommend initiating adjuvant radiation therapy within six weeks of surgery. Despite its oncologic importance, delays starting adjuvant therapy are common, disproportionately burden racial and ethnic minority populations, and contribute to poor survival and disparities in mortality.

To improve the delivery of timely, equitable adjuvant therapy, SCOR researchers launched the ENDURE (Enhanced Navigation for Disparities and Untimely Radiation thErapy) trial. This NCI-funded multisite hybrid effectiveness-implementation clinical trial will evaluate an enhanced patient navigation intervention versus usual care for decreasing delays and racial disparities starting adjuvant therapy among patients with head and neck cancer. Results may help improve survival and decrease racial disparities in mortality for patients with head and neck cancer while improving our understanding of the delivery of effective interprofessional team-based cancer care.

Development and Implementation of a Novel Shared Decision-Making Tool to Support Cancer Care Delivery Concordant with Patient Treatment Preferences

Shared Decision-Making
PI: Kathryn Engelhardt, M.D.

Shared decision-making (SDM) is a critical component to determining the optimal treatment of lung cancer. However, most interventions to enhance SDM target the provider. As a result, SDM-based interventions often shift decision-making responsibility to the overwhelmed patient.

This project aims to evaluate the implementation of a previously developed decision grid in the thoracic oncology clinics of Hollings Cancer Center and to engage patients and family members to understand what information patients want to share and how we can support transfer of this knowledge from patients to providers. Study findings will enhance the dissemination and implementation of SDM tools into clinical care for patients with lung cancer.

Unmet Psychosocial Needs Among Individuals Living with Likely Incurable Cancer

Depression Management
PIs: Jennifer Dahne, Ph.D., and Evan Graboyes, M.D., MPH

Individuals living with likely incurable cancer are a heterogeneous, growing subpopulation of cancer survivors who have unique survivorship care needs. Principal among these is the need for feasible, accessible evidence-based management of depression. Current approaches to managing depression in this patient population are limited in part by the ability to efficiently identify these patients in the electronic medical record.

To address these gaps, SCOR researchers are leading a randomized clinical trial to assess the effectiveness of a proactive identification plus digital mental health intervention approach among individuals living with likely incurable cancer. They are also aiming to develop an electronic health record-derived phenotype of likely incurable cancer to enhance efficient identification of these individuals for referral to a range of supportive care services and clinical trials. Results from this research have the potential to expand evidence-based psychosocial treatment access in a manner that is scalable across oncology settings for individuals living with likely incurable cancer.

Survivorship Needs Assessment and Planning

SNAP Trial
PI: Katherine Sterba, Ph.D., MPH

Cancer caregivers face unique and overwhelming burdens as they care for survivors with life-altering changes in physical and social functioning, devastating late and long-term treatment effects and extremely demanding follow-up care. There is a significant gap in knowledge about effective care transition interventions to address caregiver burden and survivor toxicities and improve supportive care and health care utilization (HCU).

SCOR researchers are leading a study to improve post-treatment recovery outcomes in head and neck cancer survivors and their caregivers through the delivery of a tablet-based, dyadic survivorship needs assessment planning (SNAP) tool implemented into clinic workflow at the end of treatment. Results from this NCI-funded randomized clinical trial of 176 cancer survivor-caregiver dyads may provide critical evidence supporting this sustainable, technology-enabled care planning system.

Body Image-Related Distress Among Head and Neck Cancer Survivors

BRIGHT Trial
PI: Evan Graboyes, M.D., MPH

Head and neck cancer survivors suffer high rates of body image-related distress which results in significant psychosocial morbidity and decreased quality of life. However, effective therapies to manage this disorder among head and neck cancer survivors are lacking.

To address this gap, SCOR researchers launched the BRIGHT (Building a Renewed ImaGe after Head and neck cancer Treatment) trial. This NCI-funded multisite randomized clinical trial will randomize head and neck cancer survivors (N=180) to a brief tele-cognitive behavioral therapy intervention or a dose- and delivery-matched tele-survivorship education control condition. Results could provide evidence supporting the first effective treatment in this population, thereby minimizing psychosocial morbidity, improving quality of life and developing new standards of clinical care.

Implementation of Palliative Care in Low-Resource Settings

Palliative Care Implementation
PI: Suparna Qanungo, Ph.D.

The extremely limited use of palliative care in low resource settings exacerbates suffering in patients with life-limiting illnesses such as cancer. This is particularly a problem for patients living in rural areas where barriers to care are even more pronounced.

The goal of this NCI-funded pragmatic clinical trial is to test and evaluate a home-based palliative care intervention for utilizing community health workers to facilitate the delivery of palliative care to cancer patients in rural India. Results from this trial may enhance the implementation of palliative care for patients with cancer in low-resource settings, thereby minimizing symptom burden and enhancing quality of life for cancer survivors.

Yogic Breathing Video App for Breast Cancer Survivors

Pranayama Trial
PI: Sundar Balasubramanian, Ph.D.

Cancer survivorship is associated with many long-term chronic health issues that arise as a result of cancer treatment protocols. Non-pharmacological lifestyle and mind-body interventions have been shown to be effective and critical components of a total-health strategy for cancer survivors.

In this NCI-funded Small Business Technology Transfer (STTR) Grant, PranaScience Institute seeks to develop and test a novel group video app for home-based delivery of a yogic breathing intervention that reduces symptoms of cancer treatment survival and supports total-health. Results could provide a scalable platform for a mind-body intervention to manage chronic health concerns among cancer survivors.

For more information about SCOR,
please contact:
Willie Schaub
Administrative Coordinator
Survivorship and Cancer Outcomes Research
schaub@musc.edu

For direct inquiries about research or scientific opportunities, please contact:
Evan Graboyes, M.D., MPH, FACS
Director
Survivorship and Cancer Outcomes Research
graboyes@musc.edu