A5004343506- BRCA gene mutations in cancer
- Colorectal Cancer Treatments and Studies
- COVID-19 and healthcare impacts
- Gastric Cancer Management and Outcomes
- Palliative Care and End-of-Life Issues
- Pancreatic and Hepatic Oncology Research
- Lung Cancer Treatments and Mutations
- Cancer therapeutics and mechanisms
- Cancer survivorship and care
- Cardiac, Anesthesia and Surgical Outcomes
- Economic and Financial Impacts of Cancer
- Cancer Genomics and Diagnostics
- Health Systems, Economic Evaluations, Quality of Life
- Trauma and Emergency Care Studies
- Colorectal Cancer Screening and Detection
- Esophageal Cancer Research and Treatment
- Genomics and Rare Diseases
- Genetic factors in colorectal cancer
- HER2/EGFR in Cancer Research
- Advances in Oncology and Radiotherapy
- Liver Disease Diagnosis and Treatment
- Advanced Breast Cancer Therapies
- Multiple and Secondary Primary Cancers
- PARP inhibition in cancer therapy
- Hepatocellular Carcinoma Treatment and Prognosis
Massachusetts General Hospital
2017-2025
Harvard University
2017-2025
Hôpital Cochin
2024
Assistance Publique – Hôpitaux de Paris
2024
Sorbonne Paris Cité
2024
Université Paris Cité
2024
Institut national de recherche en informatique et en automatique
2024
The University of Texas Southwestern Medical Center
2021-2024
Southwestern Medical Center
2024
University of Michigan
2024
Germline genetic testing (GT) for BRCA1/2 is instrumental in identifying patients with breast and ovarian cancers who are eligible PARP inhibitors (PARPi). Little known about recent trends determinants of GT since PARPi were approved these patients.
Technologies in genomic medicine have rapidly evolved and transformed the ability to deliver precision nearly every field of health care. As has advanced, electronic record (EHR) simultaneously been adopted into routine practice. A recent Points Consider Statement by American College Medical Genetics Genomics (ACMG) provides a framework for optimal integration data EHR.1.Grebe T.A. et al.The interface information with record: points consider statement (ACMG).10.1038/s41436-020-0841-2Genet....
Abstract Background Pharmacogenetic (PGx) testing for germline variants in the DPYD and UGT1A1 genes can be used to guide fluoropyrimidine irinotecan dosing, respectively. Despite known association between PGx chemotherapy toxicity, preemptive prior initiation is rarely performed routine practice. Methods We conducted a qualitative study of oncology clinicians identify barriers using dosing patients with gastrointestinal malignancies. Each participant completed semi-structured interview...
PURPOSE Capecitabine is an oral chemotherapy used to treat many gastrointestinal cancers. Its complex dosing and narrow therapeutic index make medication adherence toxicity management crucial for quality care. METHODS We conducted a pilot study of PENNY-GI, mobile phone text messaging–based chatbot that leverages algorithmic surveys natural language processing promote among patients with cancers on capecitabine. Eligibility initially included all capecitabine-containing regimens but was...
Malignant neoplasms of the hepatopancreaticobiliary (HPB) system constitute a significant public health problem worldwide. Treatment coordination for these tumors is challenging and can result in substandard care. Referral centers HPB disease have been used as strategy to improve postoperative outcomes, but their effect on accomplishing regionalization care improving quality cancer not well known.To evaluate implementing multidisciplinary surgical program (HPB-SP) care, outcomes within an...
Although hospitalized patients with advanced cancer have a low chance of surviving cardiopulmonary resuscitation (CPR), the processes by which they change their code status from full to do not resuscitate (DNR) are unknown.We conducted mixed-methods study on prospective cohort cancer. Two physicians used consensus-driven medical record review characterize that led order transitions DNR.In total, 1047 hospitalizations were reviewed among 728 patients. Admitting clinicians did address in 53%...
PURPOSE Germline genetic testing (GT) is recommended for all patients with pancreatic ductal adenocarcinoma (PDAC), but the traditional clinical genetics infrastructure limited in addressing unique needs of this population. We describe integration point care (POC) GT into routine practice PDAC at an academic medical center. METHODS developed a POC workflow that leverages electronic health record (EHR) tools and behavioral nudges to enhance sustainability scalability our previously described...
Background Fluoropyrimidines (fluorouracil [5-FU], capecitabine) and irinotecan are commonly prescribed chemotherapy agents for gastrointestinal (GI) malignancies. Pharmacogenetic (PGx) testing germline DPYD UGT1A1 variants associated with reduced enzyme activity holds the potential to identify patients at high risk severe chemotherapy-induced toxicity. Slow adoption of PGx in routine clinical care is due implementation barriers, including long test turnaround times, lack integration...
Abstract Background Targeted cancer drugs (TCDs) have revolutionized oncology but vary in clinical benefit and patient out-of-pocket (OOP) costs. The American Society of Clinical Oncology (ASCO) Value Framework uses survival, toxicity, symptom palliation data to quantify the net health (NHB) drugs. We evaluated associations between NHB, uptake, spending on oral TCDs. Methods conducted a retrospective cohort study patients aged 18-64 years with an incident TCD pharmacy claim 2012-2020...
PURPOSE To develop an electronic health record (EHR)–based clinical decision support (CDS) tool to promote guideline-recommended cancer risk management among patients with Lynch syndrome (LS), inherited that confers increased of colorectal and other types. MATERIALS AND METHODS We conducted a cross-sectional study determine the baseline prevalence predictors colonic surveillance annual genetics program visits LS. Multivariable log-binomial regressions estimated ratios (PRs) adherence by...
Objective: We aimed to evaluate the safety and efficacy of NAT followed by surgical resection in patients with PDAC aged ≥75 years. Summary Background Data: Whether administration neoadjuvant therapy (NAT) elderly pancreatic ductal adenocarcinoma (PDAC) is safe effective unknown. Methods: The present study a three-part comparison older (≥ 75 years) versus younger (< different settings throughout continuum care. first analysis was consecutive non-metastatic who were initiated on...
PURPOSE Less than half of the patients with newly diagnosed metastatic non–small cell lung cancer (NSCLC) undergo comprehensive molecular testing. We designed an electronic medical record (EMR)–based “nudge intervention” to prompt plasma-based testing at time initial oncology consultation. METHODS A nonrandomized prospective trial was conducted University Pennsylvania's academic practice and two affiliated community practices. Molecular genotyping performed by tissue- and/or next generation...
Background Pain is a common symptom for patients with cancer. Hospice and Palliative Medicine (HPM) physicians are expected to be experts in both pharmacologic non-pharmacologic treatment of pain this patient population. Insufficient knowledge non-pharmacologic, interventional approaches management barrier providing optimal care. This study assesses the feasibility effectiveness an curriculum on HPM fellow at single institution. Objectives The primary objective was implement fellows’...
Little is known about serious illness conversations (SIC) conducted during telemedicine visits and their impact on end-of-life (EOL) outcomes for patients with advanced cancer.
Early-onset colorectal cancer (CRC) diagnosed under age 50 is increasing at alarming rates, with >75% of early-onset cases occurring in patients between 40 and 49 years old. Germline genetic risk evaluations are key to delivering high-quality care these patients. We conducted a single-arm pilot implementation study default referral process for CRC ages 5 hospitals an academic health system. A research coordinator notified their oncologists eligibility referral, after which all who did not...
Anti human epidermal growth factor receptor 2 (anti-HER2) therapy with trastuzumab improves overall survival in patients advanced, HER2-positive gastroesophageal adenocarcinoma (GEA) and is now incorporated into national guidelines. However, little known about adherence to determinants of timely HER2 testing initiation routine practice.The authors performed a cross-sectional study who had advanced GEA diagnosed between January 2011 June 2019 nationwide electronic health record-derived...
12 Background: Precision oncology has transformed care for patients with advanced HER2+ gastroesophageal adenocarcinoma (GEA), where the addition of anti-HER2 therapy trastuzumab improves overall survival and is now incorporated into national guidelines. However, little known about adherence to determinants timely HER2 testing initiation in routine care. Methods: We performed a retrospective study GEA diagnosed between 1/2011 6/2019 nationwide Flatiron Health EHR-derived deidentified...