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New Laboratory to Address Genomics, Risk and Health Decision Making Transdisciplinary Population Science Grants Awarded Volume 5 | Issue 5 SOARNEWS November 2016 Newsletter of the Survivorship, Outcomes And Risk Program at MSK Transdisciplinary Population Science Grants Awarded Funds Support Collaboration Between SOAR Investigators and Clinical, Laboratory Researchers From left to right: Helena Furberg Barnes (Epidemiology & Biostatistics), Andrew Dannenberg (Weill Cornell Medical College), James Root (Psychiatry & Behavioral Sciences), Elin Berman (Medicine), Benjamin Roman (Surgery), Jennifer Hay (Psychiatry & Behavioral Scienc- es), Michael Tuttle (Medicine), Victoria Blinder (Epidemiology & Biostatistics), Wendy Lichtenthal (Psychiatry & Behavioral Sciences) Four projects were funded in the fourth round of the (Medicine) were funded for their study Decision Mak- MSK Transdisciplinary Population Science Awards, ing and Psychological Outcomes in Low Risk Papillary announced this month. Thyroid Cancer. This study will survey physicians and Helena Furberg Barnes (Epidemiology & Biostatis- patients who have recently been diagnosed with low tics), and Andrew Dannenberg (Weill Cornell Medical risk papillary thyroid cancer (LR-PTC), with the aim College) were funded for their study Metabo-Inflam- of investigating factors that influence the decision to mation and The Obesity Paradox in Kidney Cancer. pursue surgery or active surveillance for initial disease This project builds on previous research which identi- management. The investigators will also evaluate fied mechanisms linking white adipose tissue inflam- and compare psychological outcomes of patients who mation characterized by crown-like structures (CLS) have chosen active surveillence or surgery for LR- and cancer. The investigators will examine perinephric PTC. CLS in kidney cancer and examine its associations Victoria Blinder (Epidemiology & Biostatistics) and with clinicopathologic variables, body composition and Wendy Lichtenthal (Psychiatry & Behavioral Scienc- circulating systemic biomarkers. es) were funded for their study Development of an James Root (Psychiatry & Behavioral Scienc- Intervention to Help Low-Income Breast Cancer Pa- es) and Elin Berman (Medicine) were funded for tients Work During Treatment. This project builds on their study Assessment Of Cognitive Dysfunction in Dr. Blinder’s existing study, which found that low-in- TKI-Treated Chronic Myelogenous Leukemia Patients come breast cancer patients were less likely to retain Using Cognitive-Experimental Methods. The investi- their jobs after treatment than higher-income women. gators developed a battery of cognitive-experimen- The investigators will develop a mobile health appli- tal measures, the Sensory-Attention Battery (SAB), cation to better support low-income immigrant and which will be used to assess cognitive disfunction in minority breast cancer patients receiving chemothera- TKI-treated chronic myelogenous leukemia patients py and improve long-term employment outcomes. and age- and education-matched controls. The in- The Transdisciplinary Population Science awards vestigators will also assess whether the SAB is able are funded through MSK’s NCI Cancer Center Core to detect higher rates of cognitive dysfunction than grant, a goal of which is to stimulate collaboration traditional measures. across disciplines within a center. Applications for the Benjamin Roman (Surgery), Jennifer Hay (Psy- next funding cycle will be announced in May 2017, chiatry & Behavioral Sciences) and Michael Tuttle with an anticipated submission deadline next fall. New Laboratory to Address Genomics, Risk and Health Decision Making SOAR Investigators Expand Research in Behavioral Aspects of Personalized Medicine The Department of Psychiatry and Behavioral Sci- able Cancer Targets (IMPACT) panel. Supported by an ences recently established a new laboratory for Ge- American Cancer Society Mentored Research Scholar nomics, Risk and Health Decision Making. Under the Grant, Hamilton is studying MSK patients’ attitudes and leadership of Jennifer Hay and Jada Hamilton, the beliefs about tumor genomic profiling, and in particular, lab will facilitate translation of discoveries in cancer risk their feelings about incidental findings from tests like and genomics through research on cancer risk percep- IMPACT. Commenting on the importance of this work, tion and health decision making in patients, families, Hay noted that without studies like Hamilton’s, “we healthcare providers and the public. make assumptions about what patients understand Asked about the impetus for starting the new lab, and what they believe, and research tells us over and Hay cited the burgeoning fields of genomics and over again that our assumptions are often wrong.” personalized medicine. Hay has been studying the In addition to Hay and Hamilton, the Genomics, Risk relationship between risk perception and behavior and Health Decision Making Lab includes several train- for many years; for example, examining whether and ees and research staff members. Hamilton and Hay how a person’s perceived melanoma risk influences hope that the lab will stimulate collaborations within his or her use of skin protection strategies. But the Psychiatry and Behavioral Sciences and with investi- pace of technological advances demands increased gators in other departments. The lab aims to facilitate attention to these issues. “Personalized medicine has theoretical, methodologic and applied research in implications across the cancer trajectory and requires health decision making and risk communication. Le- the translation of rapidly emerging evidence on cancer veraging the expertise and resources of the institution, etiology and treatment,” Hay said. Hay and Hamilton hope that the new lab will enhance Research in genomics and decision making is par- MSK’s ability to respond to funding announcements ticularly relevant at MSK following the institution-wide that address cancer risk assessment, prevention and adoption of the Integrated Mutation Profiling of Action- treatment. SOAR Grants Study Shows Benefit of Adherence to Prostate Abraham Aragones (Immigrant Health Cancer Screening Recommendations & Cancer Disparities) was awarded an If U.S. men and their physicians followed R01 from the National Institute on Minority current recommendations for prostate cancer Health and Health Disparities for “Ed- screening and treatment, more than one-third Tech-HPV: A Community Approach using of prostate biopsies could be avoided with little Education and Technology to Increase impact on prostate cancer mortality, according HPV Vaccination.” to a recent study by Sigrid Carlsson (Health Malcolm Pike (Epidemiology) received an Outcomes). The study, published in Cancer, award from the Department of Defense’s included co-authors Hans Lilja (Surgery) and Ovarian Cancer Research Program to sup- Andrew Vickers (Health Outcomes). Sigrid Carlsson port the “Multidisciplinary Ovarian Cancer Carlsson and her colleagues used micro- Outcomes Group.” simulation to estimate the impact of “best practices” for prostate cancer screening compared with observed practice patterns. SOAR Seminars Best practices include not screening elderly men 70 and older, considering reflex testing before biopsy, recommending ac- tive surveillance for appropriate patients and referring men to high-volume providers when indicated. Following these best practices would result in about 400 biopsies per 1,000 men, of which 250 would be negative, compared with almost 600 biop- sies in current practice, of which more than 350 would be neg- ative. Use of best practices was associated with a 37% relative reduction in prostate cancer mortality, compared with 41% under current practice. Ann Zauber (Epidemiology & Biostatistics) An additional benefit of following best practices was improve- presented New Colorectal Cancer Screen- ment in quality of life, primarily attributable to the increase in ing Recommendations for Colorectal active surveillance for men with low-risk disease, despite the Cancer from the United States Preventive slightly greater mortality benefit associated with current prac- Services Task Force: Process and Dissem- tice. Screening 1,000 men with best practices resulted in 74 ination on September 13th. quality-adjusted life-years, while current practice was associat- ed with only 19 QALYs. Asked about the implications of the study, Carlsson said that current practice has been associated with benefit but also harm, and that by following straightforward guidelines, the net benefit of PSA screening can be improved. However, changing practice can be difficult. “We need more work in implementation science [to identify] ways of influencing physician behavior,” Carlsson said. She also noted the value of microsimulation. “Because the PSA test is so widespread in the community,” said Carlsson, Peter Bach (Health Outcomes) presented “there will never be another randomized controlled trial. Model- A Research Program on Drug Pricing on ing allows us to project lifetime outcomes and can give import- October 6th. ant information regarding who, when and how often to screen.” SOAR Honors Andrew Vickers (Health Outcomes) received the 2016 MSKCC Excellence in Mentoring Award. Philip Castle, Albert Einstein College of SOAR Investigators Receive Top Honor Medicine, presented Globalization of Cer- SOAR investigators Peter vical (Pre)Cancer Screening as a Model of Bach (Health Outcomes) and Addressing Global Cancer Health Dispari- Kenneth Offit(Clinical Genet- ties on November 17th. ics) were elected to the National Academy of Medicine. Bach and Offit are among
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