Cancer
Study Results that Support Better-Informed Decisions
Oral Blood Thinner as Effective as Injectable Type in Preventing Blood Clots in Adults with Cancer
Adults with cancer who took a newer oral blood thinner to prevent recurrent venous thromboembolism (VTE), or blood clots, fared just as well as those who took an older injectable blood thinner, according to results published in JAMA from the PCORI-funded CANVAS Trial. The study compared the effectiveness of direct oral anticoagulants (DOACs) with injectable low-molecular-weight heparin (LMHW) among 638 adults with cancer at 67 sites.
Following a six-month treatment period, the study team found that DOAC treatment was noninferior to LMHW treatment for preventing recurrent VTE. In addition, there were no significant differences between the two groups in bleeding, mortality, serious adverse events, quality of life, or burden and benefits of medication.
Changing Prescription Order Systems to Lower Risk of Febrile Neutropenia in Patients Starting Chemotherapy
The PCORI-funded TrACER study—which tested whether adding information to a prescription order system would make it easier for doctors to follow practice guidelines and for patients receiving chemotherapy to get the medicine they need to prevent febrile neutropenia (FN)—found that adding standing orders in the prescription order system did not significantly change the way that doctors prescribe the drug for patients with high or low risk for FN.
The research team, from the Fred Hutchinson Cancer Research Center, presented these results during the 2022 American Society of Clinical Oncology Annual Meeting. Febrile neutropenia is a serious health problem that some patients receiving chemotherapy can develop. FN involves having a fever and a low number of a type of white blood cells, which can place patients at an elevated risk for infection.
Telehealth Interventions Improve Outcomes for Patients with Advanced Cancer
Patients with advanced cancer who used telehealth to regularly report symptoms improved their overall well-being, compared with those who were seen less frequently via in-person clinical visits, according to results from the PCORI-funded PRO-TECT Trial. The findings were published online in JAMA and presented at the 2022 American Society of Clinical Oncology annual meeting.
The research team compared the benefits of giving patients information about symptom management and the ability to report their symptoms via an internet-based or automated telephone system, with providing patients information about symptom management during in-person clinical visits. Patients who used telehealth to communicate about their symptoms on a weekly basis said they experienced improved physical function, better control of their symptoms, and improved quality of life, compared with those who were evaluated less frequently, during in-person clinical visits.
Systematic Review on Breathlessness in Patients with Advanced Cancer
A final systematic review report on interventions for breathlessness in patients with advanced cancer is now available online. Produced by the Agency for Healthcare Research and Quality in partnership with PCORI, the review compares the benefits and harms of nonpharmacological and pharmacological interventions for the management of dyspnea.
Dyspnea is defined as difficulty breathing, or shortness of breath, and is a frequent and debilitating condition for individuals with advanced cancer. A related article also appeared in JAMA Oncology.
Acknowledging Age-Related Issues Improves Communication
Age-related challenges—including memory loss, limited caregiver availability, or chronic conditions—can affect how older adults respond to treatment for cancer, but physicians sometimes aren’t aware of them. The COACH Study wanted to see if a report about issues related to a patient’s age would improve care-planning communication among the patient, caregiver, and doctor.
As reported in JAMA Oncology, compared with patients without a report, patients who had one were engaged in and more satisfied with conversations with their physician.
Comparing Intensity of Follow-Up Tests after Colorectal Cancer Surgery
Regular follow-up testing, such as CT scans or blood tests, can help patients who have had surgery for colorectal cancer find out if the cancer has come back. But researchers at the Alliance for Clinical Trials in Oncology Foundation wanted to investigate if having more frequent tests works better for patients than having less frequent tests.
They compared data from patients and found that having less frequent tests made no difference in whether patients had a second surgery, how often a patient’s cancer came back, or how likely patients were to live for five years after their first surgery.
Cancer Study Spotlights
Helping Cancer Survivors Return to Class
There are about 429,000 survivors of childhood and adolescent cancer in the United States, but there are not enough school programs and school liaisons available to keep up with the growing number of survivors and the challenges they face at school. Learn about the tools that PCORI engagement awardees created with parents, teachers, and other stakeholders to help ease the path back to school for childhood cancer survivors.
Increasing Colon Cancer Screening Rates in the Hispanic Population
This PCORI-funded study compared the effectiveness of two communication approaches by the Lehigh Valley Health Network in Pennsylvania that aimed to increase the colon cancer screening rate among Hispanics.
Personalized Breast Cancer Screening
Women have different levels of risk for breast cancer, so the traditional approach of deciding when to have mammograms based mainly on age might not be the best one. This study compares two screening schedules—one based on risk and one on age—to see how well each detect cancer, how women feel about using a risk-based schedule, and whether that approach decreases false alarms that may lead to unneeded tests or treatments.
Additional Projects on Cancer
Database Identifies Emerging Technologies, Innovations
PCORI’s Horizon Scanning Database offers healthcare decision makers findings about advancements in six key areas of interest: Alzheimer’s disease and other dementias, cancer, cardiovascular diseases, COVID-19, mental and behavioral health, and rare diseases. This database can be used by patients, care partners, and others to track advancements in care options.
PCORI Stories
'It's Nonjudgmental Support': Breathing Easier with the Healthy Lungs Program
An estimated 30 million adults in the United States smoke cigarettes, and more than half of them live with a smoking-related health condition. To help smokers who want to kick the habit, a PCORI-funded study is comparing strategies to help people undergoing lung cancer screening to quit smoking.
With a focus on lung cancer prevention, the Healthy Lungs research team is recruiting 3,200 current smokers from underrepresented groups referred for lung cancer screening at four large health systems across the country.
Evidence for Decisions from PCORI-Funded Studies
Evidence Updates: Early-Stage and Localized Prostate Cancer
Early-stage prostate cancer can be treated in different ways.
Two PCORI-funded research studies provide new information on the effects of treatments and can help patients navigate their treatment decisions.