This project proposes a mentored research program to develop George J. Chang, M.D. into an independent clinician-scientist specializing in cancer-related health services research that brings together cancer epidemiology, outcomes evaluation, and clinical decision analysis in order to improve the treatment of colon and rectal cancer and to prevent and control cancer treatment related morbidities. Dr. Chang is a surgeon with dual board certifications in General Surgery and Colon and Rectal Surgery and a clinical expertise in the subject of this proposal. The career development plan consists of didactic education including a Master of Science degree in Clinical Research, a broad-based experiential learning program, and a mentored research experience, Mentored research will be conducted under the direction of the mentorship committee composed of Scott B. Cantor, Ph.D., Professor of Biostatistics at M. D. Anderson Cancer Center and past-president of the Society for Medical Decision Making;Jon E. Tyson, M.D., M.P.H., Professor of Pediatrics and Director of the Center for Clinical Research and Evidence-Based Medicine, University of Texas Health Sciences Center;and J. Robert Beck, M.D., Senior Vice President and Chief Academic Officer, Fox Chase Cancer Center will serve as an off-site mentor and committee member. The proposed research focuses on applied cancer control by developing toxicity minimized and quality-of-life preserving strategies for the treatment of patients with rectal cancer. Rectal cancer is a common disease for which the current treatment is highly effective but can be associated with high rates of treatment-related toxicity with significant patient quality-of-life and societal costs. Unfortunately, all recent attempts at traditional clinical trials based on investigation within the United States have;failed. The proposed research will use well-established advanced modeling techniques and patient preferences research to perform a virtual randomized controlled clinical trial to determine the least toxic and most clinically effective treatment strategies or the tens of thousands of patients affected by this common cancer each year.

Public Health Relevance

Current treatment strategies for rectal cancer do not account for advances in diagnosis and treatment or for the wide variety of patient related differences that affect outcomes. This proposal will help improve the selection of patients with rectal cancer for preoperative chemoradiotherapy in order that patients will experience less chronic toxicity, physicians will have evidence on which to base treatment recommendations, and society will encumber fewer treatment and toxicity related costs.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA133187-02
Application #
7883592
Study Section
Subcommittee G - Education (NCI)
Program Officer
Perkins, Susan N
Project Start
2009-07-01
Project End
2014-06-30
Budget Start
2010-07-12
Budget End
2011-06-30
Support Year
2
Fiscal Year
2010
Total Cost
$170,640
Indirect Cost
Name
University of Texas MD Anderson Cancer Center
Department
Surgery
Type
Other Domestic Higher Education
DUNS #
800772139
City
Houston
State
TX
Country
United States
Zip Code
77030
Alawadi, Zeinab; Phatak, Uma R; Hu, Chung-Yuan et al. (2017) Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer. Cancer 123:1124-1133
Park, In J; You, Y Nancy; Skibber, John M et al. (2017) Oncologic and Functional Hazards of Obesity Among Patients With Locally Advanced Rectal Cancer Following Neoadjuvant Chemoradiation Therapy. Am J Clin Oncol 40:277-282
You, Y N; Skibber, J M; Hu, C-Y et al. (2016) Impact of multimodal therapy in locally recurrent rectal cancer. Br J Surg 103:753-762
Chang, George J (2015) Simulating watch and wait for rectal cancer. Dis Colon Rectum 58:155-6
Bailey, Christina E; Hu, Chung-Yuan; You, Y Nancy et al. (2015) Variation in positron emission tomography use after colon cancer resection. J Oncol Pract 11:e363-72
Bailey, Christina E; Hu, Chung-Yuan; You, Y Nancy et al. (2015) Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA Surg 150:17-22
Zheng, Zhiyuan; Jemal, Ahmedin; Lin, Chun Chieh et al. (2015) Comparative effectiveness of laparoscopy vs open colectomy among nonmetastatic colon cancer patients: an analysis using the National Cancer Data Base. J Natl Cancer Inst 107:
Kneuertz, Peter J; Chang, George J; Hu, Chung-Yuan et al. (2015) Overtreatment of young adults with colon cancer: more intense treatments with unmatched survival gains. JAMA Surg 150:402-9
Hu, Chung-Yuan; Bailey, Christina E; You, Y Nancy et al. (2015) Time trend analysis of primary tumor resection for stage IV colorectal cancer: less surgery, improved survival. JAMA Surg 150:245-51
Massarweh, Nader N; Hu, Chung-Yuan; You, Y Nancy et al. (2014) Risk-adjusted pathologic margin positivity rate as a quality indicator in rectal cancer surgery. J Clin Oncol 32:2967-74

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