This project proposes a mentored research program todejvelop 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 morb dities. Dr. Chang is a surgeon with dual board certifications in General Surgery and Colon and Rectal Sijrgery 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 af 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, Univers>ity 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 controI bydeveloping toxicity minimized and quality-of-life preserving strategies for the treatment of patients withrec;tal 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. Theproposed 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 clinicallyi effective treatment strategies orthetens ofthousands 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.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic/Teacher Award (ATA) (K07)
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Study Section
Subcommittee G - Education (NCI)
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Perkins, Susan N
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University of Texas MD Anderson Cancer Center
Other Domestic Higher Education
United States
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Haynes, Alex B; You, Y Nancy; Hu, Chung-Yuan et al. (2014) Postoperative chemotherapy use after neoadjuvant chemoradiotherapy for rectal cancer: Analysis of Surveillance, Epidemiology, and End Results-Medicare data, 1998-2007. Cancer 120:1162-70
Phatak, Uma R; Li, Linda T; Karanjawala, Burzeen et al. (2014) Systematic review of educational interventions for ostomates. Dis Colon Rectum 57:529-37
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
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
Phatak, Uma R; Kao, Lillian S; You, Y Nancy et al. (2014) Impact of ileostomy-related complications on the multidisciplinary treatment of rectal cancer. Ann Surg Oncol 21:507-12
Hu, Chung-Yuan; Xing, Yan; Cormier, Janice N et al. (2013) Assessing the utility of cancer-registry-processed cause of death in calculating cancer-specific survival. Cancer 119:1900-7
Krishnan, Sunil; Chang, George J (2013) KRAS mutations and rectal cancer response to chemoradiation: are we closer to personalization of therapy? Ann Surg Oncol 20:3359-62
Bowles, Tawnya L; Hu, Chung-Yuan; You, Nancy Y et al. (2013) An individualized conditional survival calculator for patients with rectal cancer. Dis Colon Rectum 56:551-9
Tzeng, Ching-Wei D; Aloia, Thomas A; Vauthey, Jean-Nicolas et al. (2013) Morbidity of staged proctectomy after hepatectomy for colorectal cancer: a matched case-control analysis. Ann Surg Oncol 20:482-90
Overman, Michael J; Fournier, Keith; Hu, Chung-Yuan et al. (2013) Improving the AJCC/TNM staging for adenocarcinomas of the appendix: the prognostic impact of histological grade. Ann Surg 257:1072-8

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