Although they present more than half of all Americans with cancer, the elderly are under-represented on the clinical trials that seek to determine efficacy and toxicity of chemotherapy. For this reason, results of clinical trials may not be applicable to the general population of elderly cancer patients. Nonetheless, physicians need clinical information regarding tile risks and benefits of chemotherapy in this substantial group of patients. I am a medical oncologist who seeks to develop a career at the crossroads oncology and health services research that is focused on determining the risks and benefits of chemotherapy in the general population of elderly cancer patients. In five years, I want to be able to execute a series of epidemiologic studies examining the possible contribution of medical comorbidity to the chemotherapy utilization and outcomes of elderly Americans with cancer. This long-term research agenda requires additional training on my part and three preliminary studies to determine the ability of a candidate data source, Heath Care Financing Administration's Medicare claims files, to provide inexpensive but reliable clinical information for these studies. Through the three related projects, I seek to determine the reliability of Medicare chemotherapy claims at capturing three critical elements of anti-cancer therapy 1) chemotherapy administration, 2) chemotherapy-related toxicities, and 3) disease-free survival. To meet these three aims, I will create a new and unique data set by linking Medicare claims to a gold-standard of clinical information regarding chemotherapy administration and outcomes, Cancer and Leukemia Group B (CALGB) clinical trial data. Defining the CALGB data as the gold standard against which to compare the Medicare claims, I will then calculate the sensitivity and specificity of the Medicare claims at capturing 1) chemotherapy administration, and 2) specific chemotherapy-related toxicities, and 3) disease-free survival. In the next phase of my career, I will use Medicare claims, to the extent of their validity, to execute a series of epidemiologic studies examining the chemotherapy utilization and outcomes of elderly Americans with cancer and medical comorbidity.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA093892-06
Application #
7015095
Study Section
Subcommittee G - Education (NCI)
Program Officer
Gorelic, Lester S
Project Start
2002-02-01
Project End
2007-01-31
Budget Start
2006-02-01
Budget End
2007-01-31
Support Year
6
Fiscal Year
2006
Total Cost
$130,363
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Lamont, Elizabeth B; Schilsky, Richard L; He, Yulei et al. (2015) Generalizability of trial results to elderly Medicare patients with advanced solid tumors (Alliance 70802). J Natl Cancer Inst 107:336
Lamont, Elizabeth B; Dias, Lauren E (2008) Secular changes in NSAID use and invasive colorectal cancer incidence: an ecological study. Cancer J 14:276-7
Lamont, Elizabeth B; Herndon 2nd, James E; Weeks, Jane C et al. (2008) Measuring clinically significant chemotherapy-related toxicities using Medicare claims from Cancer and Leukemia Group B (CALGB) trial participants. Med Care 46:303-8
Lamont, Elizabeth B; Dias, Lauren E; Lauderdale, Diane S (2007) NSAIDs and colorectal cancer risk: do administrative data support a chemopreventive effect? J Gen Intern Med 22:1166-71
Polite, Blase N; Lamont, Elizabeth B (2006) Are venous thromboembolic events associated with subsequent breast and colorectal carcinoma diagnoses in the elderly? A case-control study of Medicare beneficiaries. Cancer 106:923-30
Lamont, Elizabeth B; Herndon 2nd, James E; Weeks, Jane C et al. (2006) Measuring disease-free survival and cancer relapse using Medicare claims from CALGB breast cancer trial participants (companion to 9344). J Natl Cancer Inst 98:1335-8
Lamont, Elizabeth B; Herndon 2nd, James E; Weeks, Jane C et al. (2005) Criterion validity of Medicare chemotherapy claims in Cancer and Leukemia Group B breast and lung cancer trial participants. J Natl Cancer Inst 97:1080-3
Gupta, Supriya K; Lamont, Elizabeth B (2004) Patterns of presentation, diagnosis, and treatment in older patients with colon cancer and comorbid dementia. J Am Geriatr Soc 52:1681-7
Lamont, Elizabeth B; Christakis, Nicholas A; Lauderdale, Diane S (2003) Favorable cardiac risk among elderly breast carcinoma survivors. Cancer 98:2-10
Lamont, Elizabeth B; Christakis, Nicholas A (2003) Complexities in prognostication in advanced cancer: ""to help them live their lives the way they want to"". JAMA 290:98-104

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