Leveraging Epidemiology and Clinical Studies of Cancer Outcomes: Recommendations and Opportunities for Translational Research

Abstract

As the number of cancer survivors continues to grow, research investigating the factors that affect cancer outcomes, such as disease recurrence, risk of second malignant neoplasms, and the late effects of cancer treatments, becomes ever more important. Numerous epidemiologic studies have investigated factors that affect cancer risk, but far fewer have addressed the extent to which demographic, lifestyle, genomic, clinical, and psychosocial factors influence cancer outcomes. To identify research priorities as well as resources and infrastructure needed to advance the field of cancer outcomes and survivorship research, the National Cancer Institute sponsored a workshop titled "Utilizing Data from Cancer Survivor Cohorts: Understanding the Current State of Knowledge and Developing Future Research Priorities" on November 3, 2011, in Washington, DC. This commentary highlights recent findings presented at the workshop, opportunities to leverage existing data, and recommendations for future research, data, and infrastructure needed to address high priority clinical and research questions. Multidisciplinary teams that include epidemiologists, clinicians, biostatisticians, and bioinformaticists will be essential to facilitate future cancer outcome studies focused on improving clinical care of cancer patients, identifying those at high risk of poor outcomes, and implementing effective interventions to ultimately improve the quality and duration of survival.

Comprehensive Audiometric Analysis of Hearing Impairment and Tinnitus After Cisplatin-Based Chemotherapy in Survivors of Adult-Onset Cancer

“…Given these increasing numbers, in-depth investigations of treatment toxicities that affect functional status, such as cisplatin-related hearing loss and tinnitus, are increasingly important. 3 Cisplatin is one of the most ototoxic drugs in clinical use, causing permanent, bilateral sensorineural hearing loss in substantial numbers of patients, with many experiencing permanent tinnitus. [4][5][6] Nonetheless, few comprehensive audiometric data exist for cisplatin-associated hearing loss in adult-onset cancer survivors.…”

Are we ready to predict late effects? A systematic review of clinically useful prediction models

“…Confronted with limited resources, the development of new risk models will require strategic leveraging and supplementing of existing data and infrastructures, to address high-priority clinical events. (24) Extending the follow-up of existing clinical trials could permit the study of late effects, as long as meaningful outcomes are routinely collected over time. Another approach is to enhance institutional databases to uniformly collect data on relevant late effects identified during routine post-treatment follow-up.…”

Cancer patients’ acceptability of incorporating an epidemiology questionnaire within a clinical trial

“…Information derived from such a questionnaire should be sufficiently flexible to facilitate the study of additional hypotheses. 33 highlighted by our study findings, clinical trial-specific epidemiology questionnaires should be adapted from the format used in traditional epidemiology studies to account for the added complexity and demands of clinical trial participation, which may involve restricting the length and content of such questionnaires. These concepts argue for growing collaborations between epidemiologists, clinicians, clinical trialists, biostatisticians and patient advocacy groups.…”