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Advancing patient-centered decision making in older adults with lung cancer: Incorporating risk of functional decline into treatment discussions

Award Number: K76AG064431
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/15/2019
PERIOD OF PERFORMANCE END DATE: 10/31/2024

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Advancing patient-centered decision making in older adults with lung cancer: Incorporating risk of functional decline into treatment discussions - PROJECT SUMMARY/ABSTRACT This is a Beeson K76 career development award for Dr. Melisa Wong, a thoracic oncology clinician- investigator dually trained in medical oncology and aging research. Dr. Wong’s long-term goal is to become a national leader in geriatric oncology research, improving cancer care for older adults by aligning treatments with individualized patient goals. More than 72% of older adults with cancer report that they would not choose a treatment that results in functional impairment, even if it improves survival. Yet, oncologists traditionally make treatment decisions based on cancer characteristics, often without discussing how treatment might affect function or eliciting patients’ goals and values. To move from cancer-centered to patient-centered decision making, oncologists must both predict which older adults are at highest risk for functional decline and communicate complex information about benefits and harms to patients in a way that aligns treatments with their goals for function, quality of life, longevity, and other priorities. This proposal aims to 1) identify risk factors for functional decline in daily activities, physical performance, and life-space mobility during chemotherapy and/or immunotherapy in older adults with metastatic lung cancer; 2A) adapt the Best Case/Worst Case (BC/WC) communication tool; and 2B) test its feasibility for use during treatment discussions with older adults with lung cancer. In Aim 1’s multi-site cohort study, patients age 65 and older with metastatic lung cancer will undergo serial geriatric assessments to measure functional status during chemotherapy and/or immunotherapy. In Aim 2A’s focus group study, older adults with lung cancer, caregivers, and oncologists will participate in focus groups to elicit feedback aimed at adapting the BC/WC tool to incorporate function and other patient priorities into patient-centered decision making. In Aim 2B’s pre-post pilot study, oncologists will be trained to use the adapted BC/WC tool; treatment discussions with older adults with lung cancer before and after training will be analyzed. Dr. Wong’s exceptional multidisciplinary mentoring team is led by Dr. Louise Walter, an internationally recognized expert on individualized decision making for cancer screening in older adults. This award will support Dr. Wong’s transition to research independence through dedicated training in 1) longitudinal modeling and risk prediction for functional decline in older adults with cancer; 2) shared decision making and decision-making interventions for older adults with functional or cognitive impairment; 3) clinical trial design to test decision-making interventions for older adults with cancer; and 4) leadership skills to direct multicenter research to transform geriatric oncology care. The results from this proposal will serve as the foundation for a multicenter cohort study to develop and validate a risk prediction score for functional decline during lung cancer treatment in older adults and a cluster-randomized trial to test the effect of the adapted BC/WC tool on communication, shared decision making, and receipt of goal-concordant care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$5,511 )
2025	2023	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Aging Research	000	6	3/5/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2025	2023	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Aging Research	001	6	4/8/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	-$5,511
														Subtotal = -$5,511

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	5	11/28/2023	NON-COMPETING CONTINUATION	-$242,381
2024	2023	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Aging Research	001	6	11/29/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$242,381
2024	2023	KAISER FOUNDATION HOSPITALS	1800 HARRISON ST FL 16	OAKLAND	CA	94612	ALAMEDA	USA	Aging Research	003	6	5/1/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$85,892
2024	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	002	4	5/1/2024	NON-COMPETING CONTINUATION	-$85,892
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $242,381 )
2023	2023	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	5	2/23/2023	NON-COMPETING CONTINUATION	$242,381
														Subtotal = $242,381

Issue Date FY: 2022 ( Subtotal = $242,543 )
2022	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	4	2/24/2022	NON-COMPETING CONTINUATION	$242,543
														Subtotal = $242,543

Issue Date FY: 2021 ( Subtotal = $242,992 )
2021	2021	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	3	2/5/2021	NON-COMPETING CONTINUATION	$242,992
														Subtotal = $242,992

Issue Date FY: 2020 ( Subtotal = $296,613 )
2020	2020	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	001	2	8/19/2020	SUPPLEMENT FOR EXPANSION	$53,999
2020	2020	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	2	2/25/2020	NON-COMPETING CONTINUATION	$242,614
														Subtotal = $296,613

Issue Date FY: 2019 ( Subtotal = $242,938 )
2019	2019	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	1	7/5/2019	NEW	$242,938
														Subtotal = $242,938

Grand Total All Awards = $1,261,956

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Advancing patient-centered decision making in older adults with lung cancer: Incorporating risk of functional decline into treatment discussions

Award Number: K76AG064431

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/15/2019

PERIOD OF PERFORMANCE END DATE: 10/31/2024

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