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George W. Sledge, Jr., MD
Chief, Division of Oncology
Professor of Medicine
Stanford University School of Medicine
Goal: To improve how treatment decisions are made for patients with metastatic breast cancer (MBC).
Impact: Dr. Sledge and his team have been analyzing the care pathways of tens of thousands of patients with MBC to determine what sequences of specific treatments and monitoring approaches are associated with better survival. This work will provide an invaluable tool that can guide doctors and patients in treatment decisions to improve outcomes and quality of life.
What’s next: He will continue to study genomic and outcome data using the research database Oncoshare, and expand his analyses to national insurance claims databases, allowing a “Big Data” view of common breast cancer therapeutic issues.
Clinical trials provide a wealth of information that guides treatment recommendations and informs the medical community about patient experiences. However, the vast majority of breast cancer patients never take part in clinical trials, so their experiences – their data– are not contributing to advances in breast cancer care. Through the Oncoshare Project, Dr. Sledge and his team have been able to link the electronic health records with genomic and outcomes data from tens of thousands of patients treated for breast cancer. This approach will allow researchers to identify cases of breast cancer relapse and treatment decisions that may inform optimal treatment for patients with MBC.
Full Research Summary
Research area: Understanding the changing population burden of metastatic breast cancer (MBC) to allow the identification of specific targets for the improvement of patient care and outcomes.
Impact: While the treatment and prognosis of early-stage breast cancer has improved significantly over recent decades, far less is known about changes in the incidence and survival outcomes of MBC. Most patients who have MBC are treated continuously from their metastatic diagnosis until their death; thus, their experiences and health care needs exceed those of other breast cancer patients. By mining information from multiple research and patient databases, Dr. Sledge aims to identify cases of breast cancer relapse and treatment decisions that may inform optimal treatment for patients with MBC.
Current investigation: To learn more about MBC, Dr. Sledge and his team are using Oncoshare, a research database of more than 29,000 breast cancer patients treated from 2000-2017. It integrates treatment data from electronic medical records (EMR) with demographic, tumor, and survival information from the nationwide Surveillance, Epidemiology and End Results (SEER) Registry. The team is using Oncoshare and other complementary datasets to map the care pathways of patients with MBC to determine what sequences of specific treatments and monitoring approaches are associated with better survival.
What he’s accomplished so far: Dr. Sledge has built bioinformatics tools that can identify the date and anatomic location of breast cancer relapse in EMR-based data and are also mining radiographic images to enhance their accuracy in predicting breast cancer relapse and survival.
What’s next: He and his team will continue to use Oncoshare to investigate the benefits and harms of common therapies for MBC in a real-world setting. They also plan to expand their analyses to national claims databases, allowing a “big data” view of common breast cancer therapeutic issues.
George W. Sledge Jr., MD, is Professor and Chief of Medical Oncology at Stanford University Medical Center. He specializes in the study and treatment of breast cancer and directed the first large, nationwide study on the use of paclitaxel to treat advanced breast cancer. His recent research focuses on novel biologic treatments for breast cancer. He has published over 290 scientific articles spannning both laboratory and clinic.
Dr Sledge serves as Editor-in-Chief of Clinical Breast Cancer, and is Past President of the American Society of Clinical Oncology. He served as chair of the Breast Committee of the Eastern Cooperative Oncology Group from 2002 – 2009, where he led the development of nationwide clinical trials. Dr. Sledge was awarded the Hope Funds for Cancer Research 2013 Award of ‘Excellence for Medicine’, and was also the recipient of the 2006 Brinker Award for Scientific Distinction, the 2007 Breast Cancer Research Foundation's Jill Rose Award and the 2010 William L. McGuire Award from the San Antonio Breast Cancer Symposium.