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George W. Sledge, Jr., MD
Chief, Division of Oncology
Professor of Medicine
Stanford University School of Medicine
- Seeking to improve how treatment decisions are made for patients with metastatic breast cancer.
- "Big data" serves as the resource for the development of treatment decision tools to improve decision making and improve outcomes in patients with metastatic breast cancer.
- This work will provide an invaluable tool that can guide doctors and patients in treatment decisions to improve both outcomes and quality of life.
The incidence of metastatic breast cancer is poorly tracked in patient databases. As a consequence, little is known about changes in incidence and survival of metastatic breast cancer that could inform the clinical care of patients. Dr. Sledge has developed a bioinformatics tool that integrates information from multiple research and patient databases. This approach will allow researchers to identify cases of breast cancer relapse and treatment decisions that may inform optimal treatment for patients with metastatic breast cancer.
Full Research Summary
The treatment and prognosis of early-stage breast cancer has markedly improved over recent decades. However, far less is known about changes in the incidence and survival outcomes of metastatic breast cancer (MBC).
Most MBC patients are treated continuously from their metastatic diagnosis until their death, and thus, their experiences and health care needs exceed those of other breast cancer patients. The focus of Dr. Sledge's BCRF-supported project is to build and validate a biomedical informatics strategy to identify the incidence of MBC, which is not currently tracked by any national registry or medical record system. The long-term goal of this project is to develop a clinical decision support tool that mines patient data to evaluate the real-world benefit of treatment options for MBC.
His team's primary resource is Oncoshare, a research database of 26,000 breast cancer patients treated between 2000 and 2015. The Oncoshare database integrates treatment data from electronic medical records with demographic, tumor, and survival information from the nationwide Surveillance, Epidemiology and End Results (SEER) Registry.
In the past year, the team developed a biomedical informatics tool called CLEVER that can identify distant metastatic relapse and loco-regional relapse with high accuracy.
In the coming year, they will use CLEVER to characterize patients with MBC in Oncoshare and will conduct parallel analyses of insurance claims datasets to evaluate the real-world effectiveness and impact of two newly approved targeted agents, palbociclib and everolimus.
This detailed analysis will offer a broad and deep perspective on the utilization, side effects, costs, and survival outcomes to guide patients and clinicians who are faced with this challenging and relatively understudied disease.
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.