George W. Sledge, Jr., MD
Chief, Division of Oncology
Professor of Medicine
Stanford University School of Medicine
Using big data approaches to understand population-level aspects of metastatic breast cancer to inform treatment and improve outcomes.
Metastatic breast cancer (MBC) is responsible for the overwhelming majority of deaths from the disease. Understanding the burden of MBC on the overall population is critical because it helps public health experts pinpoint specific targets for improving patient care and outcomes. Population-based research can reveal large-scale trends in myriad aspects of a disease that enable the characterization of important metrics such as common sites of disease recurrence, identifying high-risk populations, racial and ethnic disparities, assessing the financial aspect of treatment, how to undertake prevention, and more. These data can guide doctors and patients in treatment decisions to improve outcomes and quality of life. Dr. Sledge is using a “big data” approach to discover care trajectories that are associated with optimal survival and quality of life for breast cancer patients.
Dr. Sledge approached the complex question of population-level MBC burden by creating Oncoshare, a novel breast cancer research database that links complementary information from (1) the electronic medical records of breast cancer patients from two health care systems; (2) the population-based SEER cancer registry; (3) detailed genomic testing; and (4) tumor tissue samples. In the past year, Dr. Sledge has developed and applied novel informatic approaches to understand how metastatic breast cancer is treated across the United States. He has used them to mine medical records for the anatomic location of breast cancer recurrence and to measure the cost of breast cancer care. Dr. Sledge has also identified breast cancer care disparities associated with native language and breast cancer treatment disruptions due to COVID-19.
In the coming year, Dr. Sledge plans to apply novel informatic approaches that can construct patient trajectories and identify the timing and anatomic location of MBC recurrence to address two new questions about MBC treatment and outcomes. First, he aims to characterize the utilization, results, treatment, and mortality outcomes of clinical tumor genomic sequencing among patients with metastatic breast cancer. Tumor genetic analysis is becoming increasingly common to determine patients’ eligibility for targeted treatments, but very little is known about how genetic and genomic testing are used and interpreted in the care of MBC patients, particularly in racially/ethnically diverse patient populations. Second, he will investigate whether MBC patients who received medications that may disrupt the microbiome have differences in immune cell counts compared to patients who did not. This information may be helpful in understanding the overall role of the immune system in response to chemotherapy and in identifying which patients will benefit from immunotherapy.
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 spanning 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.
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