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Article: Remote Oncology Care: Review of Current Technology and Future Directions.

McGregor, Bradley A / Vidal, Gregory A / Shah, Sumit A / Mitchell, James D / Hendifar, Andrew E

2020 Volume 12, Issue 8, Page(s) e10156

Abstract: Cancer patients frequently develop tumor and treatment-related complications, leading to diminished quality of life, shortened survival, and overutilization of emergency department and hospital services. Outpatient oncology treatment has potential to ... ...

Abstract	Cancer patients frequently develop tumor and treatment-related complications, leading to diminished quality of life, shortened survival, and overutilization of emergency department and hospital services. Outpatient oncology treatment has potential to leave cancer patients unmonitored for long periods while at risk of clinical deterioration which has been exaggerated during the COVID19 pandemic. Visits to cancer clinics and hospitals risk exposing immunocompromised patients to infectious complications. Remote patient reported outcomes monitoring systems have been developed for use in cancer treatment, showing benefits in economic and survival outcomes. While advanced devices such as pulmonary artery pressure monitors and implantable loop recorders have proven benefits in cardiovascular care, similar options do not exist for oncology. Here we review the current literature around remote patient monitoring in cancer care and propose the use of reliable devices for capturing and reporting patient symptoms and physiology.
Keywords	covid19
Language	English
Publishing date	2020-08-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.10156
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Article ; Online: Racial and socioeconomic disparities in retroperitoneal lymph node dissection and survival in nonseminomatous germ cell tumor: A population-based study.

Bhambhvani, Hriday P / Greenberg, Daniel R / Kasman, Alex M / DeRouen, Mindy C / Cheng, Iona / Eisenberg, Michael L / Shah, Sumit A

Urologic oncology

2021 Volume 39, Issue 3, Page(s) 197.e1–197.e8

Abstract: Background: Though testicular cancer is the most common cancer in young men, there is a paucity of epidemiologic studies examining sociodemographic disparities in adjuvant therapy and outcomes. We examined the associations of sociodemographic factors ... ...

Abstract	Background: Though testicular cancer is the most common cancer in young men, there is a paucity of epidemiologic studies examining sociodemographic disparities in adjuvant therapy and outcomes. We examined the associations of sociodemographic factors with retroperitoneal lymph node dissection (RPLND) and survival among patients with nonseminomatous germ cell tumors (NSGCTs). Methods: Within the Surveillance Epidemiology and End Results database (2005-2015), we identified 8,573 patients with nonseminomatous germ cell tumors. Multivariable logistic regression and Fine-Gray competing-risks regression models were constructed to examine the association of sociodemographic factors (neighborhood SES (nSES), race, and insurance) with, respectively, adjuvant RPLND within 1 year of diagnosis and cancer-specific mortality. Results: Patients in the lowest nSES quintile (OR 0.59, 95% CI = 0.40-0.88, P = 0.01) and Black patients (OR 0.41, 95% CI = 0.15-1.00, P= 0.058) with stage II disease were less likely to receive RPLND compared to those in the highest quintile and White patients, respectively. Stage III patients with Medicaid (OR 0.64, 95% CI = 0.46-0.89, P= 0.009) or without insurance (OR 0.46, 95% CI = 0.27-0.76, P= 0.003) were less likely to receive RPLND compared to patients with private insurance. Lowest quintile nSES patients of all disease stages and Black patients with stage I disease (HR = 2.64, 95% CI = 1.12-6.20, P = 0.026) or stage II disease (HR=4.93, 95% CI = 1.48-16.44, P = 0.009) had higher risks of cancer-specific mortality compared to highest quintile nSES and White patients, respectively. Conclusions: This national study found multilevel, stage-specific sociodemographic disparities in receipt of RPLND and survival.
MeSH term(s)	Adult ; Cohort Studies ; Continental Population Groups/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Humans ; Lymph Node Excision/statistics & numerical data ; Lymphatic Metastasis ; Male ; Neoplasms, Germ Cell and Embryonal/mortality ; Neoplasms, Germ Cell and Embryonal/pathology ; Neoplasms, Germ Cell and Embryonal/surgery ; Retroperitoneal Space ; Socioeconomic Factors ; Survival Rate ; Testicular Neoplasms/mortality ; Testicular Neoplasms/pathology ; Testicular Neoplasms/surgery ; Young Adult
Language	English
Publishing date	2021-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2020.12.016
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Article ; Online: Associations of Renal Cell Carcinoma Subtype with Patient Demographics, Comorbidities, and Neighborhood Socioeconomic Status in the California Population.

Lichtensztajn, Daphne Y / Hofer, Brenda M / Leppert, John T / Brooks, James D / Chung, Benjamin I / Shah, Sumit A / DeRouen, Mindy C / Cheng, Iona

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

2022 Volume 32, Issue 2, Page(s) 202–207

Abstract: Background: Renal cell carcinoma (RCC) subtypes differ in molecular characteristics and prognosis. We investigated the associations of RCC subtype with patient demographics, comorbidity, and neighborhood socioeconomic status (nSES).: Methods: Using ... ...

Abstract	Background: Renal cell carcinoma (RCC) subtypes differ in molecular characteristics and prognosis. We investigated the associations of RCC subtype with patient demographics, comorbidity, and neighborhood socioeconomic status (nSES). Methods: Using linked California Cancer Registry and Office of Statewide Health Planning and Development data, we identified history of hypertension, diabetes, and kidney disease prior to RCC diagnosis in Asian/Pacific Islander, non-Latino Black, Latino, and non-Latino White adults diagnosed with their first pathologically confirmed RCC from 2005 through 2015. We used multinomial multivariable logistic regression to model the association of demographics, comorbidity, and nSES with clear-cell, papillary, and chromophobe RCC subtype. Results: Of the 40,016 RCC cases included, 62.6% were clear cell, 10.9% papillary, and 5.9% chromophobe. The distribution of subtypes differed strikingly by race and ethnicity, ranging from 40.4% clear cell and 30.4% papillary in non-Latino Black adults to 70.7% clear cell and 4.5% papillary in Latino adults. In multivariable analysis, non-Latino Black individuals had a higher likelihood of presenting with papillary (OR, 3.99; 95% confidence interval, 3.61-4.42) and chromophobe (OR, 1.81; 1.54-2.13) versus clear-cell subtype compared with non-Latino White individuals. Both hypertension (OR, 1.19; 1.10-1.29) and kidney disease (OR, 2.38; 2.04-2.77 end-stage disease; OR, 1.52; 1.33-1.72 non-end-stage disease) were associated with papillary subtype. Diabetes was inversely associated with both papillary (OR, 0.63; 0.58-0.69) and chromophobe (OR, 0.61; 0.54-0.70) subtypes. Conclusions: RCC subtype is independently associated with patient demographics, and comorbidity. Impact: Targeted RCC treatments or RCC prevention efforts may have differential impact across population subgroups.
MeSH term(s)	Humans ; Carcinoma, Renal Cell/epidemiology ; Carcinoma, Renal Cell/pathology ; Kidney Neoplasms/epidemiology ; Kidney Neoplasms/pathology ; California/epidemiology ; Comorbidity ; Hypertension/epidemiology ; Demography
Language	English
Publishing date	2022-12-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1153420-5
ISSN	1538-7755 ; 1055-9965
ISSN (online)	1538-7755
ISSN	1055-9965
DOI	10.1158/1055-9965.EPI-22-0784
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Article: Remote Oncology Care: Review of Current Technology and Future Directions

McGregor, Bradley A. / Vidal, Gregory A. / Shah, Sumit A. / Mitchell, James D. / Hendifar, Andrew E.

Cureus

Abstract: Cancer patients frequently develop tumor and treatment-related complications, leading to diminished quality of life, shortened survival, and overutilization of emergency department and hospital services Outpatient oncology treatment has potential to ... ...

Abstract	Cancer patients frequently develop tumor and treatment-related complications, leading to diminished quality of life, shortened survival, and overutilization of emergency department and hospital services Outpatient oncology treatment has potential to leave cancer patients unmonitored for long periods while at risk of clinical deterioration which has been exaggerated during the COVID19 pandemic Visits to cancer clinics and hospitals risk exposing immunocompromised patients to infectious complications Remote patient reported outcomes monitoring systems have been developed for use in cancer treatment, showing benefits in economic and survival outcomes While advanced devices such as pulmonary artery pressure monitors and implantable loop recorders have proven benefits in cardiovascular care, similar options do not exist for oncology Here we review the current literature around remote patient monitoring in cancer care and propose the use of reliable devices for capturing and reporting patient symptoms and physiology
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #761118
Database	COVID19

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Article ; Online: Reply to R. Kebudi et al.

Tsu-Yu Wu, Julie / Kwon, Daniel H / Glover, Michael / Henry, Solomon / Wood, Douglas / Rubin, Daniel / Koshkin, Vadim / Schapira, Lidia / Shah, Sumit A

JCO oncology practice

2021 Volume 17, Issue 6, Page(s) 364

Language	English
Publishing date	2021-04-21
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.21.00105
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Zs.A 7198: Show issues

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Article ; Online: Myocarditis Surveillance with High-Sensitivity Troponin I During Cancer Treatment with Immune Checkpoint Inhibitors.

Waliany, Sarah / Neal, Joel W / Reddy, Sunil / Wakelee, Heather / Shah, Sumit A / Srinivas, Sandy / Padda, Sukhmani K / Fan, Alice C / Colevas, A Dimitrios / Wu, Sean M / Witteles, Ronald M / Zhu, Han

JACC. CardioOncology

2021 Volume 3, Issue 1, Page(s) 137–139

Language	English
Publishing date	2021-03-16
Publishing country	United States
Document type	Journal Article
ISSN	2666-0873
ISSN (online)	2666-0873
DOI	10.1016/j.jaccao.2021.01.004
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Article ; Online: Undertreatment of High-Risk Localized Prostate Cancer in the California Latino Population.

Lichtensztajn, Daphne Y / Leppert, John T / Brooks, James D / Shah, Sumit A / Sieh, Weiva / Chung, Benjamin I / Gomez, Scarlett L / Cheng, Iona

Journal of the National Comprehensive Cancer Network : JNCCN

2018 Volume 16, Issue 11, Page(s) 1353–1360

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Black or African American/statistics & numerical data ; Age Factors ; Aged ; Androgen Antagonists/standards ; Androgen Antagonists/therapeutic use ; Antineoplastic Agents, Hormonal/standards ; Antineoplastic Agents, Hormonal/therapeutic use ; California ; Healthcare Disparities/statistics & numerical data ; Hispanic or Latino/statistics & numerical data ; Humans ; Insurance Coverage/statistics & numerical data ; Male ; Medical Oncology/standards ; Medical Oncology/statistics & numerical data ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Practice Guidelines as Topic ; Prostatectomy/standards ; Prostatectomy/statistics & numerical data ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/therapy ; SEER Program/statistics & numerical data ; Societies, Medical/standards ; Socioeconomic Factors ; White People/statistics & numerical data
Chemical Substances	Androgen Antagonists ; Antineoplastic Agents, Hormonal
Language	English
Publishing date	2018-11-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2250759-0
ISSN	1540-1413 ; 1540-1405
ISSN (online)	1540-1413
ISSN	1540-1405
DOI	10.6004/jnccn.2018.7060
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Article ; Online: Changes in Cancer Management due to COVID-19 Illness in Patients with Cancer in Northern California.

Wu, Julie Tsu-Yu / Kwon, Daniel H / Glover, Michael J / Henry, Solomon / Wood, Douglas / Rubin, Daniel L / Koshkin, Vadim S / Schapira, Lidia / Shah, Sumit A

JCO oncology practice

2020 Volume 17, Issue 3, Page(s) e377–e385

Abstract: Purpose: The response to the COVID-19 pandemic has affected the management of patients with cancer. In this pooled retrospective analysis, we describe changes in management patterns for patients with cancer diagnosed with COVID-19 in two academic ... ...

Abstract	Purpose: The response to the COVID-19 pandemic has affected the management of patients with cancer. In this pooled retrospective analysis, we describe changes in management patterns for patients with cancer diagnosed with COVID-19 in two academic institutions in the San Francisco Bay Area. Materials and methods: Adult and pediatric patients diagnosed with COVID-19 with a current or historical diagnosis of malignancy were identified from the electronic medical record at the University of California, San Francisco, and Stanford University. The proportion of patients undergoing active cancer management whose care was affected was quantified and analyzed for significant differences with regard to management type, treatment intent, and the time of COVID-19 diagnosis. The duration and characteristics of such changes were compared across subgroups. Results: A total of 131 patients were included, of whom 55 were undergoing active cancer management. Of these, 35 of 55 (64%) had significant changes in management that consisted primarily of delays. An additional three patients not undergoing active cancer management experienced a delay in management after being diagnosed with COVID-19. The decision to change management was correlated with the time of COVID-19 diagnosis, with more delays identified in patients treated with palliative intent earlier in the course of the pandemic (March/April 2020) compared with later (May/June 2020) (OR, 4.2; 95% CI, 1.03 to 17.3; Conclusion: We found significant changes in the management of cancer patients with COVID-19 treated with curative and palliative intent that evolved over time. Future studies are needed to determine the impact of changes in management and treatment on cancer outcomes for patients with cancer and COVID-19.
MeSH term(s)	Administration, Oral ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/therapeutic use ; COVID-19/complications ; COVID-19/therapy ; California ; Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Injections, Intramuscular ; Male ; Middle Aged ; Neoplasms/complications ; Neoplasms/diagnosis ; Neoplasms/therapy ; Palliative Care ; Radiotherapy/statistics & numerical data ; Retrospective Studies ; SARS-CoV-2 ; Surgical Procedures, Operative/statistics & numerical data ; Time Factors ; Time-to-Treatment/statistics & numerical data ; Young Adult
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2020-12-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.20.00790
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Article ; Online: Implementation of a cloud-based electronic patient-reported outcome (ePRO) platform in patients with advanced cancer.

Journal of patient-reported outcomes

2021 Volume 5, Issue 1, Page(s) 91

Abstract: Background: Patient reported outcomes (PROs) have been associated with improved symptom management and quality of life in patients with cancer. However, the implementation of PROs in an academic clinical practice has not been thoroughly described. Here ... ...

Abstract	Background: Patient reported outcomes (PROs) have been associated with improved symptom management and quality of life in patients with cancer. However, the implementation of PROs in an academic clinical practice has not been thoroughly described. Here we report on the execution, feasibility and healthcare utilization outcomes of an electronic PRO (ePRO) application for cancer patients at an academic medical center. Methods: We conducted a randomized trial comparing an experimental ePRO arm to standard of care in patients with advanced cancer in the thoracic, gastrointestinal, and genitourinary oncology groups at Stanford Cancer Center from March 2018 to November 2019. We describe the pre-implementation, implementation, and post-implementation phases of the ePRO arm, technological barriers, electronic health record (EHR) integration, clinician burden, and patient data privacy and security. Feasibility was pre-specified to be at least 70% completion of all questionnaires. Acceptability was based on patient and clinician feedback. Ambulatory healthcare utilization was assessed by reviewing numbers of phone messages, electronic portal messages, and referrals for supportive care. Results: Of 617 ePRO questionnaires sent to 72 patients, 445 (72%) were completed. Most clinicians (87.5%) and patients (93%) felt neutral or positive about the ePRO tool's ease of use. Exposure to ePRO did not cause a measurable change in ambulatory healthcare utilization, with a median of less than two phone messages and supportive care referrals, and 5-6 portal messages. Conclusions: Web-based ePRO tools for patients with advanced cancer are feasible and acceptable without increasing clinical burden. Key lessons include the importance of pilot testing, engagement of stakeholders at all levels, and the need for customization by disease group. Future directions for this work include completion of EHR integration, expansion to other centers, and development of integrated workflows for routine clinical practice.
Language	English
Publishing date	2021-09-15
Publishing country	Germany
Document type	Journal Article
ISSN	2509-8020
ISSN (online)	2509-8020
DOI	10.1186/s41687-021-00358-2
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Article ; Online: Impact of COVID-19 in patients on active melanoma therapy and with history of melanoma.

Johnson, Douglas B / Atkins, Michael B / Hennessy, Cassandra / Wise-Draper, Trisha / Heilman, Hannah / Awosika, Joy / Bakouny, Ziad / Labaki, Chris / Saliby, Renee Maria / Hwang, Clara / Singh, Sunny R K / Balanchivadze, Nino / Friese, Christopher R / Fecher, Leslie A / Yoon, James J / Hayes-Lattin, Brandon / Bilen, Mehmet A / Castellano, Cecilia A / Lyman, Gary H /

Tachiki, Lisa / Shah, Sumit A / Glover, Michael J / Flora, Daniel B / Wulff-Burchfield, Elizabeth / Kasi, Anup / Abbasi, Saqib H / Farmakiotis, Dimitrios / Viera, Kendra / Klein, Elizabeth J / Weissman, Lisa B / Jani, Chinmay / Puc, Matthew / Fahey, Catherine C / Reuben, Daniel Y / Mishra, Sanjay / Beeghly-Fadiel, Alicia / French, Benjamin / Warner, Jeremy L

BMC cancer

2023 Volume 23, Issue 1, Page(s) 265

Abstract: Introduction: COVID-19 particularly impacted patients with co-morbid conditions, including cancer. Patients with melanoma have not been specifically studied in large numbers. Here, we sought to identify factors that associated with COVID-19 severity ... ...

Abstract	Introduction: COVID-19 particularly impacted patients with co-morbid conditions, including cancer. Patients with melanoma have not been specifically studied in large numbers. Here, we sought to identify factors that associated with COVID-19 severity among patients with melanoma, particularly assessing outcomes of patients on active targeted or immune therapy. Methods: Using the COVID-19 and Cancer Consortium (CCC19) registry, we identified 307 patients with melanoma diagnosed with COVID-19. We used multivariable models to assess demographic, cancer-related, and treatment-related factors associated with COVID-19 severity on a 6-level ordinal severity scale. We assessed whether treatment was associated with increased cardiac or pulmonary dysfunction among hospitalized patients and assessed mortality among patients with a history of melanoma compared with other cancer survivors. Results: Of 307 patients, 52 received immunotherapy (17%), and 32 targeted therapy (10%) in the previous 3 months. Using multivariable analyses, these treatments were not associated with COVID-19 severity (immunotherapy OR 0.51, 95% CI 0.19 - 1.39; targeted therapy OR 1.89, 95% CI 0.64 - 5.55). Among hospitalized patients, no signals of increased cardiac or pulmonary organ dysfunction, as measured by troponin, brain natriuretic peptide, and oxygenation were noted. Patients with a history of melanoma had similar 90-day mortality compared with other cancer survivors (OR 1.21, 95% CI 0.62 - 2.35). Conclusions: Melanoma therapies did not appear to be associated with increased severity of COVID-19 or worsening organ dysfunction. Patients with history of melanoma had similar 90-day survival following COVID-19 compared with other cancer survivors.
MeSH term(s)	Humans ; COVID-19/therapy ; Multiple Organ Failure ; Melanoma/complications ; Melanoma/therapy ; Immunotherapy
Language	English
Publishing date	2023-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2041352-X
ISSN	1471-2407 ; 1471-2407
ISSN (online)	1471-2407
ISSN	1471-2407
DOI	10.1186/s12885-023-10708-6
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