Current Research Projects
Radiation Therapy for Medicare Patients
COPPER’s NIH-funded R01 grant, The Use and Outcomes of Radiation Therapy for Medicare Patients with Common Cancers, assesses the use of new radiation modalities for patients with breast, prostate, and lung cancer. The work conducted under this grant will generate comparative effectiveness data on the rates of adverse events associated with use of new modalities in actual clinical practice as well as the costs associated with the use of new radiation modalities.
Understanding Cost and Value in Cancer Screening and Treatment
Using SEER-Medicare data, we are assessing trends and geographic variation in Medicare expenditures for screening and treatment of breast and prostate cancers and treatment of myelodysplastic syndromes. Most studies of cancer focus exclusively on the cost of treatment, but we incorporate expenditures related to cancer screening and surveillance as well as treatment.
Studies of the cost of screening are particularly relevant in situations where guidelines and evidence do not support the use of the test or procedure. We assess concurrent trends between Medicare beneficiaries residing within defined geographic regions to assess the impact of screening and treatment approach on cost.
Cardiovascular Outcomes of Cancer
COPPER investigators are examining cardiovascular outcomes among breast and bladder cancer patients receiving potentially cardiotoxic chemotherapy including trastuzumab and anthracyclines for breast cancer and platinum-based agents for bladder cancer.
Analysis shows that trastuzumab is increasingly used among older women undergoing adjuvant breast cancer therapy, and heart failure/cardiomyopathy is a common complication persisting up to 3 years after diagnosis.
Additionally, thromboembolic events are more likely to occur in bladder cancer patients receiving platinum-based chemotherapy, especially in the first year after diagnosis.
Predictors of Chemotherapy Toxicity in Older Adults
The goal of this study is to help doctors predict which patients 65 years and above are more likely to tolerate chemotherapy for stages I to III breast cancer with minimal side effects. Dr. Gross is PI at Yale, which is one of ten sites participating in this research project coordinated by City of Hope National Medical Center in California.
We plan to enroll a total of 40 women at Yale as part of 500 women who will participate in the study. www.clinicaltrials.gov ID= NCT01472094.
Comparative Effectiveness of Treatments for Acute Myeloid Leukemia in the Elderly
We plan to assess the clinical effectiveness and cost-effectiveness of intensive and low-intensity chemotherapy in a large, population-based cohort of elderly patients with acute myeloid leukemia (AML). Findings from the study will enable physicians and patients to make more informed treatment decisions and will probably have significant policy implications.