A multi-disciplinary team of researchers led by Duke Cancer Institute surgical oncologist Dan Blazer III, MD, surgery resident Daniel P. Nussbaum, MD, and Duke Cancer Network medical director Linda M. Sutton, MD, has been awarded $100,000 by the National Comprehensive Cancer Network Oncology Research Program (NCCN) and Eli Lilly and Company for a two-year study aimed at optimizing multi-disciplinary gastric and gastroesophageal junction (GEJ) cancer care across the Duke Cancer Network (DCN).
Their study “The DCN Passport: A Novel, Patient-Centered Approach to Improve Care for Gastric/Gastroesophageal Junction Cancer Across an Academic-Community Oncology Network” is one of six quality improvement projects for gastric and GEJ cancers awarded nationwide “to identify disparities in care between the community and academic setting, and define scalable, shareable solutions that will rapidly improve adherence to guidelines and quality of care.”
“Because the challenges faced by our academic-community partnership in the Duke Cancer Network are also broadly experienced at the national level, this study represents a unique opportunity to study this nationwide challenge locally,” said Blazer.
Duke Cancer Network (DCN) is a well-established academic-community partnership between DCI and 12 affiliate community treatment centers in the Southeast.
Most of these affiliates are located in rural, traditionally underserved communities — among the poorest and most diverse in the region and the nation. These underserved communities frequently report considerably higher incidences of cancer and cancer-related deaths, including in gastric and GEJ cancers.
Relatively rare malignancies, the combined DCI and DCN gastric and GEJ cancer programs is one of the highest-volume programs of its kind in the U.S.; with about 75 new cases treated at DCN affiliates each year, and around 150 treated at DCI.
Per NCCN guidelines, multidisciplinary management of gastric or esophageal cancers using chemotherapy, radiation therapy and surgery is optimal for achieving the best outcomes in these diseases. It’s not an option for everyone, however.
Blazer explained that patients afflicted with gastric and esophageal cancers are often diagnosed late and their treatment options are limited to primarily palliative approaches. Those who are identified early enough in their disease to be candidates for multi-modal treatment are frequently quite debilitated and adherence to evidence-based care can be challenging.
“We develop these plans in our centralized DCI/DCN gastric/GEJ cancer tumor boards,” said Blazer. “We want to know why they frequently fail to complete their planned course of therapy. Despite having this great partnership with the DCN, we believe there are still barriers and this has an effect on clinical outcomes. Maybe we’re not doing as much as we should.”