Dr. Elena Izmailova
I was recently privileged to attend the ASCO Quality Care Symposium to present the work that Koneksa and the Montefiore Cancer Center are doing (see our press release here) to improve supportive patient care.
Why the ASCO Quality Care Symposium Matters
This symposium has a special place among ASCO satellite meetings because it’s focused on the quality of healthcare delivery for cancer patients: an extremely important aspect of healthcare innovation that often doesn’t receive nearly enough attention.
Our understanding of the cancer genome and development of innovative therapies, such as checkpoint inhibitors and CAR-T therapy, has made it possible to create new treatment options for cancer patients. Many R&D scientists work hard to develop novel diagnostic tests and therapies like these. But the front line of the battle with cancer is in hospitals and doctors’ offices. These are where an innovation paradigm becomes a reality.
What I Heard
The hot topics of this symposium included discussions about the challenges that doctors face every day, and about what’s needed to deliver the best patient care. I heard speakers talk about “chasing prescriptions instead of chasing the cure”, navigating the maze of treatment options to find the best ones for a patient, working to coordinate and standardize delivery, and enabling value-based care.
I heard broad agreement that extended participation in clinical trials - both at academic research centers and in community-based practices - will improve patient access to novel treatments. The field fully realizes that access to clinical trials in the US remains limited.
Many coordinated efforts are focused on keeping people out of the hospital with value-based service models and creative approaches. Technology innovation can help here. Patient-centric approaches - social support, adverse-event monitoring, appropriate palliative care, and support for end-of-life are among the top priorities for oncology, and these can be achieved via multiple ways. Something as simple as regularly scheduled phone calls can help patients a great deal.
More technical work can also make a big difference, like machine learning using EHR data and wearable devices to identify reliable, dynamic predictors of hospitalization.
What We Presented
That work was the topic of my poster presentation - I was presenting the results of a collaboration between Montefiore Montefiore Einstein Center for Cancer Care and Koneksa Health.
The goal of our study was to replicate the results from an earlier pilot study which indicated that daily step counts (collected by a Garmin Vivofit device) were a strong predictor of short-term hospitalizations. This larger study included 200 patients who were undergoing chemoradiotherapy to treat solid tumors of the head and neck, gastrointestinal tract, lung, cervix or CNS. The results were highly reproducible. Our results demonstrated a 36% decrease of hospitalization risk for every 1000 steps averaged over 3 days.
Why It Matters
These findings are important because they suggest that future interventional trials should leverage activity data to optimize supportive care during cancer therapy. Devices like fitness trackers are easy to use and the data can be collected remotely. We obtained step data from 97% of patients’ treatment days.
Our poster attracted attention from healthcare professionals looking for ways to optimize supportive care for cancer patients and to promote healthy lifestyles in the survivorship period.
Additionally, industry sponsors are looking for ways to develop novel endpoints, and to better understand how novel treatments impact patients’ activities of daily life (ADL). Efforts like these are exciting because they have an enormous potential to change how cancer is treated, and make a difference for patients and their families.