Stanford, Palo Alto Medical Foundation Launch Comprehensive Breast Cancer Study

Main Category: Breast Cancer
Also Included In: Cancer / Oncology
Article Date: 04 Jun 2009 - 5:00 PDT

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In a unique partnership, the Stanford University School of Medicine and the Palo Alto Medical Foundation will collaborate on a research project that aims to improve outcomes for breast cancer patients.

The project is the brainchild of Richard Levy, PhD, a longtime community philanthropist and business leader, who said he saw an opportunity for the two medical centers to share expertise on a subject that is of great interest to him - improving cancer survival. He and his wife, Susan, will provide a gift of $2.1 million for the three-year study, which will focus on both the medical and psychosocial factors that contribute to cancer treatment and survival.

"From the point of view of patients, what makes for good health is good technology and good environmental factors, such as the doctor/patient relationship, nutrition, exercise and lifestyle factors," said Levy, a resident of Portola Valley, Calif. "Patients need both. Here we have two world-class institutions in both areas. It's a natural partnership."

Although scientists at the two medical centers have worked together over the years on many projects, this is the first time the two institutions have officially partnered with the intent of building a long-term collaborative relationship in research.

Levy is the former president and CEO of Varian Medical Systems in Palo Alto, where he has spent the last 40 years. He has longstanding ties to both Stanford and PAMF. He has served on the board of PAMF for the past 10 years and its parent, Sutter Health, for the last three. A nuclear chemist by training, he and his colleagues at Varian worked closely over the years with Stanford scientists in the Department of Radiation Oncology to pioneer linear accelerators for cancer treatment. Levy retired as CEO in 2006 but remains the company's chairman of the board. He is also active in initiatives involving philanthropy and health-care reform.

Levy said he hopes the study will not only lead to improvements in cancer care but also point to ways of reducing medical-care costs nationally.

"If Palo Alto and Stanford can find a way to provide better care at lower cost, that will set an example for other communities," he said.

In the study, physicians and scientists at both organizations will follow the journey of hundreds of patients throughout the course of their treatment with an eye to understanding the role of cancer biology and different patterns of care in outcomes and quality. The researchers will document every aspect of the patients' treatment, including all tests, drug infusions, surgeries and radiation treatments, as well as nonmedical support they receive, such as yoga, alternative therapies or group therapy.

"By harmonizing data from the two institutions, we will have a deep data source that will enrich the understanding of the clinical course and outcome of the disease," said Ralph Horwitz, MD, professor and chair of the Department of Medicine at Stanford. "We can look comprehensively at the biological, clinical, social and environmental factors that influence outcomes."

The researchers chose to study breast cancer because it is a common disease in which there are basic protocols, though there are many variations in how patients and their doctors choose to pursue them, said Hal Luft, PhD, executive director of the Research Institute at the Palo Alto Medical Foundation. For instance, women may choose breast-conserving surgery or full mastectomy, he noted, or they may opt for different chemotherapy plans with different toxicities and frequencies.

"So there is a decision-making process for women - how do they choose among these options?" Luft said. "We will try to capture this information and analyze how women's preferences and best clinical practices can be combined with other factors to achieve optimal treatment."

The researchers also will aim to capture information on the women's experiences - their anxieties, concerns and satisfaction with the process - through interviews and patient journals.

"There is a kind of road map that physicians and patients follow. But they may deviate from that road," said Amar Das, MD, PhD, principal investigator at Stanford and assistant professor of medicine and of psychiatry and behavioral sciences. "The question is by how much? And does it matter? Are patients more satisfied going down one path over another, and what impact does that have on survival?"

All the data from the study will be collected in a new secure electronic database known as OncoShare, in which patients and their treating doctors will remain anonymous. The researchers said OncoShare will be the first large-scale research database to incorporate comprehensive information on breast cancer characteristics, practice variation and treatment effectiveness that can help answer pressing questions on how biomarkers, cancer genetics, patient choices and patterns of care all interact and relate to outcomes. Patients will have to provide consent to be included in the study.

While the focus of the study is on breast cancer, Levy said ultimately he would like to see the approach applied in other diseases as well, such as heart disease, diabetes and other types of cancer.

"There are plenty of other common diseases where the quality of health is related to both technology and lifestyle," he said.

The Stanford University School of Medicine consistently ranks among the nation's top 10 medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://mednews.stanford.edu. The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children's Hospital. For information about all three, please visit http://stanfordmedicine.org/about/news.html.

Source
The Palo Alto Medical Foundation for Health Care