NCI grant supports study of imaging surveillance strategies to optimize lung cancer outcomes

With a $3.2 million grant from the National Cancer Institute (NCI), investigators from the newly NCI-designated UF Health Cancer Center and the University of Michigan Rogel Cancer Center will work to close evidence gaps in lung cancer care delivery. Over the five-year project, the team will examine the effectiveness of imaging surveillance strategies based on community-identified needs.

Dejana Braithwaite, Ph.D., and Jiang Bian, Ph.D.

Follow-up with computed tomography (CT) imaging surveillance after curative-intent therapy for early-stage non-small cell lung cancer (NSCLC) can be life-saving if it detects early recurrence or second primary lung cancer. Optimizing imaging surveillance strategies in early-stage NSCLC is crucial to inform clinical guidelines and guide survivorship care.

The new study is led by principal investigators Dejana Braithwaite, Ph.D.,a professor of surgery and epidemiology in the UF Colleges of Medicine and Public Health and Health Professions and associate director for population sciences at the UF Health Cancer Center; Jiang Bian, Ph.D., a professor of health outcomes and biomedical informatics and chief data scientist at UF Health; Jihyoun Jeon, Ph.D., an associate research scientist at the University of Michigan School of Public Health; and Michael Gould, M.D., a lung cancer pulmonologist at Kaiser Permanente Southern California.

The team will integrate multimodal real-world data with simulation modeling to fill clinical and policy gaps in lung cancer surveillance. The group will collaborate with the OneFlorida+ Clinical Research Network, a consortium of academic and community-based health systems that serve Florida, Georgia and Alabama, contributing to the National Patient-Centered Clinical Research Network (PCORnet®) funded by the Patient-Centered Outcomes Research Institute (PCORI) and the NCI’s Lung Cancer Intervention and Simulation Modeling Network (CISNET).

pulmonary nodule painted by GEORGIA O'KEEFFE
Using artificial intelligence software, UF researchers in the department of radiology’s chest and research division and Radiomics and Augmented Intelligence Laboratory (RAIL) recreated this Georgia O’Keeffe painting with a lung cancer theme. The researchers recreated 15 paintings and are selling them to benefit lung cancer research.

No clinical trials of CT imaging surveillance have been conducted among U.S. populations with lung cancer. In the new study, the investigators propose creating a data source to assess the effectiveness of lung cancer surveillance by combining data about surveillance use patterns with patient-level sociodemographic, clinical and outcome data from patients with early-stage NSCLC. The team will engage with community and patient advocates to identify the optimal frequency of lung cancer surveillance through evidence-based recommendations.

“This study will compare whether semi-annual CT scans lead to better clinical outcomes than annual surveillance after curative-intent therapy by examining population-based estimates of recurrence risk for this rapidly growing population of lung cancer survivors,” Braithwaite said. “The findings have the potential to meaningfully improve the quality of survivorship care for patients with early-stage lung cancer.”

The study is an example of those that are possible only with robust research and real-world data infrastructure like OneFlorida+, Bian said.

“Real-world evidence generated through studies of real-world data would have a direct translational impact on patient care,” said Bian, who also serves as director of the Cancer Informatics Shared Resource at the UF Health Cancer Center.

A key focus for PCORnet® and OneFlorida+ is research that examines clinical effectiveness and addresses topics that are important for patients and clinicians, said Elizabeth Shenkman, Ph.D., a professor and chair of the department of health outcomes and biomedical informatics and OneFlorida+ principal investigator who serves as associate director for community outreach and engagement at the Cancer Center and co-director of the UF Clinical and Translational Science Institute.

“This study is an outstanding example of research designed to address a critical gap in evidence that will provide valuable information for patients and clinicians,” she said.

“This study is an outstanding example of research designed to address a critical gap in evidence that will provide valuable information for patients and clinicians.”

Elizabeth Shenkman, Ph.D.
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