Browsing by Author "Wefel, Jeffrey S."

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    The State of Neuro-Oncology During the COVID-19 Pandemic: A Worldwide Assessment
    (Oxford, 2020) Mrugala, Maciej M.; Ostrom, Quinn T.; Pressley, Shelley M.; Taylor, Jennie; Thomas, Alissa A.; Wefel, Jeffrey S.; Coven, Scott L.; Acquaye, Alvina A.; Haynes, Chas; Agnihotri, Sameer; Lim, Michael; Peters, Katherine B.; Sulman, Erik P.; Salcido, Joanne T.; Butowski, Nicholas A.; Hervey-Jumper, Shawn; Mansouri, Alireza; Oliver, Kathy R.; Porter, Alyx B.; Nassiri, F.; Schiff, D.; Dunbar, Erin M.; Hegi, Monika E.; Armstrong, Terri S.; van den Bent, Martin J.; Chang, Susan M.; Zadeh, Gelareh; Chheda, Milan G.; Pediatrics, School of Medicine
    To assess the impact of the pandemic on the field, we performed an international web-based survey of practitioners, scientists, and trainees from 21 neuro-oncology organizations across 6 continents from April 24 through May 17. Of 582 respondents, 258 (45%) were in the US, and 314 (55%) were international. 80.4% were affiliated with academic institutions. 94% respondents reported changes in clinical practice; 95% reported conversion to telemedicine for at least some appointments. However, almost 10% practitioners felt the need to see patients in person specifically because of billing concerns and perceived institutional pressure. Over 50% believed neuro-oncology patients were at increased risk of contracting COVID-19. 67% practitioners suspended enrollment for at least one clinical trial: 53% suspended phase II and 62% suspended phase III trial enrollment. 71% clinicians feared for their or their families’ safety, specifically because of their clinical duties. 20% percent said they did not have enough PPE to work safely; about the same percentage were unhappy with their institutions’ response to the pandemic. 43% believed the pandemic would negatively affect their academic career, and 52% fellowship program directors were worried about losing funding for their training programs. While 69% respondents reported increased stress, 44% were offered no psychosocial support. 37% had their salary reduced. 36% researchers had to temporarily close their laboratories. In contrast, the pandemic created positive changes in perceived patient and family satisfaction, quality of communication, and use of technology to deliver care and interactions with other practitioners. CONCLUSIONS: The pandemic has altered standard treatment schedules and limited investigational treatment options for patients. In some cases, clinicians felt institutional pressure to continue conducting billable in-person visits when telemedicine visits would have sufficed. A lack of institutional support created anxiety among clinicians and researchers. We make specific recommendations to guide clinical and scientific infrastructure moving forward.
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    The National Cancer Institute clinical trials planning meeting to address gaps in observational and intervention trials for cancer-related cognitive impairment
    (Oxford University Press, 2025) Janelsins, Michelle C.; Van Dyk, Kathleen; Hartman, Sheri J.; Koll, Thuy T.; Cramer, Christina K.; Lesser, Glenn J.; Barton, Debra L.; Mustian, Karen M.; Wagner, Lynne I.; Ganz, Patricia A.; Cole, Peter D.; Bakos, Alexis; Root, James C.; Hardy, Kristina; Magnuson, Allison; Ferguson, Robert J.; McDonald, Brenna C.; Saykin, Andrew J.; Gonzalez, Brian D.; Wefel, Jeffrey S.; Morilak, David A.; Dahiya, Saurabh; Heijnen, Cobi J.; Conley, Yvette P.; Morgans, Alicia K.; Mabbott, Donald; Monje, Michelle; Rapp, Stephen R.; Gondi, Vinai; Bender, Catherine; Embry, Leanne; McCaskill Stevens, Worta; Hopkins, Judith O.; St. Germain, Diane; Dorsey, Susan G.; Radiology and Imaging Sciences, School of Medicine
    Cancer-related cognitive impairment is a broad term encompassing subtle cognitive problems to more severe impairment. The severity of this impairment is influenced by host, disease, and treatment factors, and the impairment affects patients before, during, and following cancer treatment. The National Cancer Institute (NCI) Symptom Management and Health-Related Quality of Life Steering Committee (SxQoL SC) convened a clinical trial planning meeting to review the state of the science on cancer-related cognitive impairment and develop phase II/III intervention trials aimed at improving cognitive function in cancer survivors with non-central nervous system disease and longitudinal studies to understand the trajectory of cognitive impairment and contributing factors. Participants included experts in the field of cancer-related cognitive impairment, members of the SxQoL SC, patient advocates, representatives from all 7 NCI Community Oncology Research Program research bases, and the NCI. Presentations focused on the following topics: measurement, lessons learned from pediatric and geriatric oncology, biomarker and mechanism endpoints, longitudinal study designs, and pharmacological and behavioral intervention trials. Panel discussions provided guidance on priority cognitive assessments, considerations for remote assessments, inclusion of relevant biomarkers, and strategies for ensuring broad inclusion criteria. Three clinical trial planning meeting working groups (longitudinal studies as well as pharmacological and behavioral intervention trials) convened for 1 year to discuss and report on top priorities and to design studies. The meeting experts concluded that sufficient data exist to advance phase II/III trials using selected pharmacological and behavioral interventions for the treatment of cancer-related cognitive impairment in the non-central nervous system setting, with recommendations included herein.