Lewiston

Researchers are evaluating a new blood test called Guardant Reveal designed to detect cancer recurrence in people treated for early-stage solid tumors. The study aims to show how well this test can identify cancer returning and link its results to clinical outcomes. This will help understand the test's usefulness in real-world healthcare settings where costs are important. The types of cancers studied include bladder, lung, breast, melanoma, esophageal, gastric, pancreatic, head and neck, ovarian, endometrial, renal, and rectal cancers. Participants will have blood samples taken at the start and during their regular follow-up visits for up to five years. The Guardant Reveal test, which looks for minimal residual disease, will be used to analyze these blood samples to detect any signs of cancer returning. This study includes various groups based on specific tumor types and stages, such as muscle invasive carcinomas, non-small cell lung cancer, high-risk breast cancer, melanoma, gastrointestinal cancers, and others. Each group follows standard care treatments, and the study observes how the new test performs alongside usual monitoring. During the study, participants will provide blood samples coinciding with their routine follow-up care, and their clinical information will be collected and shared with researchers in a de-identified way. The main outcome measured is the time until distant cancer recurrence over three years. The study tracks participants for up to five years to assess the test's ability to detect recurrence early, aiming to improve monitoring and management of these cancers.

Researchers are evaluating ways to improve advance care planning (ACP) among underserved communities, who often receive lower quality end-of-life care and unwanted, costly treatments. This study compares two conversation-based tools designed to encourage discussions about end-of-life wishes and motivate ACP behaviors. The goal is to increase high-quality end-of-life care, reduce health disparities, and lessen unnecessary suffering for patients and families. The study is a cluster randomized controlled trial involving 75 underserved communities across the US. It compares a serious conversation game called Hello, the widely used Conversation Project (CP) Starter Kit, and usual care where only an advance directive is distributed. The Hello game has 32 questions prompting sharing of values and beliefs about end-of-life issues, while the CP Starter Kit is a workbook with prompts and resources to facilitate conversations. The third group receives a general conversation game called Table Topics. Participants include adults from underserved populations who have not completed an advance directive in the past 5 years. Researchers will assess completion of a visually verified advance directive six months after the intervention. Other ACP behaviors will also be measured. The study involves community events, follow-up, and data collection to understand which tools best engage underserved groups in ACP and improve end-of-life care outcomes.