Dansville

Researchers are evaluating the impact of geriatric evaluation and management combined with survivorship health education GEM-S compared to usual care on physical function in older cancer survivors. This phase III trial aims to improve how older adults who have survived cancer manage daily activities, mental well-being, and memory after chemotherapy. The study also seeks to understand how such care affects the quality of life for both cancer survivors and their caregivers. Participants are assigned to one of two groups based on their practice site. One group receives routine follow-up care from their doctors over three visits within six months. The other group takes part in a one-hour GEM consultation discussing geriatric assessment results and recommendations, attends survivorship health education sessions twice weekly for four weeks, and participates in a daily walking and resistance exercise program called EXCAP. Both survivors and their caregivers are involved in these activities. Throughout the study, participants complete patient-reported assessments on physical and cognitive function, objective tests like a 6-minute walk and cognitive exams, and questionnaires about satisfaction with care and coordination. Caregiver distress and quality of life are also measured. Follow-up continues for six months after the interventions to monitor outcomes and gather data on the effects of the GEM-S approach.

This research aims to better understand cancer cachexia CC, a condition involving weight, muscle, and fat loss that affects patients with advanced colorectal, lung, or pancreatic cancer that cannot be removed by surgery or is at stage IV. CC is linked to reduced physical function, lower quality of life, and poorer survival. The study seeks to identify different subtypes of CC based on patient characteristics to improve diagnosis and tailor treatments more effectively than a one-size-fits-all approach. It also aims to validate these subtypes and explore tumor factors that may contribute to CC. Participants will complete surveys and physical function tests lasting about 30 minutes each, provide blood samples and archived tumor tissue, and wear an actigraph device for 7 days to monitor sleep and activity. These assessments occur at the start of the study and again after three months. Standard imaging scans such as CT or PETCT are performed as part of usual care throughout the study. Medical records are reviewed at baseline, 3 months, and 1 year to collect comprehensive clinical data. During the study, researchers will evaluate physical function, symptoms, body composition, blood biomarkers, and activity levels to identify distinct CC diagnostic subtypes and their association with survival. Surveys and functional tests help measure symptoms and physical ability. The actigraph tracks daily activity and sleep patterns. The study follows participants for up to one year to monitor changes and outcomes, aiming to build a detailed database to support future research and clinical trials for cancer-related weight and muscle loss.

Researchers are comparing the rates of surgical and minimally invasive interventions, as well as any harms, in Medicare beneficiaries treated with the MILD procedure versus those treated with interspinous process decompression IPD for lumbar spinal stenosis with neurogenic claudication. This observational study uses Medicare claims data to follow patients for 24 months after their initial procedure starting from January 1, 2017. The purpose is to evaluate outcomes between these two types of procedures without requiring prior patient enrollment or consent. The study includes two groups patients who received MILD, which is a percutaneous image-guided lumbar decompression performed under fluoroscopic guidance through a dorsal approach to the spine, and patients who received IPD, a different device-based decompression procedure. Data on reoperations and complications will be collected for both groups over a 24-month follow-up period using Medicare claims. Enrollment continues until the sponsor decides to stop. Participants involvement is passive as the study uses existing Medicare claims data. Researchers will monitor rates of harms related to the initial procedure and subsequent surgical or minimally invasive interventions over two years. No direct patient visits or interventions are conducted, and the study is exempt from institutional review board oversight. The total study duration extends to December 2026, covering cases treated since early 2017.

Researchers are investigating how well standard systemic therapy, with or without additional definitive treatment such as prostate removal surgery or radiation therapy, works in treating men with prostate cancer that has spread to other parts of the body. This phase III trial aims to compare overall survival and progression outcomes between patients receiving systemic therapy alone and those receiving systemic therapy plus definitive treatment of the primary tumor. The study also examines quality of life factors, including urinary function, pain, and physical functioning. Participants first receive one of six acceptable forms of standard systemic therapy for 22 to 28 weeks, which may include hormonal therapies, oral medications, injections, or chemotherapy drugs like docetaxel. After this induction period, participants are randomly assigned to continue standard systemic therapy alone or to receive systemic therapy plus prostatectomy or radiation therapy within a specific timeframe. Following treatment, participants are monitored and followed up for up to eight years. During the study, participants undergo various assessments including physical exams, laboratory tests for prostate-specific antigen PSA and testosterone levels, and imaging scans to monitor disease progression. Patient-reported outcomes related to urinary symptoms, pain, and quality of life are collected at multiple time points up to three years. The main outcome measured is overall survival over an eight-year period. Researchers also bank tissue and blood samples for future studies and observe safety and disease progression throughout the follow-up period.

Researchers are comparing two radiation therapy approaches for men with high-risk prostate cancer to see if a shorter treatment duration can prevent cancer recurrence as effectively as the usual longer radiation schedule. This phase III trial evaluates stereotactic body radiation therapy SBRT, which delivers higher doses in five treatments over two weeks, against standard external beam radiation therapy EBRT, which involves 20 to 45 treatments over 4 to 9 weeks. The study includes men with specific high-risk features and uses advanced imaging to assess outcomes. Participants are randomly assigned to one of two groups. One group receives SBRT, involving five precise radiation treatments over two weeks, while the other group receives EBRT with 20 to 45 treatments over 4 to 9 weeks. Both groups undergo imaging tests such as bone scans, CT, MRI, or PETCT during screening and on study. Optional blood and urine samples may be collected during the trial. During the study, participants are followed every six months for up to five years to monitor metastasis-free survival, treatment effects on urinary, bowel, and sexual functions, fatigue, and overall quality of life. Various patient questionnaires and physician assessments track side effects and treatment burden. The trial also includes long-term evaluations of survival and disease progression, with imaging and laboratory tests supporting these assessments.

Researchers are evaluating whether adding stereotactic body radiation therapy SBRT to the usual treatment improves outcomes for patients with locally advanced, inoperable non-small cell lung cancer NSCLC that has spread to nearby tissues or lymph nodes. This phase III trial compares the effect of SBRT combined with conventional image guided radiation therapy IGRT, chemotherapy, and immunotherapy or targeted therapy against the usual treatment alone. The study aims to assess overall survival, progression-free survival, tumor response, lung function, quality of life, and treatment-related side effects. Participants are randomly assigned to one of two groups. In the first group, patients receive conventional IGRT and chemotherapy with drugs such as paclitaxel, carboplatin, pemetrexed, cisplatin, or etoposide during radiation, followed by immunotherapy with durvalumab or targeted therapy with osimertinib. The second group receives SBRT combined with conventional IGRT and similar chemotherapy, followed by the same immunotherapy or targeted therapy options. Both groups undergo CT andor PETCT scans during follow-up. Chemotherapy schedules vary by drug, including weekly or every 21-day dosing during radiotherapy, with consolidation treatments lasting up to one year. Throughout the study, participants undergo assessments including lung function tests FEV1 and DLCO, quality of life questionnaires, imaging scans, and monitoring for side effects using standard criteria. Follow-up visits occur every three months for the first year, every six months during years two and three, and annually thereafter, continuing for the duration of the study. Biospecimens and advanced imaging data are collected for exploratory analyses, including development of machine learning tools for radiation planning. Overall survival and progression-free survival are the primary outcomes measured up to eight years after randomization.