CARinG Pilot Grants
NIH/NIA R21/R33 CARinG Pilot Grants
Nine awards was funded during the grant period! The goal was for this internal pilot funding to serve as a foundation/model upon which future investigators will design and initiate research projects leading to externally funded awards and foster research collaborations across cancer centers. Read about our nine Pilot Grants awards below:
Pilot Grant 1
Title: Development of a Personalized Discussion Priorization Tool for Older Adults Considering Adjuvant Chemotherapy for Breast Cancer
Co-PIs: Allison Magnuson, DO and Mina Sedrak, MD, MS
Grant Period: September 1. 2019 – August 31, 2020
Overall Objective: Develop and test a technology-mediated DPT, which integrates personalized information on risk factors for adjuvant chemotherapy-related toxicity in older women with breast cancer
Specific Aims
Aim 1: Conduct a secondary analysis of patients enrolled on NCT01472094 to determine the association between clinical factors and reduced RDI of a prescribed chemotherapy regimen.
Aim 2: Adapt a DPT to include personalized information regarding risk of chemotherapy toxicity and risk of reduced RDI, and evaluate the usability of the DPT in ten older adults considering adjuvant chemotherapy for breast cancer.
Pilot Grant 2
Title: Evaluation of Loneliness and Social Isolation in Older Adults with Cancer
PI: Katherine Clifton, MD
Grant Period: March 2021 – February 2022*
Overall Objective: Develop an intervention to combat loneliness and social isolation in older adults with cancer using stakeholder input and feedback from patient advocates.
Specific Aims
Aim 1: Assess loneliness and social isolation during the COVID-19 pandemic in older adults with cancer.
Aim 2: Adapt an intervention to address loneliness in older adults with cancer during the COVID-19 pandemic for the future.
Pilot Grant 3
Title: A Telehealth Advance Care Planning Intervention for Older Patients with Acute Myeloid Leukemia and Myelodysplastic Syndrome
PI: Melissa Loh, BMedSci, MBBCh, BAO
Grant Period: March 2021 – February 2022*
Overall Objective: Adapt and assess the feasibility and usability of a telehealth-delivered ACP intervention for older patients with AML and MDS. The optimization of the ACP intervention will be guided by the Center for eHealth and Wellbeing Research (CeHRes) Roadmap which emphasizes structural stakeholder involvement.
Specific Aims
Aim 1: To incorporate telehealth into an evidence-based ACP intervention that is adapted for older patients suffering from AML and MDS utilizing qualitative interviews with patients, their caregivers, and oncology providers
Aim 2: To assess the feasibility and usability of the adapted telehealth-delivered ACP intervention in a single-arm pilot study of 20 older patients with AML and MDS.
Pilot Grant 4
Title: Geriatric Assessment with Management for Older Adult Hematopoietic Cell Transplant Candidates
PI: Sarah Wall, MD, MPH
Grant Period: March 2021 – February 2022*
Specific Aims
Aim 1: Determine the relationship between geriatric assessment with management (GAM) and post-transplant outcomes in a historical cohort of older adult allogeneic hematopoietic cell transplant (allo-HCT) recipients
Aim 2: Evaluate the effectiveness of GAM to optimize physical function, nutrition, mental health, and medication adherence in a prospective pilot study of adults ≥ 60 years old undergoing evaluation for allo-HCT
Pilot Grant 5
Title: Developing and pilot testing the Patient-centered Pharmacy Pathway for Oral Chemotherapy (P3OC) for older adults
Co-PIs: Angela M. Stover and Mary-Haston Vest
Grant Period: March 2022 – February 2023*
Overall Objective: To develop and pilot test the “Patient-centered Pharmacy Pathway for Oral Chemotherapy” (P3OC). P3OC will be a standardized care pathway and toxicity risk tool integrated in the electronic health record (EHR) in UNC Health’s existing pharmacist-led oral chemotherapy management program.
Specific Aims
Aim 1: To develop the “Patient-Centered Pharmacy Pathway for Oral Chemotherapy” (P3OC) through stakeholder engagement, including a Delphi panel (with pharmacists, MDs, and CARG), interviews with older adults receiving oral chemotherapy and CARG advocates, and usability testing with pharmacists
Aim 2: To assess the feasibility and pharmacist adoption of P3OC in a single-arm pilot study of 20 older adults prescribed oral chemotherapy for breast or hematological malignancies.
Pilot Grant 6
Title: Fit for CAR T: Quantifying the impact of baseline functional impairments on chimeric antigen receptor T cell therapy (CAR T) toxicity and functional recovery in older adults with diffuse large B-cell lymphoma (DLBCL)
PI: Geoffrey Shouse
Grant Period: March 2022 – February 2023*
Overall Objective: This study is poised to identify the tools to bridge the gap between efficacy and toxicity in older patients receiving CAR T.
Specific Aims
Aim 1: To quantify the impact of baseline functional impairment as determined by the short physical performance battery (SPPB) on CAR T-mediated toxicities including cytokine release syndrome (CRS) and neurotoxicity through day 30 among older adults treated with CD19 CAR T-cell therapy for relapsed and/or refractory (r/r) DLBCL.
Aim 2: To characterize the influence of baseline functional impairment as determined by the SPPB on functional recovery by day 30 after CD19 CAR T-cell therapy in older adults with r/r DLBCL.
Pilot Grant 7
Title: Senescence and neurovascular dysfunction: exploring a mechanistic model of accelerated aging and chemotherapy-related cognitive impairment in older female cancer survivors
PI: Andriy Yabluchanskiy
Grant Period: March 2022 – February 2023*
Overall Objective: To gain better understanding of CRCI pathomechanism and develop clinically relevant biomarkers for future preventive and interventional strategies.
Specific Aims
Aim 1: Measure cerebrovascular aging in cancer survivors with or without cognitive symptoms.
Aim 2: Estimate correlation between cerebrovascular age, plasma-based markers of vascular senescence and indicators of cognitive dysfunction.
Pilot Grant 8
Title: Feasibility of Exercise Prehabilitation Among Older Patients with Hematological Malignancies Preparing for Chimeric Antigen Receptor (Car) T-Cell Immunotherapy
PI: Ciara Freeman, MD, PhD
Grant Period: January 2023 – December 2023*
Overall Objective: In this project, we aim to determine the feasibility, safety, and acceptability of a home-based exercise program designed to improve fitness and treatment tolerance among older patients referred for CAR-T therapy.
Specific Aims
Aim 1: Evaluate the feasibility, safety, and acceptability of a remote, multimodal exercise intervention as prehabilitation for patients with hematological malignancies who are referred for CAR-T therapy.
Aim 2: Assess changes in objective and self-reported physical functioning, aerobic fitness, skeletal muscle mass and radiodensity, fatigue, and health-related quality of life among intervention participants.
Aim 3: Compare changes in skeletal muscle mass and radiodensity, health-related quality of life, and clinical outcomes (length of hospital stay and ICU admissions) between exercise participants and retrospectively identified, non-intervention patients who received standard care.
Pilot Grant 9
Title: A Pilot Study of Remote Symptom Monitoring in Older Adults with Multiple Myeloma at Risk of Infection
PI: Matthew Pianko, MD
Grant Period: January 2023 – December 2023*
Overall Objective: The overall objective of the study is to elucidate whether a remote monitoring program using wearable technology and symptom tracking using electronic patient-reported outcomes (ePRO) are a feasible and acceptable approach for the early detection of infection in older adults with MM.
Specific Aims:
Aim 1: To evaluate the feasibility of implementation of an 8-week remote patient monitoring pilot program including: (1) use of wearable devices for near-continuous temperature monitoring and mobility, (2) a weekly electronic patient-reported outcome (ePRO) symptom reporting tool, and (3) baseline electronic geriatric assessment (eGA) in a pilot study of 20 ambulatory older adults receiving a new line of therapy for multiple myeloma with high risk of infection.
Aim 2: To evaluate the acceptability to older adult patients with MM and treating clinicians of an 8-week remote monitoring program using wearable devices and an electronic patient reported outcome (ePRO) symptom tracking platform using adherence assessments, directed surveys and semi-structured interviews before, during, and after the 8-week monitoring period.