Dr Randall on the Goals and Methods of Prospective Research on Disparities in Sarcoma Survivorship

"Together, this will really develop, hopefully, into a persistent survivorship platform, where we know patients that are at risk are going to get different sorts of interventions in their survivorship..."

R. Lor Randall, MD, FACS, the David Linn Endowed Chair for Orthopedic Surgery, chair of the Department of Orthopedic Surgery, and a professor at the University of California (UC) Davis Comprehensive Cancer Center, outlined the goals and methodology of key prospective research concerning outcome disparities in pediatric sarcoma survivorship care. This research is being conducted by his colleague, Elysia Marie Alvarez, MD, MPH, a pediatric oncologist at UC Davis Comprehensive Cancer Center.

Randall highlighted that the research will proceed in distinct phases, beginning with quantifying and characterizing existing disparities. Alvarez is utilizing institutional registries and SEER data gathered from across California and beyond. Through these data, Alvarez aims to identify how treatment exposures and social determinants of health impact survival and late effect outcomes in pediatric and AYA adolescent young adult (AYA) patients, Randall explained

The second phase seeks to define the biologic correlates underlying these late effects, he continued. This involves integrating transcriptomic and molecular data to discover specific biological pathways associated with recurrence and long-term toxicities. This step is crucial for connecting molecular signatures with demographic and clinical predictors, Randall emphasized.

Finally, Alvarez’s team is working to develop a predictive survivorship model. Randall explained that this model is data-driven and combines sociodemographic, biologic (as referenced), and clinical variables to stratify survivors based on their risk profile. This risk-stratification method enables targeted surveillance and intervention measures specifically for those patients predicted to have a more compromised survivorship, he added. Randall concluded that the collective goal is to establish a persistent survivorship platform, ensuring that patients identified as being high-risk receive different interventions in their long-term survivorship care than those who are expected to "sail along in the rest of their life."