A paper recommending more rigorous definitions of what constitutes “undertreatment” and “overtreatment” of older adults with cancer that was published recently in the prestigious Journal of Clinical Oncology is a testament to how CARG’s Buddy Program fosters collaboration.
For the past three years, the senior author, William Dale, MD, PhD, has served as a mentor to the lead author, Clark DuMontier, MD, through the Buddy Program. The study grew out of career advice discussions Dale had with DuMontier and their shared interest in how to minimize “undertreatment” and “overtreatment” in older adults with cancer.
DuMontier, a geriatrician and research fellow at Brigham and Women’s Hospital and Marcus Institute for Aging Research in Boston, led the extensive literature review that, Dale says, “found the terms ‘undertreatment’ and ‘overtreatment’ have been used with great variability in meaning, with an overemphasis on survival or surrogate outcomes and an underemphasis on other outcomes, such as function and patient preferences.”
The study, “Defining Undertreatment and Overtreatment in Older Adults With Cancer: A Scoping Literature Review,” seeks to “right-size” treatment and outcomes by incorporating the latest evidence from cancer and aging into research studies, and focusing not only on survival, but also on patient-centered outcomes important to older adults, such as function and quality of life.
Building Strong Partnerships Across Disciplines
“Our publication is a literal product of CARG from start to finish,” DuMontier says.
DuMontier and Dale, professor and chair of Supportive Care Medicine at City of Hope Comprehensive Cancer Center in Duarte, CA, discussed the project’s progress on regular calls and in-person at annual meetings for the American Society of Clinical Oncology and the International Society of Geriatric Oncology. Leaders in the field helped shape the research project on CARG’s bi-weekly conference calls, and Melissa Loh, M.B.B.Ch., “played an integral role in helping complete the project,” DuMontier says. The research team also received helpful feedback from CARG by presenting an earlier version of the manuscript during a conference call.
“I have been impressed from the beginning with Clark’s thoughtfulness about questions, thoroughness in approach, and persistence in completing his work,” Dale says. “I look forward to continuing to mentor him as he builds his career, networks in CARG and other spheres, and develops his leadership skills.”
DuMontier, says Dale, “has shared his career experience with me, providing helpful strategies to build strong partnerships across disciplines.
“CARG fuels my local efforts in geriatric oncology with the feeling of advancing a larger mission,” he adds. “The Buddy Program and other collaborations within CARG are pieces of the whole that Dr. Arti Hurria and others envisioned in CARG’s founding: to connect individuals across disciplines and generations toward improving the care of older adults with cancer.”