ONtario Patient Reported Outcomes of Symptoms and Toxicity
Symptoms and toxicities are important clinical outcomes, but for research purposes, symptoms and toxicities are important surrogates or markers of important biological processes occurring in the cancer patients. Understanding these relationships require improved methods of collecting and analyzing symptom and toxicity data.
What is ON-PROST?
ON-PROST is an offshoot of AMP-PEL because there had not been systematic collection of symptom and toxicity data at Princess Margaret or elsewhere with the exception of clinical trials. ON-PROST served to develop tools to improve the collection of patient-reported outcomes. This work eventually led to the understanding that the current knowledge gaps are not only in the lack of systematic collection of data, but also in the ability to interpret complex toxicity and symptom longitudinal data. The 2BLAST pipeline (see 2BLAST) is designed to address the analytical challenges of working with symptom and toxicity data. ON-PROST was funded from 2011-2017 from Cancer Care Ontario, and now has a multi-source funding from academia, philanthropy, and industry.
ON-PROST milestones and projects:
1. ON-PROST has developed symptom/toxicity screening tools to reduce patient burden and survey burnout. It has impact on provincial (Cancer Care Ontario) decisions on introducing innovative strategies in patient-reported outcomes (PROs). ON-PROST is led by two laboratories: that of Geoffrey Liu and Doris Howell.
2. The laboratory publications from the past six years have set up the logical next steps, which is to study the implementation of PROs into clinical practice, for example, through multiple pilot studies for rapid symptom response using new technology (see CLINTA).
3. Publications on how PROs relate to behaviours such as smoking, alcohol consumption, and physical activity under the leadership of junior Principal Investigator, Dr. Lawson Eng, have led to the recent funding of two smoking cessation implementation grants.
4. Other publications within ON-PROST involve the use and implementation of routine health utility and toxicity data collection, which is critical when evaluating health technology assessment of new approaches such as targeted therapies, immunotherapies, and radiotherapy for provincial funding agencies such as pCODR (pan-Canadian Oncology Drug Review), mainly through CHUQoLS (see CHUQoLS).
5. The ON-PROST structure has thus helped to develop the CARMA study (see CARMA), which is assessing Canadian data on rare molecular alterations, based on relationships with multiple pharmaceutical companies.