2020 Grantee: Gillian Gresham, PhD
Cedars-Sinai Medical Center
Research Project: Evaluating Objective Measures of Physical Function in Pancreatic Cancer
Award: 2020 Pancreatic Cancer Action Network Career Development Award in memory of Skip Viragh
Award Period: July 1, 2020 – June 30, 2022
Dr. Gresham is an assistant professor of hematology/oncology in the department of medicine at Cedars-Sinai Medical Center. After obtaining a PhD in epidemiology at Johns Hopkins University, Dr. Gresham pursued a postdoctoral fellowship in oncology trials and joined the Pancreatic Cancer Research Team at Cedars-Sinai Medical Center.
Her research interests lie at the intersection of cancer outcomes research, emerging technologies in healthcare and patient-reported outcomes. Dr. Gresham has dedicated the majority of her academic career to understanding and improving treatment tolerability, quality of life and survival outcomes in pancreatic cancer patients.
Physical function is a key measure of cancer treatment tolerability, and a decrease in physical function is known to be associated with diminished quality of life and higher risk for death. There are currently no validated methods to systematically evaluate and monitor physical function decline in pancreatic cancer outside of the clinic setting.
Patients diagnosed with advanced pancreatic cancer are in particular need for physical function assessment because of the significant physiological and psychological effects associated with the disease and its treatment. Although objective measures of physical function such as hand grip strength and gait (walking) speed are known predictors of morbidity and mortality (how a patient feels and how long they live), their assessment is limited to clinic settings, and they are not always feasible to obtain. Furthermore, measurements taken in the clinic do not capture the dynamic changes in physical function that patients can experience over the course of their treatment experience.
Thus, there is a critical need for access to real-time objective measures of physical function to inform treatment decisions and provide timely delivery of supportive care. Recent advances in wearable technology present a fresh opportunity to address this need. Wearable activity monitors allow for the measurement of continuous biometric data, including physical activity (e.g., steps, stairs, distance), sleep and heart rate. To date, their role as tools to predict functional outcomes in cancer patients is relatively unexplored. Dr. Gresham and her team will build upon their previous work, which established feasibility of the use of wearable activity monitors in advanced cancer patients, to conduct a six-month study focused on patients with advanced pancreatic cancer.
Dr. Gresham’s proposed study will examine associations between novel measures of physical function, remotely assessed with the Fitbit Charge HR, and current objective measures including gait speed and hand grip strength as assessed in the clinic. The investigators will also explore the prospective (forward-looking) relationship between remotely assessed biometric data and patient-reported physical function decline. They plan to develop a model that combines remotely assessed biometric data with patient characteristics to predict survival outcomes, including toxicity, hospitalization and death.
Findings from this research can lead to the use of novel technology for the early detection of physical function decline and lead to the development of individualized care plans that will ultimately improve functional independence and quality of life in pancreatic cancer patients.