Cancer studies

Our Southern California Cancer Research Program continues to grow, with the initiation of many clinical trials and epidemiological and behavioral studies. Our scientists and clinicians engage in innovative research across the continuum, from etiology, prevention, and treatment to quality of life and survivorship in children and adults. Kaiser Permanente has been awarded a grant by the National Cancer Institute as a member of the National Cancer Institute Community Oncology Program. We also participate in a number of national collaborative groups, including the National Cancer Institute’s Cancer Research Network.

A Cohort study of co-morbid conditions and risk of chemotherapy associated febrile neutropenia in patients with selected types of cancers in Kaiser Permanente Southern California

The goal of this study is to examine the association between chronic co-morbid conditions and risk of febrile neutropenia, and grade III and IV neutropenia associated with first cycle chemotherapy.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Amgen, Inc.

Funding Years:

2013 - 2016

Research Categories:

A Registry to Improve Care and Research in Lung Cancer Screening

This is an award to demonstrate the feasibility of developing a registry of individuals who undergo lung cancer screening with low-dose CT.

Principal Investigator:

Michael K. Gould, MD, MS

Funding Source:

Cancer Research Network (CRN)

Funding Years:

2014 - 2016

Research Categories:

,

Addressing cancer treatment disparities for persons with HIV

This study is to investigate disparities by HIV status and modifiable risk factors for delays in cancer treatment initiation, treatment completion, and short- and long-term adverse events for persons with HIV (PWH) who were members of the Veteran’s Administration or Kaiser Permanente, the two largest healthcare systems in the United States. Study findings will provide necessary data to inform HIV-specific cancer treatment guidelines and improve cancer care delivery and outcomes for PWH.

Site Principal Investigator:

Rulin C. Hechter, MD, PhD

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2021 - 2026

Research Categories:

,

Addressing Disparities in Outcomes of Screening for Colorectal Cancer in Community-Based Settings

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States and although the overall CRC mortality rate has been decreasing, disparities have persisted, particularly for Black and Native American people. The goal of this study is to inform feasible and effective strategies for advancing health equity by elucidating the extent to which differences in care along the entire screening process cumulatively contribute to disparities. We will comprehensively evaluate the entire screening continuum from the tests used and screening quality to receipt of follow-up care and guideline-concordant treatment in a cohort of about 3.8 million people per year over a nearly 2-decade period in Kaiser Permanente Northern California (KPNC) and Kaiser Permanente Southern California (KPSC).

Site Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2023 - 2028

Research Categories:

,

Adverse Health Outcomes in Breast Cancer Survivors exposed to Pain Medications

The aim of this longitudinal cohort study is to evaluate the comparative safety and risk of opioids and psychotropic drugs in women with breast cancer who suffer from chronic pain due to cancer or its treatments.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

California Breast Cancer Research Program (CBCRP)

Funding Years:

2020 - 2023

An Examination of Chronic Health Problems of Survivors of Cancer

An Examination of Chronic Health Problems of Survivors of Cancer

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

City Of Hope

Funding Years:

2014 - 2016

Research Categories:

Antidepressants and Breast Cancer Pharmacoepidemiology

This study examines drug interactions between tamoxifen and antidepressants in nearly 23,000 breast cancer survivors diagnosed with early stage disease in the two largest health plans in California.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2010 - 2014

Research Categories:

,

Biobehavioral Vulnerability to Accelerated Aging in Breast Cancer Survivors

The aim of this project is to examine cellular and genomic markers of inflammation, telomere erosion, telomere length, and microarray data of 300 breast cancer survivors and comparison women who are enrolled in the KPSC-UCLA collaborative STRIVE1 and STRIVE2 studies.

Site Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

American Cancer Society

Funding Years:

2016 - 2019

Breast cancer screening decisions in younger women: a hybrid effectiveness-implementation study

The major goals of the project are to evaluate the effectiveness of a web-based decision aid on improving knowledge about breast cancer screening in women age 40 to 49 and reducing decisional conflict about breast cancer screening, and to explore the acceptability and feasibility of large-scale implementation.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Natl Cancer Inst

Funding Years:

2017

Research Categories:

,

Cardiovascular toxicity following aromatase inhibitor use

The aim of this cohort is to assess the risk of cardiovascular disease associated with endocrine treatments for breast cancer.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

California Breast Cancer Research Program (CBCRP)

Funding Years:

2013 - 2017

Characterizing patients with HER2 breast cancer who relapse after HER2 directed adjuvant treatment

To understand real world outcomes in patients with invasive stage breast cancer who receive HER2-directed adjuvant treatment.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Puma Biotechnology, Inc.

Funding Years:

2020 - 2022

Research Categories:

Chemotherapy Induced Compliances: FN risk in selected regimens

The goal of this observational study is to evaluate the average risk of febrile neutropenia (FN) in patients receiving chemotherapy regimens with previously undefined FN risk.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Amgen, Inc.

Funding Years:

2014 - 2016

Research Categories:

Chronic Health Problems in Survivors of Adolescent and Young Adult Cancer

The goal of this project is to evaluate the long-term health outcomes, including mortality, second cancer and comorbidities among survivors of adolescent and young adult cancer. The magnitude of risk increase of specific late effects associated with specific cancer therapeutic exposure will also be characterized.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

American Cancer Society

Funding Years:

2015 - 2019

Research Categories:

,

Chronic Myelogenous Leukemia and Outcomes of Tyrosine Kinase Inhibitor Therapy

The aim of this investigation initiated retrospective cohort study are to examine long-term health effects in the cohort of CML and determine if health effects vary by drug adherence to TKIs.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Novartis Pharmaceuticals Corporation

Funding Years:

2013 - 2018

Clinical pregnancy outcomes in adolescent and young adult female cancer survivors

The goals of this study are to assess pregnancy risks among female AYA cancer survivors; assess risk of adverse infant birth outcomes; and examine factors that may contribute to risk of pregnancy loss or adverse birth outcomes

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

National Institute of Child Health and Human Development (NICHD)

Funding Years:

2017

Research Categories:

,

Comparing Strategies for Implementing Primary HPV Testing for Routine Cervical Cancer Screening

The major goal of this project is to compare two implementation strategies to facilitate adoption of primary HPV testing for routine cervical cancer screening measured by patient-, provider- and system-centered outcomes. A sub-analysis and survey data collection will evaluate the impact of the COVID pandemic on this practice change and cervical cancer screening.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2019 - 2023

Developing tailored de-implementation strategies to reduce use of low-value cancer care services

The goal of this mixed methods study is to develop and test interventions to reduce use of surveillance biomarkers for early stage breast cancer patients.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Kaiser Permanente, Southern California

Funding Years:

2014 - 2015

Diet and Lifestyle in a Prospective Study of Bladder Cancer Survivors

This study will examine the role of cruciferous vegetable intake, in conjunction with genetic polymorphisms related to ITC metabolism, in potentially reducing disease recurrence and progression, and increasing the efficacy of intravesical bladder cancer treatment.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2014 - 2020

Research Categories:

,

Economic, Epidemiologic and Clinical Burden Associated with Neutropenia and Febrile Neutropenia in Three Cancers

The primary objective of this study is to estimate the resource utilization and direct medical expenditure associated with neutropenia and febrile neutropenia, in Non-Hodgkin’s Lymphoma, Breast cancer and Lung cancer patients. The secondary objective is to determine the trend of incidence of neutropenia with and without fever in Non-Hodgkin’s Lymphoma, Breast cancer and Lung cancer. The study will also describe management patterns and evaluate trend of management patterns for febrile neutropenia. Lastly, we will also estimate the febrile neutropenia specific mortality rate in hospitalized patients by cancer type.

Principal Investigator:

Aniket A. Kawatkar, PhD, MS

Funding Source:

Amgen, Inc.

Funding Years:

2011 - 2015

End-of-Life Care for Adolescents and Young Adults with Cancer: An Evaluation of Care and Development of Patient-Centered Quality Measures.

Adolescents and young adults with cancer aged 12-39 account for more than 70,000 new cancer diagnoses in the United States per year, and cancer is their leading disease-related cause of death. This study will evaluate the current state of end-of-life care quality among adolescent and young adult patients and develop a set of quality indicators that capture adolescent and young adult values for care. This work will enable valid assessment of care quality and rigorous evaluation of interventions to improve adolescent and young adult end-of-life care delivery.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2018 - 2023

Research Categories:

,

Extracting and Validating Symptoms Prior to Pancreatic Cancer Diagnosis From Electronic Medical Records (EHR)

In this nested case control study, we extract and validate both common and rare symptoms of pancreatic cancer based on electronic health records (EHR) of Kaiser Permanente Southern California (KPSC). More specifically, we attempt to (1) extract from the stored information on symptoms from EHR based on structured, semi-structured and un-structured data, (2) evaluate the accuracy of such EHR information, overall and in different clinical settings, (3) report the prevalence of each symptom in cases and controls and the median time to diagnosis in cases for each specific symptom, (4) examine the association of the each symptom with PDAC status, and finally (5) make recommendations on the appropriate application of the electronic algorithms to identify symptoms for future studies related to pancreatic cancer.

Principal Investigator:

Wansu Chen, PhD

Funding Source:

Not Applicable

Funding Years:

2022 - 2024

Research Categories:

Follow-up care and preventive service use among survivors of adolescent and young adult cancer.

This project aims to evaluate adherence to Children’s Oncology Group Long-Term Follow-up Guidelines and population preventive care guidelines among survivors of adolescent and young adult (AYA) cancer.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Not Applicable

Funding Years:

2016

Research Categories:

,

Hereditary Cancer Moderate Risk Gene Results vs. Claus Model Breast Cancer Risk Score and Breast MRI

Dr. Haque was awarded travel funds to attend conferences related to hereditary cancers.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

GeneDx

Funding Years:

2015 - 2018

Research Categories:

Identification of DNA methylation markers for risk of metastasis in localized prostate

The goal of this project is to develop DNA methylation marker-based prediction algorithms that will assist clinicians when providing therapeutic recommendations for men with localized prostate cancer.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2015 - 2021

Research Categories:

,

Impact of Bariatric Surgery on Cancer Incidence in Severely Obese Adults

The goal of this project is to estimate the impact of bariatric surgery versus routine non-surgical care on the incidence of cancer (all types) in all severely obese patients (men and women).

Principal Investigator:

Corinna Koebnick, PhD, MSc

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2014 - 2018

Research Categories:

, ,

Impact of Body Composition and Related Inflammatory and Immune Responses on Prognosis of Non-Muscle Invasive Bladder Cancer

In the Be-Well Study of 1,472 non-muscle invasive bladder cancer (NMIBC) survivors, we propose to conduct a comprehensive investigation of body composition and the immune/inflammatory state at the time of cancer diagnosis and their outcomes at eight years post-diagnosis.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2023 - 2028

Research Categories:

Implementing systematic distress screening in breast cancer

This project focuses on implementation and effectiveness of an evidence-based guideline recommendation for systematic distress screening for breast cancer patients.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Not Applicable

Funding Years:

2016

Research Categories:

,

Influence of comorbidities on survival disparities in women with metastatic breast cancer

The aim of this cohort study is to examine if management of comorbidities can help mitigate the disparities seen in survival among women with metastatic breast cancer.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

California Breast Cancer Research Program (CBCRP)

Funding Years:

2022 - 2025

Research Categories:

,

Kaiser Permanente NCI National Community Oncology Research Program-Cancer Care Delivery Research Program

The specific aim of the Cancer Care Delivery Research portion of this program is to conduct and help design cancer care delivery research within the National Community Oncology Research Program (NCORP

Funding Source:

Natl Cancer Inst

Funding Years:

2014

Research Categories:

Longitudinal Assessment of Benefits and Harms of Cannabis Use Among Community-Based Cancer Patients During Initial Cancer Treatment

Given the lack of evidence regarding the benefits or harms of cannabis, we will conduct a new study of 1000 adult cancer patients to compare people who use cannabis versus non-users. Our study will provide new information to educate individuals and their healthcare providers about whether to consider using cannabis alongside other conventional ways to manage cancer-related symptoms.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2023 - 2028

Research Categories:

,

Molecular and Genetic Determinants of non-Hodgkin Lymphoma

The goal of this study is to investigate whether the genetic variation in the human leukocyte antigen and other key a priori genes linked to human leukocyte antigen, including tumor necrosis factor play a role in non-Hodgkin lymphoma prognosis and overall survival.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2012 - 2017

Research Categories:

,

Next Generation Sequencing Testing to Inform Clinical Decision-Making for Non-Small Cell Lung Cancer (NSCLC) in a Large Integrated Healthcare Delivery System

The goal of this study is to examine the effectiveness of NGS testing (tissue failure rates, time to NGS results), distribution of NGS testing, and prevalence of targetable driver mutations by patient’s demographic and clinical characteristics.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Care Improvement Research

Funding Years:

2022

Research Categories:

Observational Study of the Epidemiology in Clinical Outcomes of Breast Cancer in Women with BRCA Mutations

This cohort study examines the long-term clinical outcomes of women with breast cancer who are BRCA mutation carriers.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

AstraZeneca

Funding Years:

2015 - 2019

Research Categories:

, ,

OPATS: Outcomes of Prostate Cancer Androgen Deprivation Therapy Study

The goal is to assess fatal and morbid outcomes up to 15 years following androgen deprivation therapy for men initially diagnosed with localized prostate cancer.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2010 - 2014

Research Categories:

,

PD-1/PD-L1 Blockage Plus Kinase Inhibitor Therapies for B cell Lymphomas

This study aims to explore rational combination therapies aimed at cytoreduction of advanced tumors followed by antibody-mediated immune checkpoint inhibition to stimulate adaptive T cell anti-lymphoma immunity. We will study a large cohort of human diffuse large B cell (DLBCL) samples and utilize syngeneic, immunocompetent mouse lymphoma models that mimic the varied sensitivity of human B cell NHL to kinase inhibitors

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Leukemia and Lymphoma Society

Funding Years:

2013 - 2016

Research Categories:

,

Personalized Risk-Adaptive surveIllance Strategies in cancEr (PRAISE)

The major goals of this project are to develop innovative risk-adaptive models of cancer surveillance for colorectal, chronic myeloid leukemia, and prostate cancer using value-of-information statistical methodology.

Site Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Nat'l Inst of Health

Funding Years:

2018

Research Categories:

Pilot Study of Neutropenia in Cancer Patients with Co-Morbid Conditions

The goal of this study is to evaluate the feasibility of determining the occurrence of neutropenia and febrile neutropenia as well as cancer treatment using electronic medical records.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Amgen, Inc.

Funding Years:

2009

Research Categories:

REPRISE 2: Is depression associated with prostate cancer progression?

This study examines if depression and its treatment can affect the course of prostate cancer.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2018 - 2022

Research Categories:

, ,

Return of KPRB Hereditary Breast/Ovarian Cancer & Lynch Syndrome Results

This project will develop a population-based approach to returning results of genetic testing for these conditions to increase detection and offer risk reducing and early screening options for patients. This project represents an important opportunity for KPSC in implementing broad population-screening.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Not Applicable

Funding Years:

2024

Research Categories:

,

Risk Factors for molecular subtypes of NHL- a prospective evaluation

This study aims to evaluate purported risk factors for NHL and its subtypes using a pooled analysis of>500,000 individuals from five cohort studies

Site Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2016 - 2021

Research Categories:

Risk of Cancer in Childhood and Adolescence Associated with Medical Imaging

The goal of this study it to evaluate patterns of medical imaging associated with cumulative exposure to radiation (CT, nuclear medicine, fluoroscopy, angiography, and radiography), and subsequent risk of childhood cancers.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2015 - 2020

Risk prediction of breast cancer treatment-related cardiotoxicity to guide clinical decision making

The aim of this cohort study is to examine how combined breast cancer adjuvant therapies affect the risk of developing early and late cardiovascular disease. Results will be used to develop risk prediction models to inform clinical decision-making to optimize cancer control while mitigating cardiovascular disease risk.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Heart, Lung, and Blood Institute (NHLBI)

Funding Years:

2020 - 2024

Research Categories:

,

Sleep Disturbance, Inflammation & Cellular Aging in Breast Cancer Survivors (STRIVE 2)

The goal of this prospective recruitment study is to evaluate longitudinal differences in the rates of change in inflammation and telomere erosion in breast cancer survivors vs. non-cancer comparison women to determine if such molecular changes are due to cancer biology, or its treatment, or consequences of aging.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2016 - 2023

Sleep Inflammation and Depression Occurrence in Breast Cancer Survivors (STRIVE1)

The aim of this prospective study is to examine the association between sleep disturbance, cellular and genomic markers of inflammation, and depression occurrence in breast cancer survivors.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2012 - 2019

Transcriptomic Classification of Non-muscle Invasive Bladder Cancer and its Clinical and Prognostic Implication

The goal of this project is to define molecular subtypes of non-muscle invasive bladder cancer using data and samples from the Bladder Cancer Epidemiology, Wellness, and Lifestyle Study (Be-Well), the largest prospective cohorts of newly diagnosed bladder cancer patients, with an ultimate goal to identify molecular signatures to refine the current pathological risk stratification and inform treatment response prediction.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2022 - 2027

Research Categories:

,

Treatment Variations and Clinical Outcomes in Patients with HR+/HER2- and HER2+ Metastatic Breast Cancer Treated in an Integrated Health System

In a multiregional, retrospective cohort study of patients with hormone-receptor positive/HER2+ and HER2-metastatic breast cancer diagnosed from 2012-2019, we will describe sociodemographic factors, clinical characteristics, and treatment modalities and describe clinical outcomes.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Pfizer, Inc.

Funding Years:

2022 - 2024

Research Categories:

Use of Multiple Biomarkers with the Risk of Ovarian Cancer Algorithm (ROCA) for Early Detection of Ovarian Cancer in Female Carriers of BRCA1 and BRCA2 mutations

The goal of this prospective recruitment study is to determine if ovarian cancer screening is enhanced by more frequent biomarker testing (CA125 & HE4) versus usual testing frequency in women with BRCA1/2 mutations.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

Garfield Memorial Fund

Funding Years:

2016 - 2019

Using Stakeholder Perspectives to Improve Survivorship Care Plan Implementation

The goal of this study is to gain insight and understanding into planned and implemented processes of survivorship care in diverse health care settings.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2016 - 2017

Utilization and Impact of Extended-Interval Dosing of Immunotherapy on Outcomes in Patients with Locally Advanced NSCLC

A retrospective analysis to evaluate the utilization of Q2W and dosing of durvalumab and impact on treatment outcomes among patients with unresectable stage III NSCLC treated within the Kaiser Permanente integrated delivery system.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

AstraZeneca

Funding Years:

2021 - 2023

Research Categories: