Predicting OptimaL cAncer RehabilItation and Supportive care
Due to advances in early detection and treatment, survival after cancer has improved substantially. Unfortunately for most patients, cancer survivorship is associated with long term adverse physical and psychosocial symptoms, reducing the quality of life (QoL). Numerous cancer rehabilitation and supportive care programs aiming at improving QoL exist, but effect sizes are generally small to moderate. Clinical practice shows that a program may be effective in some patients, but not in others. The working components of rehabilitation and supportive care programs should be identified and rehabilitation and supportive care needs to shift from a one-size fits all approach to personalized care, tailored to the patient’s characteristics, capabilities, and preferences.
POLARIS aims to improve QoL of cancer patients by optimizing cancer rehabilitation and supportive care using an individually tailored and evidence-based approach.
It aims to identify what rehabilitation and supportive care program works best for which (groups of) patients, under what circumstances (moderators) and through which mechanisms (mediators).
Furthermore, we aim to build a clinical prediction model that predicts which intervention has th highest probability of success for the patient.
The POLARIS study is embedded in the inter-institutional research program of the EMGO+ Institute and VUmc CCA/V-ICI ‘Quality of life in cancer and immunology’.
We set-up a unique international network of experts in rehabilitation and supportive care in cancer. We create a comprehensive database of individual patient data from high quality randomized controlled trials (RCTs), and infrastructure for inclusion of future trials in the database. Consequently, we conduct individual patient data meta-analyses. We evaluate the effect of exercise and psychosocial interventions on QoL compared with usual care or wait-list control group using multilevel regression analyses.
We investigate what program works best for whom, under what circumstances (moderators), and through which mechanisms (mediators), using state-of-the-art moderation and mediation analysis.. We conduct a series of moderated multiple regression analyses to investigate which socio-demographic, clinical and personal characteristics and intervention type and circumstances moderate the effect of exercise and psychosocial interventions on QoL. We conduct-state-of-the-art mediation analyses to study whether the intervention effect on QoL is mediated by fatigue, physical fitness and function, or psychosocial function.
We conduct multiple backwards logistic regression analysis to build a model that predicts which intervention has the highest probability of success, i.e. improve the patient’s QoL. Subsequently, the prediction model is internally and externally validated and translated into an easily applicable clinical decision rule.
POLARIS is funded through the Bas Mulder Award, granted to Laurien Buffart by the Alpe d’HuZes foundation/Dutch Cancer Society. (4 years)
J. Kalter, MSc, Health scientist, physiotherapist EMGO Institute for Health and Care research and the dpt. of Epidemiology and Biostatistics, VUmc
L.M. Buffart, PhD, Human movement scientist, epidemiologist, EMGO Institute for Health and Care research and the dpt. of Epidemiology and Biostatistics, VUmc
Prof. J. Brug, PhD, director of the EMGO Institute for Health and Care Research, VUmc
Prof I.M. Verdonck-de Leeuw, PhD, Psychologist, Speech and Language Therapist, Linguïst, dpt. Otolaryngology-Head&Neck Surgery, VUmc.
prof. N. Aaronson (Dutch Cancer Institute); prof. G. Bleijenberg (Expert centre for chronic fatigue, Radboud University Medical Center, Nijmegen); prof. P. Cuijpers (Faculty of Psychology and Education, VU University Amsterdam); dr. A. May (Julius Centrum UMC Utrecht; prof. J. Prins (Dept. of Medical Psychology, Radboud University Medical Center, Nijmegen); prof. R. Sanderman (Rijksuniversiteit Groningen/University Medical Center Groningen) enriched by members of the Dutch comprehensive cancer centres (dr. M. Velthuis (IKNL) and dr. L. van de Poll-Franse (IKZ and Tilburg University).
dr. S. Berntsen (University of Oslo & Cancer Centre for Education and Rehabilitation, Haukeland University Hospital, Bergen, Norway); prof. I. De Bourdeaudhuij (University of Gent, Belgium),; prof. W. Breitbart (Memorial Sloan-Kettering Cancer Center in New York); prof. K. Courneya (Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada); E. van Hoof (director Cancer center, Belgium); prof. M. Irwin (Yale University School of Medicine, New Haven, USA); prof. P. Jacobsen, (Lee Moffit Cancer Center and Research Institute University of South Florida, Tampa); prof. C. Johansen (Institute of cancer epidemiology, Copenhagen, and National Centre for Cancer Rehabilitation Research, Odense, Denmark); prof. R. Newton (Centre for of exercise and sports science, Edith Cowan University, Perth, Australia); dr. J. Savard (Centre de recherche en cancérologie de l'Université Laval, Québec, Canada); dr. K. Steindorf (German Cancer Research Center, Heidelberg, Germany); dr. J. Wiskemann (German Cancer Research Center, Heidelberg, Germany); dr. L. Jones (Duke Cancer Institute, Durham, USA)
For questions, please contact:
Laurien Buffart, PhD
Phone: +31 (0)20-4449931