Andrew E Chapman

Andrew E Chapman
Thomas Jefferson University | Jefferson · Department of Medical Oncology

Doctor of Osteopathic Medicine

About

75
Publications
3,498
Reads
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1,810
Citations
Citations since 2017
43 Research Items
1379 Citations
2017201820192020202120222023050100150200250
2017201820192020202120222023050100150200250
2017201820192020202120222023050100150200250
2017201820192020202120222023050100150200250
Additional affiliations
July 1994 - present
Thomas Jefferson University
Position
  • Co-Director, Jefferson Senior Adult Oncology Center

Publications

Publications (75)
Article
Full-text available
Background Older adults (≥65 years) with gastrointestinal (GI) cancers who receive chemotherapy are at increased risk of hospitalization caused by treatment-related toxicity. Geriatric assessment (GA) has been previously shown to predict risk of toxicity in older adults undergoing chemotherapy. However, studies incorporating the GA specifically in...
Article
Full-text available
Few treatment decision support interventions (DSIs) are available to engage patients diagnosed with late-stage non-small cell lung cancer (NSCLC) in treatment shared decision making (SDM). We designed a novel DSI that includes care plan cards and a companion patient preference clarification tool to assist in shared decision making. The cards answer...
Article
PURPOSE Hospitalizations during cancer treatment are costly, can impair quality of life, and negatively affect therapy completion. Our objective was to identify risk factors for unplanned hospitalization among older adults receiving chemotherapy. METHODS This is a secondary analysis of a multisite cohort study (N = 750) of patients ≥ 65 years of a...
Conference Paper
Background: Physical resilience, the ability to resist decline and maintain functional status despite a stressor such as chemotherapy, is a central aspect of successful aging. Understanding clinical and biological factors associated with resilience in older women receiving chemotherapy for early breast cancer may facilitate the development of targe...
Article
Polypharmacy poses a significant public health problem that disproportionately affects older adults (≥65 years) since this population represents the largest consumers of medications. Clinicians caring for older adults with cancer must rely on evidence to understand polypharmacy and its implications, not only to communicate with patients and other h...
Article
We developed an outpatient salvage chemotherapy regimen using bendamustine, ofatumumab, carboplatin and etoposide (BOCE) to treat relapsed/refractory non-Hodgkin lymphoma (RR NHL) in a single-center phase I/II study. Primary objectives were safety, tolerability and overall response rate (ORR). Thirty-five RR NHL patients (57% de novo large cell [DL...
Article
2034 Background: The benefits of supportive medicine (SM) for cancer patients include improved quality of life, increased patient satisfaction, improved symptom management, increased cost savings and improved survival rates. At one NCI-designated cancer center, all patients were screened for distress; those who screened positive or were directly re...
Article
Objectives Polypharmacy (≥5 concurrent medications) is common among older patients with cancer (48%–80%) and associated with increased frailty, morbidity, and mortality. This study examined the relationship between polypharmacy and inpatient hospitalization among older adults with cancer treated with intravenous (IV) chemotherapy. Materials and Me...
Article
Full-text available
Background: Nutritional status can directly affect morbidity and mortality in older adults with cancer. This study evaluated the association between pretreatment body mass index (BMI), albumin level, and unintentional weight loss (UWL) in the prior 6 months and chemotherapy toxicity among older adults with solid tumors. Methods: This was a secon...
Article
Full-text available
Introduction: Cognitive impairment (CI) increases chemotherapy toxicity risk with need to understand this association utilizing publicly available short screening tools. We evaluated this utilizing a lower threshold on a short screening tool in older adults with cancer. Materials and methods: We analyzed data from the Cancer and Aging Research G...
Article
Background Currently available salvage chemotherapy regimens for patients (pts) with relapsed or refractory (RR) aggressive B-cell non-Hodgkin lymphoma (NHL) are mostly inpatient regimens and offer comparable response rates. Bendamustine has single agent activity in RR NHL. In vitro studies with Ofatumumab in NHL show more complement-dependent cyto...
Article
206 Background: Electronic patient reported outcomes (ePROs) can bridge the communication gap with a patient’s care, providing insight into patients’ symptoms between clinical visits and improving both symptom management and overall survival. PROs are typically monitored through standardized questionnaires given to patients at specific times during...
Article
Full-text available
Background: Elderly patients (≥65yr) with advanced prostate cancer and cardiovascular disease (CVD) conditions are often excluded from clinical trials of abiraterone acetate (AA) or enzalutamide (ENZ). Consequently, little is known about the effects of these medications on these vulnerable patients. Objective: To assess the short-term outcomes o...
Conference Paper
Full-text available
Background: Advanced prostate cancer patients with pre-existing cardiovascular diseases (CVD) are often excluded from clinical trials of abiraterone acetate (AA). Therefore, the clinical outcomes of these patients are uncertain. This study was undertaken to examine their outcomes - changes in the rate of hospitalization and short-term mortality aft...
Conference Paper
Background: Advanced prostate cancer patients with pre-existing cardiovascular diseases (CVD) are often excluded from clinical trials of abiraterone acetate (AA). Therefore, the clinical outcomes of these patients are uncertain. This study was undertaken to examine their outcomes - changes in the rate of hospitalization and short-term mortality aft...
Article
6632 Background: The Oncology Care Model (OCM) is a 5-year demonstration project led by the Centers for Medicare and Medicaid Services (CMS) to create a framework for the future of oncology care in the United States. More than half way through the project, our large, urban NCI-designated cancer center chose to focus on and invest in resources and p...
Article
e23023 Background: While autologous stem cell transplant (ASCT) has been shown to be safe and effective in the geriatric population, age alone is not a sufficient predictor of outcomes. Minimal data exists regarding the use of a comprehensive geriatric assessment (CGA) tool prior to ASCT as a predictor of patient outcomes. This study aims to assess...
Article
Full-text available
Background: Falls in older adults with cancer are common, yet factors associated with fall-risk are not well-defined and may differ from the general geriatric population. This study aims to develop and validate a model of factors associated with prior falls among older adults with cancer. Methods: In this cross-sectional secondary analysis, two...
Article
Objectives: Drug-drug interactions (DDIs) represent an escalating concern for older adults attributed to polypharmacy, multi-morbidity and organ dysfunction. Few studies have evaluated the prevalence of major DDIs and the variability between DDI detection software which confuses management. Materials and methods: Prevalence of major DDIs was exa...
Article
319 Background: Data from clinical trials has shown that octogenarians are at increased risk for prostate cancer specific mortality (PCSM). Patients with significant comorbidities were excluded from the trials; consequently, the findings from clinical trials may not be applicable to the general population. Data on patients age 80+ with metastatic p...
Article
Background: Older adults are less likely to be included in clinical trials leading to the approval of novel cancer treatments. The Institute of Medicine and ASCO have identified therapeutic phase II trials as a key research priority to increase the evidence base for older adults with cancer. While targeted therapies may represent a less toxic optio...
Article
BACKGROUND Hearing and visual impairments are common among community‐dwelling older adults, and are associated with psychological, functional, and cognitive deficits. However, to the authors' knowledge, little is known regarding their prevalence among older patients with cancer. METHODS The current study was a secondary analysis combining 2 prospe...
Article
Full-text available
Background: Adjuvant chemotherapy for resected early-stage non-small-cell lung cancer (NSCLC) provides a modest survival benefit. Bevacizumab, a monoclonal antibody directed against VEGF, improves outcomes when added to platinum-based chemotherapy in advanced-stage non-squamous NSCLC. We aimed to evaluate the addition of bevacizumab to adjuvant ch...
Article
Full-text available
Purpose: Older adults compose the majority of patients with cancer in the United States; however, it is unclear how well geriatrics or geriatric oncology training is being incorporated into hematology-oncology (hem-onc) fellowships. Methods: A convenience sample of hem-onc fellows completed a (written or electronic) survey assessing their educat...
Article
e21523 Background: Older adults undergoing chemotherapy for GI cancers are at increased risk of HOS due to treatment related toxicity; however, there are limited data regarding which individuals are at greatest risk. We therefore sought to identify risk factors for HOS among older adults with GI cancers receiving chemotherapy. Methods: We performed...
Article
e19005 Background: No standard salvage regimen exists for patients (pts) with relapsed or refractory (RR) NHL or CLL. Bendamustine, pentostatin and ofatumumab have activity in pts with CLL and NHL, but have not been combined as a single regimen. We conducted a phase I trial to assess the safety of this regimen. Methods: Pts with RR B-NHL or CLL wer...
Article
10036 Background: Hearing and visual impairment increase the risk of psychological, functional, and cognitive deficits in older adults. However, little is known about their impact in older patients (pts) with cancer. Methods: This is a cross-sectional analysis of 2 prospective studies of pts ≥65 with cancer (Hurria et al. JCO 2011 & 2016) which ide...
Article
Objectives: Medication-related problems (MRP) affecting older adults are a significant healthcare concern and account for billions in medication-related morbidity. Cancer therapies can increase the prevalence of MRP. The objective of this study was to test the feasibility and effectiveness of implementing a pharmacist-led individualized medication...
Article
Full-text available
The concepts of quality and value have become ubiquitous in discussions about health care, including cancer care. Despite their prominence, these concepts remain difficult to encapsulate, with multiple definitions and frameworks emerging over the past few decades. Defining quality and value for the care of older adults with cancer can be particular...
Article
Healthcare is at a crossroads, under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. Yet primary care accounts for only a small portion of total healthcare spending, and...
Article
The concepts of quality and value have become ubiquitous in discussions about health care, including cancer care. Despite their prominence, these concepts remain difficult to encapsulate, with multiple definitions and frameworks emerging over the past few decades. Defining quality and value for the care of older adults with cancer can be particular...
Article
Full-text available
Purpose: Older adults are at increased risk for chemotherapy toxicity, and standard oncology assessment measures cannot identify those at risk. A predictive model for chemotherapy toxicity was developed (N = 500) that consisted of geriatric assessment questions and other clinical variables. This study aims to externally validate this model in an i...
Article
Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. "GA with management" is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer pat...
Article
Full-text available
Comorbidity is an issue of growing importance due to changing demographics and the increasing number of adults over the age of 65 with cancer. The best approach to the clinical management and decision-making in older adults with comorbid conditions remains unclear. In May 2015, the Cancer and Aging Research Group, in collaboration with the National...
Article
The prevalence of complementary and alternative medication (CAM) use in senior adult oncology (SAO) patients is widely variable and little is known about whether polypharmacy (PP) and potentially inappropriate medication (PIM) use influences CAM use given the increased number of comorbidities and polypharmacy. One approach to optimize medication ma...
Article
Full-text available
The interface between cancer and aging has been explored in research conducted over the past 10 years. Critical topics relevant to the biology of aging and cancer include: immune senescence, telomere shortening, and roles of chronic inflammation and antigen stimulation.
Article
The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment. We retrospectively examined medica...
Article
Full-text available
Age-based reduction of chemotherapy dose with the first cycle (primary dose reduction, PDR) is not routinely guideline recommended. Few studies, however, have evaluated how frequently PDR is utilized in the treatment of older patients with cancer and which factors may be associated with this decision. We conducted a secondary analysis of a multi-in...
Article
Background The proportion of older patients with cancer is expected to grow exponentially in the next two decades. This population has large heterogeneity and it is well known that chronologic age is a poor predictor of outcomes. Research has shown that these patients are best served with a Comprehensive Geriatric Assessment (CGA) to formulate indi...
Article
Full-text available
The primary objective was to determine the response rate in patients with metastatic pancreatic cancer treated in first line with irinotecan/docetaxel combination (Arm A) or with irinotecan/docetaxel/cetuximab combination (Arm B). Secondary endpoints were progression-free survival (PFS), overall survival (OS), toxicity, and the rate of thromboembol...
Article
4642 Background: Gemcitabine (G) is standard for metastatic pancreatic cancer (PC), with median survivals of 6 months (m). We conducted this randomized phase II trial to determine the activity of this non-G regimen, and whether combining it with cetuximab (C ) was feasible and active. Primary endpoint was response. 50% fall in CA19–9 is examined as...
Article
4519 Background: Gemcitabine (G) is standard for metastatic pancreatic cancer (PC), with median survivals of 6 months (m). Second cytotoxic or biologic agents do not substantially advance survival. EGFR is expressed on PC and a phase II trial of G plus cetuximab (C) resulted in favorable 1 year survival. A phase II trial of irinotecan/docetaxel (I/...
Article
4031 Background: Trimodality therapy has been shown in select series to be associated with an improved outcome over surgery alone for esophageal ca. A Phase I trial of preoperative paclitaxel (P), carboplatin (C), 5-FU and radiation (RT) was previously reported (IJROBP 45:3, supplement) and a phase II study initiated. The phase II study has now bee...
Article
Cancer presenting during pregnancy is a rare event. There are no reports of an unknown primary tumor presenting during pregnancy. A 35-year-old primigravida presented at 16 weeks' gestation with multiple cerebral infarcts. After a negative workup she was discharged on anticoagulation therapy, only to return at 29 weeks with diffuse, metastatic canc...
Article
Twenty-four patients with non-small cell lung cancer received induction chemotherapy (paclitaxel, carboplatin) followed by concurrent thoracic irradiation (RT) and weekly paclitaxel. Acute esophagitis was scored weekly. Amifostine (AMI), 500 mg intravenously twice weekly, was added to the regimen in the second cohort of 12 patients. AMI was well to...
Article
Esophagitis is a major toxicity of chemoradiotherapy for lung cancer. Twenty-four patients with non-small-cell lung cancer received induction chemotherapy (paclitaxel/carboplatin) followed by concurrent thoracic irradiation (RT) and weekly paclitaxel. Acute esophagitis was scored weekly. Since a high rate of grade 3 esophagitis was noted in the ini...
Article
Estramustine (EM), an antimicrotubule agent, is effective against hormone-refractory prostate cancer when used in combination with vinblastine or paclitaxel. To understand the effect of EM on beta-tubulin, a cellular target for this class of drugs, human prostate carcinoma cells (DU-145) were made resistant to EM, and two cell lines were selected a...
Article
Estramustine phosphate is a unique antimitotic agent that binds to tubulin and microtubule-associated proteins. Preclinically, estramustine combined with other microtubule inhibitors, like vinblastine or paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ), produced additive or greater antimitotic and cytotoxic effects. Clinically, the e...
Article
Previous preclinical studies of combinations of estramustine and vinblastine or paclitaxel (Taxol) have shown that it is possible to achieve a greater than additive cytotoxicity with these antimicrotubule drug combinations. Phase II studies in hormone-refractory prostate cancer have demonstrated clinical antitumor activity of sufficient magnitude t...

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