Lynn Howie

Lynn Howie
Flatiron Health · Clinical Science

MD, MA

About

41
Publications
4,800
Reads
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929
Citations
Citations since 2017
16 Research Items
723 Citations
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2017201820192020202120222023050100150
2017201820192020202120222023050100150
2017201820192020202120222023050100150
Additional affiliations
July 2012 - June 2015
Duke University Medical Center
Position
  • Fellow
Education
August 2005 - May 2009

Publications

Publications (41)
Article
Objectives: Real-world data (RWD) from the routine care of patients with cancer captured through EHRs is a valuable resource for research. Understanding the relationship between characteristics and outcomes of patients treated in the real world and those treated in clinical trials is essential to produce evaluable trial-like populations using RWD i...
Article
Background: The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 Physical Functioning subscale is a widely used patient-reported outcome measure that quantifies cancer patients' physical functioning. Strong floor/ceiling effects can affect a scale's sensitivity to change. The aim of this stud...
Conference Paper
Background: The EORTC QLQ-C30 Physical Functioning (PF) subscale is a widely used patient-reported outcome (PRO) measure that quantifies cancer patients’ physical function. Responsiveness, the degree to which a scale can assess clinical deterioration and improvement, is an important measurement characteristic that can be assessed by looking at floo...
Article
Purpose: Many older women will be treated with a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor and an aromatase inhibitor (AI), given US Food and Drug Administration approval of three agents in this class. The current pooled analysis examines the efficacy and safety of this combination in older women. Patients and methods: We pooled data from t...
Article
Background: Patient-reported outcomes (PROs) are commonly included in submissions to the United States Food and Drug Administration (FDA). Open-label designs are frequent in cancer trials. Between-arm differences in PRO missingness may affect results. We sought to compare PRO completion rates between study arms in randomized open-label and double-...
Article
Full-text available
Background: Patient-reported outcome measures can be used to capture the patient's experience with disease and treatment. Immunotherapy agents including the anti-programmed death receptor-1/programmed death-ligand-1 inhibitor therapies have unique symptomatic side effects and patient-reported outcome data can help to characterize the benefits and...
Article
On December 20, 2017, the Food and Drug Administration granted regular approval to pertuzumab in combination with trastuzumab and chemotherapy for the adjuvant treatment of patients with HER2-positive early breast cancer (EBC) at high risk of recurrence. Approval was based on data from the APHINITY trial, which randomized patients to receive pertuz...
Article
Chemotherapy-induced peripheral neuropathy (CIPN) is a common and potentially dose-limiting side effect of neurotoxic chemotherapies. No therapies are available to prevent CIPN. The small number of positive randomized clinical trials (RCTs) evaluating preventive therapies for CIPN provide little guidance to inform the design of future trials. Moreo...
Article
Full-text available
The FDA approved niraparib, a poly(ADP-ribose) polymerase (PARP) inhibitor, on March 27, 2017, for maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in response to platinum-based chemotherapy. Approval was based on data from the NOVA trial comparing niraparib with placebo in tw...
Article
Full-text available
Importance Accelerated approval (AA) is a US Food and Drug Administration (FDA) expedited program intended to speed the approval of drugs and biologics that may demonstrate a meaningful advantage over available therapies for diseases that are serious or life-threatening. Observations This review describes all malignant hematology and oncology AAs...
Article
Background: With recent FDA approvals of inhibitors of Cyclin Dependent Kinases 4 and 6 (CDK 4/6) in combination with endocrine therapy for the treatment of postmenopausal women with hormone-receptor positive metastatic breast cancer (MBC), an increasing number of older adults will be treated with this class of agents. An improved understanding of...
Article
134 Background: Patient-reported outcome measures (PROs) can capture the patient’s experience with disease and treatment. Anti-PD-1/PD-L1 therapies have unique symptomatic side effects; PRO data can help to better understand the patient experience on therapy. Health-related quality of life (HRQL) components most impacted by therapy include disease...
Article
Background: Stromal tumor-infiltrating lymphocytes (TILs) might predict pathologic complete response (pCR) in patients with HER2-positive (HER2+) breast cancer treated with trastuzumab (H). Docetaxel (T), carboplatin (C), H, and pertuzumab (P) have immune-modulating effects. Pre- and post-treatment immune biomarkers in cancers treated with neoadju...
Article
Full-text available
Context In the emerging Learning Health System (LHS), the application and generation of medical knowledge are a natural outgrowth of patient care. Achieving this ideal requires a physician workforce adept in information systems, quality improvement methods, and systems-based practice to be able to use existing data to inform future care. These skil...
Article
Background: Baseline TIL density and T-cell clonality predict pathological complete response (pCR) to neoadjuvant (NA) trastuzumab (TRAS). Preclinical data suggests that a major mechanism of TRAS is enhancement of antibody-dependent cytoxicity (ADCC) and T-cell mediated tumor kill and that the combination of TRAS with pertuzumab (PERT) may enhance...
Chapter
Breakthrough pain is a relatively new concept, first coined by Portenoy and Hagen in 1990 [1], and anecdotal observation suggests that awareness of breakthrough pain as a distinct clinical entity remains relatively low [2]. Cancer pain is often variable, with a waxing and waning course throughout a day. For example, variations in activity level may...
Article
Recent advances in immune modulating therapies show great promise for patients with advanced melanoma, however optimal strategies for achieving long-term disease control in locally advanced melanoma are unclear. We present two cases of neoadjuvant ipilimumab, one case in combination with isolated limb infusion (ILI) followed by surgical resection a...
Article
BACKGROUND: Breast cancer treatment contributes the greatest proportion of cancer-related health care spending in the United States. Locoregional therapy comprises a significant share of these costs. We hypothesized that among eligible women with early-stage breast cancer treated with lumpectomy, evidence-based utilization of hypofractionated whole...
Article
Background: Randomized controlled trials have demonstrated that neoadjuvant chemotherapy (NAC) offers equivalent long-term outcomes when compared to adjuvant chemotherapy while improving rates of breast conservation therapy (BCT). We sought to evaluate the national use of NAC and the patient, tumor, and provider characteristics associated with its...
Article
281 Background: Surgical quality measures look to reduce variation and improve outcomes. Procedure goals can range from cure to symptom improvement. Knowledge of procedures used in this population can inform quality metrics, ensure palliation is included and that metrics do not discourage interventions where benefits are other than traditional meas...
Conference Paper
Aim: Sipuleucel–T (ST) is an autologous active cellular immununotherapy for men with metastatic castration-resistant prostate cancer. The role of ST in controlled trial settings has been reported. However, its use in routine clinical care is less well defined. What is the pattern of ST utilization and patient experience in an academic cancer center...
Article
Full-text available
Purpose: To identify insured services that are most important to Medicare beneficiaries with cancer and their family caregivers when coverage is limited. Methods: A total of 440 participants (patients, n = 246; caregivers, n = 194) were enrolled onto the CHAT (Choosing Health Plans All Together) study from August 2010 to March 2013. The exercise...
Article
Full-text available
Background Concerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prioritizing insured services offers a valuable strategy for informing Medicare coverage policy. We...
Article
The goal of comparative effectiveness research is to assess medical therapies and allow patients, health care providers, payers, and policy makers to make evidence-based decisions about the most appropriate therapies in routine clinical practice. To conduct this type of research and to inform health care delivery, data about the impact of intervent...
Article
Full-text available
Cancer clinical trials are intended to evaluate novel interventions and to improve outcomes. Such research depends on the participation of patients seeking the best options for care. The design, conduct, and analysis of trials must therefore be grounded in an ethical framework that respects and protects the interests of clinical trial participants.
Article
Full-text available
Patients with advanced cancer often experience symptoms of disease and treatment that contribute to distress and diminish their quality of life (QOL). Care that is aimed at control of these symptoms, whether or not the patient is undergoing ongoing disease-directed therapy to control the cancer, is thus a key feature of high-quality patient-centere...
Article
Full-text available
Patients near the end of life often undergo invasive procedures, such as biliary stenting for obstructive jaundice, with the intent of relieving symptoms. We describe a case in which the medical team and a patient and family are considering a second palliative biliary stent despite the patient's limited life expectancy. We review available evidence...
Article
Full-text available
Although research linking motivational interviewing (MI) to behavior change exists, few studies report on MI's quality or explore how it may influence effectiveness. We studied MI quality and adherence to antiretroviral therapy (ART) in the context of a randomized, controlled trial. We used a structured instrument to code MI sessions and then corre...
Article
Full-text available
Motivational interviewing (MI) is a counseling technique that has been used effectively to change a number of health-related behaviors. We sought to assess the impact on patients' antiretroviral therapy (ART) adherence of a multicomponent, MI-based ART adherence intervention compared with that of an HIV informational control program. Two-arm, rando...

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Project (1)