Key Dates

Related Announcements

• November 21, 2024 - Innovative Approaches to Studying Cancer Communication in the New Information Ecosystem (R01 Clinical Trial Optional). See NOFO PA-25-294
• November 21, 2024 - Innovative Approaches to Studying Cancer Communication in the New Information Ecosystem (R21 Clinical Trial Optional). See NOFO PA-25-295
• November 12, 2024 - Cancer Prevention and Control Clinical Trials Grant Program (R01 Clinical Trial Required). See NOFO PAR-25-167
• November 08, 2024 - Exploratory Grants in Cancer Control (R21 Clinical Trial Optional). See NOFO PA-25-253
• November 07, 2024 - Modular R01s in Cancer Control and Population Sciences (R01 Clinical Trial Optional). See NOFO PA-25-172
• October 18, 2024 - NCI Small Grants Program for Cancer Research (NCI Omnibus) (R03 Clinical Trial Optional). See NOFO PAR-25-078
• December 14, 2022 - National Cancer Institute Program Project Applications for the Years 2023, 2024, and 2025 (P01 Clinical Trial Optional). See PAR-23-059

Issued by

National Cancer Institute (NCI)

Purpose

The purpose of this Notice of Special Interest (NOSI) is to encourage applications focused on understanding and improving cancer treatment communication and decision-making processes, including informed, shared, and goal-concordant treatment decision-making, in a complex and dynamic cancer treatment context.

Background

Key Definitions

• Cancer treatment: Curative and non-curative therapies delivered after cancer diagnosis, including but not limited to chemotherapy, radiation, surgery, hormone therapy, targeted therapy, immunotherapy, vaccine therapy, palliative and end-of-life care, and therapies under investigation in clinical trials.
• Cancer Information Ecosystem: Rapidly evolving information environment characterized by copious clinical data, development and diffusion of many digital tools and technologies, widespread access to online health information of varying quality, and increased prevalence of social media and online communities.

Cancer treatment decision-making requires that patients, caregivers, and clinicians work together to make treatment decisions that are informed by available clinical evidence and aligned with patients’ values and preferences. Effective treatment communication and decision-making are associated with improved treatment- and health-related outcomes including treatment adherence, symptom management and quality of life. They are also essential to achieving ethical and equitable cancer care as members of many populations experiencing health disparities (e.g., African Americans, LGBTQ+ individuals) are more likely to experience poorer quality patient-clinician communication, which has downstream effects on health outcomes.

During cancer treatment, individuals with cancer interact with clinicians providing medical care across a variety of specialties, as well as behavioral health, supportive, and palliative care. They interact with these diverse health professionals over time and across many care settings (e.g., home, clinic, hospital, virtual). Multiple considerations arise when making treatment decisions, such as goals of care, prognostic clarity, direct and indirect costs, trade-offs between clinical benefit and risk of acute toxicities or late effects, therapeutic interactions with treatment for comorbidities, and possible long-term symptom management needs. For example, the rise in early-onset cancers requires patients and their clinicians to balance long- and short- term treatment benefits and risks (e.g., chemotherapy-induced cardiotoxicity, infertility). Together, these factors underscore the complexity of cancer treatment decisions.

In addition to varied treatment options, the cancer information ecosystem has changed patients’ and providers’ roles, expectations, and approaches to cancer treatment communication and decision-making. For example, online social networks have become a central forum for treatment-related discussions for many cancer patients. Such networks can empower patients to engage in cancer treatment decision-making but may also contribute to poor provider-patient relationships or lack of trust when patients are presented with conflicting information from various sources. Patient portals give patients easier access to their electronic health records (EHR) and clinical data, but it is not clear how patients’ receiving diagnostic and treatment-related test results through an online portal prior to discussing them with a care team impacts treatment communication and decision-making. Chatbots and other artificial intelligence (AI)-based platforms are also being increasingly adopted into clinical practice, and their impact on patient-clinician communication and cancer treatment decision-making must be evaluated.

New approaches are needed to address the complexity of cancer treatment communication and decision-making within a dynamic information ecosystem. Addressing this complexity may help to promote effective and equitable cancer outcomes.

Research Objectives

The purpose of this NOSI is to encourage research applications at the intersection of the complex and dynamic cancer treatment and cancer information contexts to understand and improve cancer treatment communication and decision-making. Proximal outcomes of interest may include communication quality, trust, and patient/clinician satisfaction, and distal outcomes may include adherence, symptom management, receipt of guideline-concordant care, and enhanced quality of life. Responsive applications may include observational or intervention research approaches. Approaches designed to reduce cancer disparities and improve equitable health outcomes are strongly encouraged.

Research priorities include, but are not limited to:

• Development and application of research methods that (1) capture the dynamic nature of the cancer information ecosystem of people undergoing cancer care and the providers delivering it and (2) identify which aspects of the information ecosystem are most influential in cancer treatment communication and decision-making.
• Testing communication strategies to guide informed and shared treatment decision-making in cases where uncertain or evolving cancer treatment information is prevalent in the information ecosystem.
• Examining how system-level changes impacting the cancer information ecosystem (e.g., a health system’s adoption of financial navigation services; release of updated cancer treatment guidelines; capturing social determinants of health measures in the EHR) influence proximal and distal outcomes of cancer treatment communication and decision-making.
• Maximizing benefit and minimizing harm from policy and regulatory changes that affect the information ecosystem, such as the immediate release of medical records mandated by the 21^st Century Cures Act.
• Investigate how providers' information environments, including provider-facing clinical data (e.g., patient-reported outcomes, data from digital tools and technologies) or available resources (e.g., decision support tools, AI-based prediction models) can best be deployed to support patient-clinician communication, decrease clinician burnout, and/or improve treatment decision-making and related outcomes.
• Testing the role of digital platforms in improving patient-provider communication, including telehealth and electronic health messaging, to improve engagement, adherence, and efficiency in cancer care.

Application and Submission Information

Applicants must select the IC and associated NOFO to use for submission of an application in response to the NOSI. The selection must align with the IC requirements listed in order to be considered responsive to that NOFO. Non-responsive applications will be withdrawn from consideration for this initiative. In addition, applicants using NIH Parent announcements will be assigned to those ICs on this NOSI that have indicated those NOFOs are acceptable and based on usual application-IC assignment practices.

This notice applies to due dates on or after February 05, 2025, and subsequent receipt dates through September 7, 2028. This NOSI expires on September 08, 2028.

Submit applications for this initiative using one of the following notice of funding opportunity (NOFO) or any reissues of these announcements through the expiration date of this notice. Applicants are strongly encouraged to review the Application Due Date matrix for each listed NOFO in order to seek/determine the correct dates for applications.

All instructions in the SF424 (R&R) Application Guide and the listed funding opportunity announcements must be followed, with the following additions:

• For funding consideration, applicants must include “NOT-CA-25-006” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.
• Investigators are strongly encouraged to reach out to the relevant contacts listed in the Inquiries section of this NOSI to determine whether the NOFO and funding mechanism selected are appropriate for the proposed research.

Applications nonresponsive to terms of this NOSI will be withdrawn from consideration for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Please direct all inquiries to the Scientific/Research, Peer Review, and Financial/Grants Management contacts in Section VII of the listed notice of funding opportunity.

Nicole Senft Everson, PhD
National Cancer Institute (NCI)
Telephone: 240-234-0773
Email: [email protected] 

Peer Review Contact(s) 
Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).
 

Financial/Grants Management Contact(s)
Crystal Wolfrey
National Cancer Institute (NCI)
Telephone: 240-276-6277
Email: [email protected]