Goals: Our goal is to implement a multi-faceted and systematic program assessment with a targeted improvement plan using a hub and spoke model that will allow dissemination of lung cancer screening and clinical trials to a wide geographic footprint, resulting in increased numbers of patients screened for lung cancer and improved accrual to lung precision oncology trials. We anticipate that this program will be sustainable after funding for the Lung Precision Oncology Program (LPOP) expires.
Site Scientific Disciplines and Research Strengths: The Minneapolis VA Health Care System (MVAHCS) has a history of excellence in pulmonary research into COPD, lung carcinogenesis, and the implementation science of lung cancer screening. Translational research involving the interaction of lung microbiota and lung pathology is a unique strength developed in the last several years. Dr. Ganti at the Omaha site of the Nebraska-Western Iowa Health Care System (NWIHCS) has a long history of leading clinical trials in lung cancer, while the MVAHCS and Omaha VA Medical Center have a history of excellence in clinical trials in lung cancer, including leading a national VA Thoracic Oncology committee focused on expansion of multi-site lung cancer trials at VA sites throughout the United States. The MVAHCS has been a member of the VA-NCI NAVIGATE program, and involvement in this program has been highly successful with regard to high accrual to NCI oncology-specific clinical trials.
Implementation Plan: The "Upper Midwest VA Lung Cancer Screening and Research Network" will consist of 2 hub sites: the MVAHCS and NWIHCS and 3 spoke sites: the St. Cloud VA Healthcare System, the Central Iowa VA Healthcare System, and the Fargo VA Healthcare System. Two PI’s from the MVAHCS and one from the NWIHCS will lead this program. Several personnel from all 5 sites will play an integral part in the development of this new network. Network activities will focus around 1) a qualitative barrier analysis to determine where to focus on improvements for expansion of lung cancer screening and clinical trial activities, 2) expansion of lung cancer screening and clinical trials at all 5 VA sites based on findings from the barrier analysis, to be routinely assessed for necessary changes to improve trial accrual and assure quality, 3) a pilot trans-omics and microbiota study to develop preliminary data for a VA Merit Application in lung precision oncology, 4) submission of a CSRD Multi-site Merit Application with Dr. Ganti as PI, and 5) cost assessments incorporated into all implementation activities to aid in long-term strategic planning for sustainment. If successful, at the end of the 5 years of funding, the Upper Midwest VA Lung Cancer Screening and Research Network will be a sustained network with plans for implementing changes at the remaining VISN 23 sites.