LEAP / Challenge Buckets

1. Standardization of protocol for various cancers in resource-constrained settings

Standardizing cancer treatment protocols in resource-constrained settings is a complex but necessary endeavor. It requires a multidisciplinary approach, collaboration, and a focus on optimizing outcomes within the limitations of available resources.

You are required to:

• Identify steps and considerations for standardizing protocols in such settings.

• Identify what alliances with national and international cancer organizations, medical professionals, and experts are needed to develop or adapt standardized cancer treatment guidelines.

• Identify what solutions can encourage and support research to find more cost-effective and innovative treatment solutions.

2. Evidence-based screening in high-risk populations

Evidence-based screening in high-risk populations is essential for identifying individuals at greater risk of specific cancers and initiating early interventions. High-risk populations typically include individuals with specific risk factors, such as family history, genetic predisposition, or exposure to environmental hazards. What are some of the key considerations for implementing evidence-based screening in high-risk populations?

You are required to:

• Identify criteria for high-risk populations specific to the oncology context.

• Provide best-case scenarios for using existing risk assessment tools or suggest the need for developing new ones specific to different types of cancer.

• Elaborate on what existing public awareness and advocacy measures can support these initiatives at the community and policy levels.

3. How to set up a successful multidisciplinary team in a cancer practice?

Setting up a successful multidisciplinary team (MDT) in a cancer practice is essential for providing comprehensive and coordinated care to cancer patients. MDTs bring together various healthcare professionals with different specialties to collaboratively plan, deliver, and manage patient care. What are the steps to establish a successful MDT in a cancer practice?

You are required to:

• Identify the ideal composition of an MDT in oncology settings.

• Elaborate on a simple patient-centered approach, and on how to ensure that decisions are made with the patient's best interests in mind.

• Develop standardized processes and workflows for MDT meetings and patient care coordination that can serve as a blueprint in cancer care settings.

4. Reliable CDSS in oncology

A reliable clinical decision support system (CDSS) in oncology is crucial for assisting healthcare providers in making evidence-based and personalized treatment decisions for cancer patients. What are the key features and considerations for implementing a reliable CDSS in oncology?

You are required to:

• Pinpoint predefined clinical pathways for common oncology diagnoses and adapt them as needed to align with the latest research and best practices.

• How to adopt CDSS in Indian settings where electronic health record is not yet universal?

• Identify solutions that can enable transparency in the decision-making process by providing explanations and references for recommendations to build trust with clinicians.

5. Risk assessment model adoption in oncology

Adopting a risk assessment model (RAM) in oncology can significantly enhance clinical decision-making and improve patient outcomes. Risk assessment models help healthcare providers identify individuals at higher risk of developing cancer or experiencing specific outcomes. What are the steps to successfully adopt a RAM in oncology?

You are required to:

• Focus on a RAM that applies to the specific type of cancer or outcome you are targeting.

• Elaborate why the RAM is underused in clinical settings.

• Develop solutions for integrating the RAM into the clinical workflow to support healthcare providers in identifying high-risk patients and making informed decisions.

1. Technology in nursing care in oncology

Technology plays a vital role in improving nursing care in oncology. It enhances patient care, streamlines processes, and provides valuable resources for both patients and healthcare providers. What are the key approaches in which technology is used in nursing care in oncology?

You are required to:

• Identify solutions as to how the integration of technology into oncology nursing care improves patient outcomes, enhances safety, and facilitates the efficient management of complex cancer treatment regimens.

• Provide a broad commentary on what capacity-building measures are needed for the above.

• Detail what automation technology can assist in repetitive tasks, such as preparing medications or handling lab specimens, reducing the risk of human error.

2. In-hospital safety measures for oncology nurses

In-hospital safety measures for oncology nurses are crucial to protect both the healthcare workers and the patients. Oncology nurses work closely with patients undergoing cancer treatment, which often involves chemotherapy, radiation therapy, and other complex interventions. What are the important safety measures for oncology nurses within a hospital setting?

You are required to:

• Provide an overview of established chemotherapy safety guidelines, including proper handling, preparation, and administration of chemotherapy drugs.

• Develop solutions for the safe disposal of hazardous waste, including chemotherapy waste, sharps, and contaminated materials, per regulatory guidelines.

• Identify quality improvement initiatives to continuously enhance safety measures in the oncology setting.

3. Simplifying chemotherapy administration techniques for nurses

Simplifying chemotherapy administration techniques for nurses is essential to ensure safe and efficient delivery of cancer treatment. Oncology nurses play a critical role in chemotherapy administration, and simplifying the process can help reduce the risk of errors and improve patient care. What strategies can help simplify chemotherapy administration techniques for nurses?

You are required to:

• Provide solutions to implement standardized protocols for chemotherapy administration that follow evidence-based guidelines.

• Elaborate on a best-case scenario followed in a global center of excellence.

• Adopt the solution to Indian settings and how hospitals can implement the same.

4. Nursing specialization in oncology care

Specializing in oncology care as a nurse can be a rewarding and challenging career path. Oncology nursing focuses on providing care to patients who are dealing with cancer. It requires a deep understanding of cancer, its treatments, and the physical and emotional challenges faced by patients and their families. How can this specialization receive the attention it deserves?

You are required to:

• Identify specialized courses and training in oncology nursing that can benefit Indian nurses.

• Develop solutions on what clinical rotations or internships in oncology units or cancer centers can help nurses gain hands-on experience in cancer care.

• Elaborate on what additional training in palliative care and end-of–life care can help nurses adopt a patient-centered approach.

5. Day of chemotherapy: Standardizing activities

A reliable clinical decision support system (CDSS) in oncology is crucial for assisting healthcare providers in making evidence-based and personalized treatment decisions for cancer patients. What are the key features and considerations for implementing a reliable CDSS in oncology?

You are required to:

• Develop a checklist that can be standardized across hospitals.

• Elaborate on how nurses can identify any immediate side effects or symptoms that arise, such as nausea, fever, or allergic reactions, and follow established protocols for handling the same.

• Develop a post-discharge checklist that educates the patient on post-chemotherapy care, potential side effects to watch for, and when to seek medical attention.

1. Accessibility and affordability of immunotherapy in oncology care

The accessibility and affordability of immunotherapy in oncology care are critical factors that impact the availability of this advanced treatment to cancer patients. Immunotherapy has shown significant promise in the treatment of various cancers, but its cost and availability can be challenging for many patients. What are the potential solutions to enhance accessibility and affordability?

You are required to:

• Identify global patient access programs from other therapies (optional) that can serve as an example in oncology.

• Develop a path on how pharmaceutical companies work with healthcare providers and governments to find solutions for reducing the cost of

• immunotherapy and improving patient access.

  Look at what advocacy efforts can help push for legislative changes that improve access to affordable immunotherapy for cancer patients.

2. Molecular and cellular drivers of primary vs. secondary immune escape in cancer immunotherapy

Primary and secondary immune escape are critical concepts in understanding the complex interplay between the immune system and cancer cells during cancer immunotherapy. These processes are driven by various molecular and cellular factors. How can the awareness of the molecular and cellular drivers of primary vs. secondary immune escape in cancer immunotherapy be leveraged to develop better treatment approaches?

You are required to:

• Elaborate on why understanding the drivers of primary and secondary immune escape is crucial for developing strategies to overcome these obstacles in cancer immunotherapy.

• Provide an overview of the development of combination therapies, including immune checkpoint inhibitors, targeted therapies, and other treatments that can address both primary and secondary immune escape mechanisms.

• Identify innovative approaches to enhance the efficacy of immunotherapy and improve outcomes for cancer patients.

3. Impact of steroids on cancer immunotherapy

Steroids can have a significant impact on cancer immunotherapy, as they can modulate the immune response and potentially affect the effectiveness of immunotherapeutic treatments. The use of steroids in cancer patients receiving immunotherapy is a complex issue, and its impact can vary depending on several factors, including the type of immunotherapy, the timing of steroid administration, and the patient's circumstances. What are some of the key considerations regarding the impact of steroids on cancer immunotherapy?

You are required to:

• Elaborate on the optimal timing of steroid administration.

• Develop approaches that can help balance the potential benefits of managing side effects with the potential reduction in immunotherapy efficacy.

• Develop solutions on individualizing steroid administration in cancer care.

4. Personalized approaches through composite biomarkers in oncology

Personalized approaches in oncology are becoming increasingly important as they allow for tailored treatment plans that consider the unique characteristics of each patient and their specific cancer. Composite biomarkers play a significant role in achieving this personalization. A composite biomarker is a combination of multiple individual biomarkers, which can provide a more comprehensive and accurate assessment of a patient's cancer and its response to treatment. How can the use of composite biomarkers be optimized in cancer care?

You are required to:

• Make a case for expanding the use of specific biomarkers in specific cancers in oncology settings.

• Develop optimal approaches for integrating the use of biomarkers for diagnostic and therapeutic use in oncology.

• Provide solutions for increasing awareness at the HCP level.

5. Multiagent cancer immunotherapy combination regimens

Multiagent cancer immunotherapy combination regimens are an exciting and rapidly evolving area of cancer treatment. These regimens involve the simultaneous or sequential use of multiple immunotherapeutic agents to enhance the immune system's ability to recognize and eliminate cancer cells. The goal is to achieve a synergistic effect that can lead to more profound and durable responses. What are some of the key components and considerations related to multiagent cancer immunotherapy combinations?

You are required to:

• Identify challenges related to multiagent cancer immunotherapy combination regimens in terms of side effects and cost.

• Develop approaches to help refine the selection of agents and patient populations most likely to benefit from these approaches.

• Elaborate on what further research is needed to ensure effective and tailored combination regimens to improve cancer treatment outcomes.

1. How to bring chemotherapy/immunotherapy closer to patients' homes?

Bringing chemotherapy and immunotherapy closer to patients' homes can improve access to cancer treatment, enhance patient comfort, and reduce the burden of traveling long distances to receive care. What are some of the strategies and models for making chemotherapy and immunotherapy more accessible in a home or community setting?

You are required to:

• Identify barriers in the overall cancer care experience in India.

• Develop a roadmap for close collaboration among healthcare providers, patients, caregivers, and policymakers to address logistical, safety, and regulatory considerations in this space.

• Make a case for home-based cancer care models in specific rural settings in India.

2. Coping strategies for patients in oncology

A cancer diagnosis can be emotionally and physically challenging for patients. Coping strategies are essential for helping patients navigate the complexities of cancer treatment, manage emotional distress, and improve their overall well-being. What can be the ideal coping strategies for patients in oncology?

You are required to:

• Develop solutions to ease the mental burden of coping with a cancer diagnosis.

• Identify support groups or ideate on forming new support groups in oncology.

• Identify and elaborate on how a global best-case scenario can be used in India.

3. Medication adherence strategies in oncology

Medication adherence is critical in oncology to ensure that patients receive the full benefit of their cancer treatment. Missing doses or not following the prescribed regimen can impact treatment effectiveness and overall outcomes. What are the strategies to promote medication adherence in oncology?

You are required to:

• Provide a roadmap for ensuring effective communication and collaboration among healthcare providers, patients, caregivers, and pharmacists to improve adherence.

• Identify barriers to potential solutions in Indian settings.

• Develop solutions on how technology can be used to motivate patients to adhere to prescribed therapies.

4. Off chemotherapy days: How to optimize health?

Optimizing health on days when a cancer patient is not receiving chemotherapy is important for overall well-being and to support the body's ability to tolerate and recover from treatment. What are some of the strategies to help patients make the most of their off-chemotherapy days?

You are required to:

• Identify approaches to keep communication channels open during off-days.

• Develop solutions for personalized guidance and support to help patients optimize health and manage the challenges associated with cancer treatment.

• Pinpoint on what additional support can help overcome the fear of chemotherapy.

5. How to ensure that research is meaningful for patients in cancer care?

Ensuring that cancer research is meaningful and patient-centered is essential for improving cancer care outcomes and patient experiences. Patients should be active partners in the research process, and their perspectives, needs, and priorities should be considered. What strategies are needed to promote patient-centered research in cancer care?

You are required to:

• Elaborate on potential measures to improve the relevance and impact of cancer studies at the patient level.

• Develop approaches to enhance the patient’s experience and contribute to better outcomes by aligning research efforts with the needs and preferences of those directly affected by cancer.

• Make a case for optimizing this approach in the Indian context.

1. Cost vs. benefit impact analysis for oncology drugs

Conducting a cost–benefit analysis for oncology drugs is a critical aspect of healthcare decision-making. It involves evaluating the costs associated with a particular drug against the benefits it provides in terms of patient outcomes and overall healthcare system impact. What are the key components and steps involved in a cost–benefit impact analysis for oncology drugs?

You are required to:

• Propose practical models in this scenario.

• Identify any existing model for adoption in oncology settings.

• Identify solutions focusing on how all stakeholders can contribute to improving the value and affordability of cancer treatments.

2. Adopting an MGTO-based approach to cancer care in India

The adoption of a multigene test-oriented (MGTO) approach to cancer care in India involves incorporating genetic testing and personalized medication into the diagnosis, treatment, and management of cancer. This approach aims to improve the precision and effectiveness of cancer treatment by tailoring it to the unique genetic characteristics of each patient's tumor. What are the key steps and considerations for implementing MGTO-based cancer care in India?

You are required to:

• Evaluate the existing MGTO approach in India critically.

• Propose ways to improve the current processes.

• Develop solutions that can enhance adoption at the in-clinic level.

3. A framework for data sharing and data policy in oncology care

Establishing a robust framework for data sharing and data policy in oncology care is essential to facilitate research, improve patient outcomes, and enhance the quality of cancer treatment. This framework should balance the need for data accessibility with patient privacy and data security. How can a structured framework for data sharing and data policy be implemented in oncology care?

You are required to:

• Make a case for data stewardship at the central level.

• Propose a framework for data collection and integration at the central level.

• Develop solutions for balancing data accessibility to advance research and treatment with stringent privacy and security measures to protect patient information and rights.