The National Palliative Care Research Center

Curing suffering through palliative care research.


Alexi Wright, MD, MPH

Assistant Professor

Dana-Farber Cancer Institute

Grant Year
Grant Term
Grant Type
Pilot & Exploratory Project Support Grant

Project Description
The HOPE Trial: Helping Ovarian cancer Patients Excel

The goal of palliative chemotherapy is to reduce symptoms and extend survival. Yet, oncologists’ methods of monitoring patients’ symptoms are underdeveloped. Studies show that clinicians consistently miss more than half of cancer patients’ symptoms, even in clinical trials that mandate collection of treatment toxicities. Similarly, oncologists’ estimates of patients’ performance statuses are highly subjective, yet key determinants of patients’ eligibility for clinical trials, chemotherapy, and hospice. Oncologists’ performance status estimates are only moderately correlated with one another and are even less reliable when compared with patients’ estimates.

Smartphones offer an accessible, low-cost method for conducting assessments of patients' symptoms and activity levels. The goal of this proposal is to adapt, refine, and pilot-test an existing smartphone research platform named “HOPE: Helping Ovarian cancer Patients Excel” to assess patients’ toxicities and activity levels in a population of seriously-ill patients with gynecologic cancers receiving palliative chemotherapy. This study is innovative because it will harness a validated app, paired with both a phone-based and wearable Fitbit accelerometer, to collect patients’ toxicities and activity levels between clinic visits, categorize patients’ symptoms as low- or high-risk, and provide patients with tailored advice to help manage their symptoms in real time in the real world. The app will also generate a graphical display of data obtained between visits for patients and physicians to discuss during subsequent visits.

We will conduct a pilot randomized controlled trial of the adapted and refined smartphone app plus a wearable accelerometer vs. usual care in 60 patients with metastatic gynecologic cancers to assess the feasibility and acceptability of the intervention. If we meet our feasibility and acceptability targets, we will plan a full-scale randomized trial of the HOPE intervention to formally test whether it improves symptoms, activity levels, and clinical outcomes in cancer patients with serious illnesses.


Alexi A. Wright, MD, MPH is Assistant Professor of Internal Medicine at Harvard Medical School and a practicing medical gynecologic oncologist at Dana-Farber Cancer Institute. Dr. Wright is a health services researcher whose work focuses on improving outcomes in women with gynecologic cancers and ensuring that cancer patients’ end-of-life care is both patient-centered and congruent with their informed values. She is currently examining how patients, caregivers, and physicians make decisions about palliative chemotherapy and the outcomes of these decisions. She is also testing interventions to improve cancer patients’ decision-making, quality of life, and outcomes while receiving palliative chemotherapy. Dr. Wright has received funding from the National Palliative Care Research Center, the American Society of Clinical Oncology, the American Cancer Society, and the National Cancer Institute.