Strengthening GU Cancer Care on Long Island

Andrew Laccetti, MD, has joined Perlmutter Cancer Center at NYU Langone Hospital—Long Island to serve as medical director of quality for hematology and medical oncology. A genitourinary medical oncologist with expertise in prostate cancer, Dr. Laccetti will work alongside colleagues in radiation oncology and urology to further strengthen the cancer center’s world-class, multidisciplinary genitourinary care on Long Island.

In this interview, Physician Focus speaks with Dr. Laccetti about his new role and his research aimed at reducing the functional impact of hormone therapy for men with prostate cancer. He also shares his commitment to supporting general oncologists, as the field of oncology works to fully realize the promise of precision medicine and subspecialized care.

Physician Focus: What challenges or opportunities are you eager to tackle in your new role?

Dr. Laccetti: I’m excited about the opportunity to optimize and enhance the quality of cancer care in my community. The breadth and complexity of oncology care in the United States has increased dramatically in recent decades, resulting in a monumental amount of information for oncologists to master. Standards of tumor-specific care are also advancing rapidly, making it almost impossible to stay up-to-date on the hundreds of cancer types that make up the field.

For these reasons, subspecialty hematologists–oncologists, who focus on a subset of cancers or blood disorders, have emerged. But their numbers are limited among general oncologists, who are tasked with the vital responsibility of caring for the majority of cancer patients. I’m eager to help create systems that bridge the divide between generalists and specialists, ensuring high-quality care regardless of practice location and enabling patients to forge relationships with providers close to home.

Under the umbrella of the NYU Langone network, we have an incredible opportunity to build systems that serve as national models through the ongoing evolution of cancer care. I’m excited to contribute to that effort and improve quality and access for patients, not only on Long Island but across the entire NYU Langone network.

Clinically, what excites me and draws me into the clinic every day is the opportunity to care for men with prostate cancer, a disease that touches many lives and families. Fortunately, we’ve made great progress in its treatment, allowing many men to live long, full lives despite the condition. Considering this longevity, it’s particularly important to minimize drug side effects.

I’m eager to bring my passion for personalized care to NYU Langone, specifically balancing the benefits of treatment with potential negative impacts on quality of life. It’s a privilege to offer that level of care and hopefully improve the lives of the many patients and families affected by this disease.

Physician Focus: What experience are you bringing with you to this role?

Dr. Laccetti: I previously served as clinical director for genitourinary medical oncology at Memorial Sloan Kettering (MSK). I also held the role of strategic partnership medical director, where I helped develop relationships between MSK and external, inpatient, and outpatient providers in an effort to facilitate comprehensive care closer to home. I’m passionate about helping bridge access to highly specialized tertiary- and quaternary-level care by bringing it into community settings.

Physician Focus: Tell us about your research interests.

Dr. Laccetti: My research has focused primarily on novel drug development for hormone-based therapies in prostate cancer. I’m also interested in research and quality improvement efforts to enhance quality of life for men with prostate cancer, including therapeutic de-escalation strategies.

Recently, I’ve been exploring the role of physical activity and the use of novel technologies—such as wearable activity trackers like Apple Watches and Fitbits, as well as smartphone-based surveys and apps—to better understand and manage treatment-related side effects and improve the patient experience.

Physican Focus: What has your research with activity trackers revealed?

Dr. Laccetti: I presented initial findings from one of our studies at the Genitourinary ASCO Symposium this past February. We provided wearable activity trackers to about 30 patients on androgen deprivation therapy (ADT) and monitored their step counts, heart rates, and sleep patterns, while also surveying them to assess fatigue and other treatment-related symptoms. We used this data—along with a variety of clinical features, such as the type of hormone therapy and whether patients were receiving radiation—to develop a predictive model of how a patient’s physical activity is likely to change over the course of a year on ADT.

Our goal is to further refine the model and use it to identify patients at higher risk for severe functional limitations related to treatment. We hope this will enable us to intervene earlier through medication adjustments, strategies to ameliorate side effects, or targeted exercise therapy.

Physician Focus: What does stepping into this new role at NYU Langone mean to you?

Dr. Laccetti: NYU Langone is a dynamic and rapidly growing institution doing innovative work not only in cancer care but also in many other specialties. I’m thrilled about the opportunity to bring my administrative, clinical, and research experience to help support and build upon the exciting initiatives that make the institution so unique.