About

Alexandre Chan, PharmD, PhD, MPH, is a Professor of Clinical Pharmacy and the Principal Investigator at his research group focused on optimizing cancer supportive care and survivorship. His research homepage emphasizes pushing boundaries in this field, indicating a commitment to advancing clinical pharmacy practices to improve outcomes for cancer patients. The group includes a diverse team of staff, postdoctoral fellows, postgraduate trainees, and undergraduate students, reflecting a robust academic and research environment under his leadership. The presence of ongoing trials and a comprehensive team suggests active engagement in clinical research and translational studies aimed at enhancing supportive care for cancer survivors.

Research topics

• Computer Science
• Medicine
• Nursing
• Family medicine
• Political Science
• Artificial Intelligence
• Internal medicine
• Pharmacology
• Psychiatry
• Public relations
• Intensive care medicine
• Oncology
• Medical education
• Physical therapy

Selected publications

• Consensus co-expression analysis identifies a common set of co-expressed genes associated with diabetic peripheral neuropathy and chemotherapy-induced peripheral neuropathy

  Molecular Pain · 2026-03-01

  articleOpen access

  BACKGROUND: Diabetic peripheral neuropathy (DPN) and chemotherapy-induced peripheral neuropathy (CIPN) are major clinical challenges with limited therapeutic options. While these conditions arise from different causes, they may share common molecular mechanisms that could be targeted for intervention. METHODS: We performed consensus weighted gene co-expression network analysis (WGCNA) on two publicly available datasets: GSE185011 (DPN vs healthy controls in peripheral blood mononuclear cells) and GSE173610 (paclitaxel-treated vs control iPSC-derived sensory neurons). After filtering all but the most variable genes, consensus analysis was used to identify conserved co-expression modules across both conditions. RESULTS: = 0.0060). Functional enrichment analysis of this module revealed pathways related to Glycolysis, FoxO signaling, Apoptosis, and Autophagy. CONCLUSIONS: Our analysis reveals a convergent molecular signature underlying both DPN and CIPN, centered on metabolic reprogramming, transcriptional stress, and programmed cell death. These findings provide a systems-level framework for developing therapies targeting shared pathological mechanisms.

  PublisherDOI

• Impact of healthcare providers’ training (ISOPP-OPAB) on biosimilars use for cancer care at a university hospital in Nigeria

  Journal of Oncology Pharmacy Practice · 2026-03-21

  articleSenior author

  This study assessed the impact of a targeted training program offered by the International Society of Oncology Pharmacy Practitioners in enhancing biosimilar knowledge among healthcare professionals at the University of Ilorin Teaching Hospital, Nigeria, addressing the critical need for cost-effective cancer care. An interventional, pre- and post-test design was employed, involving 24 healthcare professionals comprising of 16 physicians, 3 pharmacists, and 5 nurses. Participants underwent a one-day training session focused on biologics, biosimilars, and their clinical applications in cancer care, delivered by trained oncology pharmacists. Comparison of pre- and post-training knowledge was assessed using a standardized questionnaire. Statistical analysis, including descriptive statistics and paired t-tests, was conducted to evaluate the impact of the intervention.Results demonstrated a significant improvement in biosimilar knowledge following the training. The mean (±SD) post-test score (7.3 ± 3.0) was significantly higher than the mean pre-test score (4.6 ± 2.3), with a 2.7-point increase (p < 0.001). Despite participants' professional experience, baseline knowledge was notably low compared to the post-test. The training program effectively bridged this knowledge gap, indicating its potential to facilitate biosimilar adoption. This study concludes that targeted training significantly enhances healthcare professionals' understanding of biosimilars. Continued education and training are crucial to optimizing biosimilar implementation and improving access to affordable cancer care in resource-limited settings

  PublisherDOI

• Incidence of Clinically Significant Neutropenia and Complications Related to Antibody-Drug Conjugates: A Real-World Study at the University of California

  Cancers · 2026-05-12

  articleOpen accessSenior authorCorresponding

  Background/Objectives: Using real-world data, this study evaluates the use of ADCs over a decade across six University of California (UC) medical centers, focusing on the incidence of neutropenia-related adverse effects and associated clinical outcomes. Methods: A real-world retrospective study utilizing UC Health Data Warehouse records of patients receiving at least one dose of the ten most-used ADCs at one of the 6 UC hospitals between 2012 and 2024. The outcomes evaluated in this study were grade 3+ neutropenia and febrile neutropenia (FN) during any treatment cycle, and healthcare utilization outcomes including G-CSF prophylaxis, hospital and ICU admission, and mortality. Multivariate logistic regression was conducted to identify predictors for neutropenia-related events after the first dose of ADC. Results: Data from 3511 patients (mean ± SD age: 56.7 ± 17.6 years) were analyzed. The most commonly observed cancer types were breast cancer (43.4%), lymphoid, hematopoietic (41.8%), and urinary tract cancer (13.4%). The top three most commonly prescribed ADCs were fam-trastuzumab deruxtecan (22.6%), ado-trastuzumab emtansine (19.4%), and brentuximab vedotin (18.1%). Their respective all-cycle rates of FN were 5.4%, 1.2%, and 10.4%, while grade 3+ neutropenia rates were 16.4%, 5.1%, and 40.1%. Gemtuzumab ozogamicin and inotuzumab ozogamicin were associated with the highest rates of FN (both 18.1%), and inotuzumab ozogamicin was associated with the highest rates of hospital admissions (27.1%), ICU admissions (3.8%), and deaths (5.2%). Anemia and immunodeficiency disorders were identified as predictors for first-dose FN among patients receiving ADCs. Conclusions: Real-world data from this large multi-center cohort showed substantial variation in neutropenia-related events across ADCs. As ADC use continues to grow, these findings highlight the need for vigilant monitoring and proactive supportive care.

  PublisherOA PDFDOI

• Incidence and predictors of immune checkpoint inhibitor treatment–related cognitive impairment in a racial and ethnic diverse population

  Supportive Care in Cancer · 2025-06-01 · 2 citations

  articleOpen accessSenior author

  INTRODUCTION: Immune checkpoint inhibitors (ICI) have revolutionized cancer therapy in recent years. In addition to rejuvenating anti-cancer immunity, ICI may cause immune dysregulation, impacting homeostasis, including brain functions. Thus, the association of ICI with cognitive function needs further investigation. Using NIH's PROMIS system, this study investigates self-reported cognitive impairment within a diverse cohort of ICI-treated patients. Additionally, we explore risk factors influencing self-reported cognitive function, including concurrent symptoms and racial/ethnic background. METHODS: This was a prospective, longitudinal study conducted between July 2021 and June 2023. Included patients were ≥ 18 years old, newly diagnosed with cancer, and scheduled to receive ICI therapy. Serial patient-reported outcomes (PROs) were collected from self-reported patient surveys at therapy initiation and while receiving treatment. Clinically significant cognitive impairment was defined as mild to severe symptoms measured on computer adaptive tests using the PROMIS Bank v2.0 - Cognitive Function. Multi-step analysis utilizing generalized estimating equations (GEE) was implemented to evaluate characteristics associated with cognitive function T-scores. RESULTS: Our study included 51 ICI patients, with 51% being of Asian or Hispanic descent. Of 126 PROMIS symptom survey sets collected, 16.7% reported clinically significant cognitive impairment, with incidence peaking in survey sets collected 1-2 months removed from therapy initiation at 26.1%. All concurrent PROMIS symptom scores significantly correlated with cognitive function, including physical function (r = 0.33, p < 0.001), fatigue (r = - 0.61, p < 0.001), depression (r = - 0.56, p < 0.001), and anxiety (r = - 0.56, p < 0.001). Multi-variable regression demonstrated impaired physical function (Coef = - 4.01, p = 0.007), fatigue (Coef = - 5.15, p = 0.005), and anxiety (Coef = - 4.45, p < 0.001) are associated with decreased cognitive function scores, after adjusting for other patient characteristics. CONCLUSION: Patients receiving ICI therapy experience significant cognitive impairment with therapy initiation and in subsequent weeks and months during their therapy course. Managing and monitoring concurrent symptoms and inflammatory biomarkers may help identify at risk patients and alleviate cognitive impairments.

  PublisherOA PDFDOI

• Myelin water imaging in adolescent and young adult cancer patients and cognitive impairment: A feasibility longitudinal case-control study

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2025-09-16

  article

  Motivation: Brain MRI changes in adolescent and young adult cancer (AYAC) patients are underexplored. Goal(s): Evaluate value of myelin water imaging (MWI) in chemotherapy-related cognitive impairments (CRCI) compared to conventional DTI. Approach: Evaluate MWI changes in relation to CRCI on longitudinal brain MRI and neuropsychiatric assessments in a AYAC case-control cohort undergoing chemotherapy. GRASE-derived myelin water fraction (MWF) maps were used to create the first Southeast Asian MWF atlas, highlighting regional MWF variability in patients, and compared to FA from DTI. Results: Our MWI atlas was comparable to publicly available atlases. MWF and FA showed significant reduction in non-overlapping ROIs in AYAC patients post-chemotherapy. Impact: Myelin water fraction is a complementary quantitative marker to fractional anisotropy, detecting white matter dysmyelination in post-chemotherapy adolescent and young adult cancer patients.

  PublisherDOI

• R-DA-EPOCH Versus DA-EPOCH-R: Impact of Chemoimmunotherapy Sequencing on Treatment Outcomes in Patients With Diffuse Large B-Cell Lymphoma

  Clinical Lymphoma Myeloma & Leukemia · 2025-06-23

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Sociodemographic Disparities and Reasons for Delayed Healthcare Among U.S. Cancer Survivors: An All of Us Study

  Research Square · 2025-11-18 · 1 citations

  preprintOpen access
  PublisherDOI

• Comparison of two electroacupuncture regimens on symptoms and brain structures in breast cancer survivors: A randomized, controlled trial.

  Journal of Clinical Oncology · 2025-05-28

  article1st authorCorresponding

  12119 Background: Although electroacupuncture (EA) has shown usefulness in managing neuropsychiatric symptoms in cancer survivors, a specific acupoint regimen has not been established. We conducted a randomized, controlled, patient- and assessor-blinded pilot trial to compare two EA regimens on neuropsychiatric symptoms and associated brain structural changes in breast cancer survivors. (Clinicaltrials.gov: NCT05283577). Methods: Breast cancer survivors who self-reported cognitive impairment, fatigue, insomnia, or psychological distress were randomized (1:1) to receive ten weekly therapeutic EA to target either neuropsychiatric-specific (nEA) or non-neuropsychiatric-specific (sham EA, sEA) acupoints. Outcomes were assessed using patient-reported outcomes (EORTC QLQ-C30, FACT-Cog, MFSI-SF), neurocognitive tests (CANTAB), and neuroimaging (measuring gray matter, white matter, cerebrospinal fluid, diffusion tensor metrics, and volume and mean intensity of the hippocampus) before and after treatment. We computed group-specific treatment effect sizes (Glass's Δ) adjusted for baseline variability using linear mixed models. A Pearson’s correlation analysis was performed between the neurocognitive scores and the imaging metrics. Multiple testing was controlled via the Benjamini-Hochberg method, with statistical significance set at P-adjusted &lt; 0.05. Adverse events (AEs) were graded with CTCAE v5. Results: Thirty-five participants were recruited, of which five dropped out, leaving 30 (86%) completing all treatment sessions. The average (±SD) age was 58.2 ±12.2 years, with 66% non-Hispanic White, 77% holding a Bachelor’s degree or higher, 94% received systemic treatment and/or radiotherapy for cancer, 86% reporting ≥2 neuropsychiatric symptoms. Both groups showed statistically significant pre-post medium-to-large effect sizes in perceived cognitive function, fatigue, and quality of life. nEA group observed significant improvement in cognitive domains of attention (ES=0.708, P-adjusted=0.004), memory (ES=0.488, P-adjusted=0.026), and emotional functioning (ES=0.664, P-adjusted=0.004). Neuroimages showed greater gray matter volume change (P=0.0327) and post-treatment hippocampus mean intensity (P=0.0468) in nEA versus sEA. In the nEA group, correlations were observed between attention and gray matter volume (P=0.0198) and between executive function and hippocampus volume (P=0.0204). All AEs were grade 2 or lower: nEA participants reported pain (n=1) and bleeding (n=1), while sEA participants reported numbness (n=2), bruising (n=1), nausea (n=1), and redness (n=1). Conclusions: Ten weeks of electroacupuncture targeting neuropsychiatric-related acupoints, compared to sham acupoints, improves neuropsychiatric symptoms in breast cancer survivors, supported by clinically relevant structural brain changes. Clinical trial information: NCT05283577 .

  PublisherDOI

• Measuring out-of-pocket healthcare cost (OOPC) and its impact on health-seeking behavior (HSB) in cancer: A systematic review.

  JCO Oncology Practice · 2025-10-01

  article

  10 Background: High OOPC represents the objective dimension of financial toxicity and may lead to adverse HSB, such as disengagement from care. However, methodology for OOPC measurement is inconsistent and limited studies have linked OOPC to behavioral patterns. Understanding how OOP influences HSB can help identify patients at risk of cost-related forgone care and inform insurance plan design. In this systematic review, we examined OOPC measurement and the relationship between OOPC and HSB among individuals with a history of cancer. Methods: A search was performed in PubMed and EMBASE with keywords associated with OOPC and cancer, supplemented by citation searching of relevant reviews. Studies were included if the target population was cancer patients/survivors and OOPC was reported quantitatively. Secondary research was excluded, or if OOPC was not based on empirical data or only for a specific treatment/procedure. Study screening and data extraction were performed independently by two researchers using Covidence. Data elements that were extracted included study characteristics, OOPC measures/methodology and if reported, any relationship between OOPC and HSB. For this review, HSB refers to behavior in response to health issues experienced or perceived. Results: Our search yielded 8,598 unique papers; 149 (representing 147 studies) met inclusion criteria. Among eligible studies, 44.9% were from the United States. Breast cancer was the most common among studies with 1 tumor site (15.6%) while 44.9% included &gt; 1 cancer types. Cost outcomes were reported only for the treatment phase in 32.7% of studies while 36.7% extended the study period to the survivorship phase; 25.2% did not specify the phase of care. Average OOPC varied widely depending on study setting and OOPC measurement approaches. Some studies (41.5%) included non-medical costs in OOPC such as transportation (40.8%), accommodation (27.9%) and meals (19.7%). Additionally, 28.6% incorporated deductibles in OOPC. When reporting OOPC, a few studies accounted for the capacity to pay, either household/individual income (19.0%) or expenses (surrogate of disposable income) (7.5%). Only 7 (4.7%) studies examined how OOPC influence HSB, primarily medication/treatment adherence (71.4%) and healthcare resource utilization (28.6%). Across all studies, lower adherence and higher risk of cost-related care avoidance were consistently observed with increased OOPC. OOPC thresholds where nonadherence or forgone care substantially increased were not reported or different due to variability in OOP components and measurement approaches. Conclusions: OOPC measurement is heterogenous, warranting best practices to be established to allow comparison and synthesis of published OOPC data. Minimal research has been conducted to examine OOPC and HSB but OOPC can potentially be used to predict and monitor for risk of forgone care.

  PublisherDOI

• Candesartan, an angiotensin receptor blocker, prevents cognitive impairment in female mice with mammary cancer

  Brain Behavior and Immunity · 2025-12-04

  article
  PublisherDOI

Frequent coauthors

• Terence Ng

  Northwell Health

  159 shared

• Raymond J. Chan

  Flinders University

  145 shared

• Kiley Wei-Jen Loh

  National Cancer Centre Singapore

  119 shared

• Sara A. Hurvitz

  Fred Hutch Cancer Center

  100 shared

• DJ Slamon

  University of California, Los Angeles

  100 shared

• Stephen Chia

  University of British Columbia

  100 shared

• DA Yardley

  100 shared

• O Kong

  Sarah Cannon

  100 shared

Labs

• Alex Chan's Research LabPI

Education

• Other

  Rutgers University

  2004

• Other

  University of California San Francisco

  2005

• Other

  University of California Davis Medical Center

  2006

• Other

  National University of Singapore

  2011

• Ph.D.

  Flinders University

  2025

Awards & honors

• Young Scientist Award by National University of Singapore (2…
• Steven M. Grunberg Memorial Award by Multinational Associati…
• MASCC Innovator Award (2023)
• UCI 2025 Basic Science College of Health Sciences Team Resea…
• Hematology Oncology Pharmacy Association (HOPA) 2025 Oncolog…