Photo of Alexi A. Wright,  MD, MPH

Alexi A. Wright, MD, MPH

Dana-Farber Cancer Institute

Dana-Farber Cancer Institute
Phone: (617) 632-3857
Fax: (617) 632-3479

Alexi A. Wright, MD, MPH

Dana-Farber Cancer Institute


  • Assistant Professor, Medicine, Harvard Medical School
  • Assistant Professor, Medical Oncology, Dana-Farber Cancer Institute


Research Abstract

I am a medical oncologist specializing in gynecologic oncology and a health outcomes researcher who studies the “overuse” of medical care in patients with advanced, incurable cancers. The goal of my research is to improve advanced cancer patients’ quality of life and medical outcomes by 1) creating an evidence base to guide chemotherapy decision-making at the end-of-life (EOL) and 2) developing interventions to ensure that advanced cancer patients’ EOL care is effective, patient-centered, and congruent with patients’ informed treatment preferences.

My early training in journalism gave me an appreciation for the power of effective communication, and its potential for improving patient outcomes. In medical school, I was awarded a Howard Hughes fellowship to examine the genotype of human placental cells that invade the uterus like tumors. This early research experience resulted in two empiric publications and cemented my decision to become an academic oncologist. During fellowship, I examined how EOL discussions shape advanced cancer patients’ mental health, medical outcomes, treatment goal attainment, and health care expenditures. We found that EOL discussions were associated with greater patient acceptance of terminal illness, better patient quality of life near death, and fewer intensive interventions at the EOL.

As a junior faculty member, I examined how patients’ place of death influences their quality of life at the EOL and their caregivers’ bereavement adjustment. We found that patients who die in intensive care units have significantly worse quality of life, compared to those who died at home with hospice, and their caregivers have 15-fold higher odds of developing post-traumatic stress disorder six months later. More recently, I have found that palliative chemotherapy is one of the most powerful predictors of the intensity of patients’ EOL care, and I am now focusing on understanding the structural, medical, social, and psychological determinants and outcomes of EOL chemotherapy with support from the American Cancer Society and the National Cancer Institute.

Communication is also a central focus of my work as an educator. As a junior faculty member, I have organized the Dana-Farber/Harvard Cancer Center’s Outcomes Research Seminar, and participated in OncoTalk Teach, an intensive communication course designed to teach oncologists how to 1) communicate more effectively with patients and 2) teach these skills to other physicians. This training has shaped my clinical work and educational work with medical residents and oncology fellows, improving my ability to offer “goal-directed” teaching and feedback. In the future, I plan to develop patient- and provider-based communication interventions to ensure that advanced cancer patients’ treatment decision-making and medical care reflect their informed preferences.



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  • Cohn DE, Havrilesky LJ, Osann K, Lipscomb J, Hsieh S, Walker JL, Wright AA, Alvarez RD, Karlan BY, Bristow RE, DiSilvestro PA, Wakabayashi MT, Morgan R, Mukamel DB, Wenzel L. Consensus in Controversy: The Modified Delphi Method Applied to Gynecologic Oncology Practice. Gynecol Oncol 2015. PubMed
  • Narang AK, Wright AA, Nicholas LH. Trends in Advance Care Planning in Patients With Cancer: Results From a National Longitudinal Survey. JAMA Oncol 2015. PubMed
  • Meyer LA, Bohlke K, Powell MA, Fader AN, Franklin GE, Lee LJ, Matei D, Coallier L, Wright AA. Postoperative Radiation Therapy for Endometrial Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Guideline. J Clin Oncol 2015. PubMed
  • Horowitz NS, Wright AA. Impact of obesity on chemotherapy management and outcomes in women with gynecologic malignancies. Gynecol Oncol 2015; 138:201-206. PubMed
  • Pirl WF, Greer JA, Irwin K, Lennes IT, Jackson VA, Park ER, Fujisawa D, Wright AA, Temel JS. Processes of Discontinuing Chemotherapy for Metastatic Non-Small-Cell Lung Cancer at the End of Life. J Oncol Pract 2015. PubMed
  • Odejide OO, Salas Coronado DY, Watts CD, Wright AA, Abel GA. End-of-Life Care for Blood Cancers: A Series of Focus Groups With Hematologic Oncologists. J Oncol Pract 2014. PubMed
  • Wright AA, Hatfield LA, Earle CC, Keating NL. End-of-Life Care for Older Patients With Ovarian Cancer Is Intensive Despite High Rates of Hospice Use. J Clin Oncol 2014. PubMed
  • Ojesina AI, Lichtenstein L, Freeman SS, Pedamallu CS, Imaz-Rosshandler I, Pugh TJ, Cherniack AD, Ambrogio L, Cibulskis K, Bertelsen B, Romero-Cordoba S, Treviño V, Vazquez-Santillan K, Guadarrama AS, Wright AA, Rosenberg MW, Duke F, Kaplan B, Wang R, Nickerson E, Walline HM, Lawrence MS, Stewart C, Carter SL, McKenna A, Rodriguez-Sanchez IP, Espinosa-Castilla M, Woie K, Bjorge L, Wik E, Halle MK, Hoivik EA, Krakstad C, Gabiño NB, Gómez-Macías GS, Valdez-Chapa LD, Garza-Rodríguez ML, Maytorena G, Vazquez J, Rodea C, Cravioto A, Cortes ML, Greulich H, Crum CP, Neuberg DS, Hidalgo-Miranda A, Escareno CR, Akslen LA, Carey TE, Vintermyr OK, Gabriel SB, Barrera-Saldaña HA, Melendez-Zajgla J, Getz G, Salvesen HB, Meyerson M. Landscape of genomic alterations in cervical carcinomas. Nature 2014; 506:371-5. PubMed
  • Wright AA, Zhang B, Keating NL, Weeks JC, Prigerson HG. Associations between palliative chemotherapy and adult cancer patients' end of life care and place of death: prospective cohort study. BMJ 2014; 348:g1219. PubMed
  • Dizon DS, Ambrosio AJ, Feltmate C, Wright AA, Campos SM, Viswanathan A, . Pushing the bar in treatment of cervical cancer: what can comprehensive cancer centers do on their own? Gynecol Oncol 2013; 131:464-6. PubMed
  • Wright AA, Howitt BE, Myers AP, Dahlberg SE, Palescandolo E, Van Hummelen P, Macconaill LE, Shoni M, Wagle N, Jones RT, Quick CM, Laury A, Katz IT, Hahn WC, Matulonis UA, Hirsch MS. Oncogenic mutations in cervical cancer: Genomic differences between adenocarcinomas and squamous cell carcinomas of the cervix. Cancer 2013; 119:3776-83. PubMed
  • Krishnan MS, Epstein-Peterson Z, Chen YH, Tseng YD, Wright AA, Temel JS, Catalano P, Balboni TA. Predicting life expectancy in patients with metastatic cancer receiving palliative radiotherapy: The TEACHH model. Cancer 2013. PubMed
  • Balboni TA, Balboni M, Enzinger AC, Gallivan K, Paulk ME, Wright A, Steinhauser K, VanderWeele TJ, Prigerson HG. Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Intern Med 2013; 173:1109-17. PubMed
  • Krishnan M, Temel JS, Wright AA, Bernacki R, Selvaggi K, Balboni T. Predicting life expectancy in patients with advanced incurable cancer: a review. J Support Oncol 2013; 11:68-74. PubMed
  • Shoni M, Parra-Herran CE, May T, Wright AA, Feltmate CM. Multiple synchronous primary gynecologic malignancies in an MSH2 mutation carrier with endometriosis. J Clin Oncol 2013; 31:e33-6. PubMed
  • Wright AA, Stieglitz H, Kupersztoch YM, Paulk ME, Kim Y, Katz IT, Munoz F, Jimenez RB, Mutchler J, Rivera L, Back AL, Prigerson HG. United States Acculturation and Cancer Patients' End-of-Life Care. PLoS ONE 2013; 8:e58663. PubMed
  • Katz IT, Nkala B, Dietrich J, Wallace M, Bekker LG, Pollenz K, Bogart LM, Wright AA, Tsai AC, Bangsberg DR, Gray GE. A qualitative analysis of factors influencing HPV vaccine uptake in Soweto, South Africa among adolescents and their caregivers. PLoS ONE 2013; 8:e72094. PubMed
  • Gao X, Prigerson HG, Diamond EL, Zhang B, Wright AA, Meyer F, Maciejewski PK. Minor Cognitive Impairments in Cancer Patients Magnify the Effect of Caregiver Preferences on End-of-Life Care. J Pain Symptom Manage 2012. PubMed
  • Maciejewski PK, Phelps AC, Kacel EL, Balboni TA, Balboni M, Wright AA, Pirl W, Prigerson HG. Religious coping and behavioral disengagement: opposing influences on advance care planning and receipt of intensive care near death. 2011. PubMed
  • Wright AA, Keating NL, Balboni TA, Matulonis UA, Block SD, Prigerson HG. Place of death: correlations with quality of life of patients with cancer and predictors of bereaved caregivers' mental health. J Clin Oncol 2010; 28:4457-64. PubMed
  • Wright AA, Mack JW, Kritek PA, Balboni TA, Massaro AF, Matulonis UA, Block SD, Prigerson HG. Influence of patients' preferences and treatment site on cancer patients' end-of-life care. Cancer 2010; 116:4656-63. PubMed
  • Mack JW, Weeks JC, Wright AA, Block SD, Prigerson HG. End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences. J Clin Oncol 2010; 28:1203-8. PubMed
  • Zhang B,Wright AA,Huskamp HA,Nilsson ME,Maciejewski ML,Earle CC,Block SD,Maciejewski PK,Prigerson HG. Health care costs in the last week of life: associations with end-of-life conversations. Arch Intern Med 2009; 169:480-8. PubMed
  • Wright AA,Zhang B,Ray A,Mack JW,Trice E,Balboni T,Mitchell SL,Jackson VA,Block SD,Maciejewski PK,Prigerson HG. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA 2008; 300:1665-73. PubMed
  • Wright AA, Katz IT. Letting go of the rope--aggressive treatment, hospice care, and open access. N Engl J Med 2007; 357:324-7. PubMed
  • Katz IT, Wright AA. Preventing cervical cancer in the developing world. N Engl J Med 2006; 354:1110. PubMed