Dr. Gross's research interests include developing clinical trials for children with cancers and cancer predisposition syndromes with a focus on incorporating functional outcomes. She is the lead associate investigator on a multi-site phase II study of an orally bioavailable MEK inhibitor for children with neurofibromatosis type 1(NF1) and inoperable plexiform neurofibromas. A unique aspect of this trial is the use of detailed prospective measurements of functional outcomes. 

NF1 is a member of a family of rare diseases known as RASopathies, all of which are caused by germline mutations in the RAS pathway, which is also mutated in many sporadic cancers.  Dr. Gross serves as the co-primary investigator on a new NCI initiative to Advance RASopathy Therapies (ART) designed to establish the natural history and then clinical trials for these rare diseases. For all of these rare syndromes, there is a wide array of manifestations for which clinical trials are not currently feasible because validated outcome measures do not exist.  Dr. Gross is working to develop patient-focused functional outcomes for these patients and to integrate patient advocates and patients into the design of clinical trials.

In addition, given the recent successes of orally administered targeted therapies in the NF1 and other rare tumor patient populations, the need for patient adherence to long-term treatment (over months or years) is becoming a significant issue. Patients often struggle to stay on a medication due to side effects or other issues, even knowing that stopping the medication can cause the disease manifestations to return.  Dr. Gross is working with Dr. Staci Martin from the Health Psychology and Neurobehavioral Research Group to learn more about medication adherence patterns in the NF1 population and hopes to create an intervention to help patients and their physicians better communicate and deal with this issue in the future.