Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations.
Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers: Review and Research Recommendations.
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DOI：
10.1001/jamaoncol.2021.1160
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发表时间：
2021-11-01
期刊：
影响因子：
28.4
通讯作者：
Carroll J
中科院分区：
文献类型：
--
作者：
Mandelblatt JS;Ahles TA;Lippman ME;Isaacs C;Adams-Campbell L;Saykin AJ;Cohen HJ;Carroll J
肿瘤学的实践将涉及越来越多的中晚期癌症患者的护理。根据诊断时生物学年龄的差异，管理这些个体是复杂的。生物年龄是衡量生命过程中对生物系统的累积损害、储备损失以及对功能退化和死亡的脆弱性的尺度。生物学年龄很重要，因为它影响了管理癌症治疗的严格性，幸存者的功能和癌症进展的能力。然而，生物学年龄在临床上并不总是明显的。我们提出了一个概念框架的生命过程中的生物老化，总结候选措施，并描述了一个研究议程，以促进临床肿瘤学实践的翻译。中晚期癌症是由生命过程中生物老化的累积模式引起的慢性疾病。在诊断之前，每个新患者都处于与过去的暴露、生活经历、遗传和非癌症慢性疾病相关的生物衰老过程中。癌症及其治疗也会影响生物衰老。生物学年龄的几种测量方法已用于肿瘤学研究，包括p16INK4a，表观遗传年龄，端粒长度，炎症和身体组成标志物。这些措施中的一个或多个可能是有用的癌症护理，无论是单独或与临床病史和老年评估相结合。然而，在常规实践中推荐生物学年龄评估之前，还需要进一步的研究，包括确定生物学年龄知识会改变治疗的情况，确定对生物学年龄的治疗效果是短暂的还是持久的，以及测试干预措施以改变生物学年龄，降低治疗毒性并保持功能能力。了解生物衰老的差异最终可以使临床医生更好地个性化治疗和支持性护理，制定量身定制的生存护理计划，并根据衰老机制制定预防或改善治疗和行为。
The practice of oncology will involve care of a growing population of individuals with mid- and late-life cancers. Managing these individuals is complex based on differences in biological age at diagnosis. Biological age is a measure of accumulated life course damage to biological systems, loss of reserve and vulnerability to functional deterioration and death. Biological age is important because it affects the ability to manage the rigors of cancer therapy, survivors’ function, and cancer progression. However, biological age is not always clinically apparent. We present a conceptual framework of life course biological aging, summarize candidate measures and describe a research agenda to facilitate clinical translation to oncology practice. Mid- and late-life cancers are chronic diseases arising from cumulative patterns of biological aging occurring over the life course. Before diagnosis each new patient was on a distinct course of biological aging related to past exposures, life experiences, genetics and non-cancer chronic disease. Cancer and its treatments can also affect biological aging. Several measures of biological age have been used in oncology research including p16INK4a, epigenetic age, telomere length, and inflammatory and body composition markers. One or more of these measures could be useful in cancer care, either alone or in combination with clinical history and geriatric assessments. However, further research will be needed before biological age assessment can be recommended in routine practice, including determination of situations where knowledge about biological age would change treatment, ascertaining whether treatment effects on biological aging are short-lived or persistent, and testing interventions to modify biological age, decrease treatment toxicities and maintain functional abilities. Understanding differences in biological aging could ultimately allow clinicians to better personalize treatment and supportive care, develop tailored survivorship care plans, and prescribe preventive or ameliorative therapies and behaviors informed by aging mechanisms.
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影响因子：
4.7
作者：
Forrester, Sarah;Jacobs, David;Kiefe, Catarina, I
通讯作者：
Kiefe, Catarina, I
影响因子：
13.6
作者：
Castagné R;Garès V;Karimi M;Chadeau-Hyam M;Vineis P;Delpierre C;Kelly-Irving M;Lifepath Consortium
通讯作者：
Lifepath Consortium
影响因子：
10.3
作者：
Guida, Jennifer L.;Ahles, Tim A.;Hurria, Arti
通讯作者：
Hurria, Arti
影响因子：
6.4
作者：
Dugue, Pierre-Antoine;Bassett, Julie K.;Milne, Roger L.
通讯作者：
Milne, Roger L.
DOI：
10.6004/jnccn.2017.0122
发表时间：
2017-07-01
影响因子：
13.4
作者：
Guerard, Emily J.;Deal, Allison M.;Lund, Jennifer L.
通讯作者：
Lund, Jennifer L.