Effect of Immune-Enhancing Nutrition on Radical Cystectomy Outcomes
免疫增强营养对根治性膀胱切除术结果的影响
基本信息
- 批准号:10172864
- 负责人:
- 金额:$ 55.55万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-07-01 至 2023-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAffectAmino AcidsAntibioticsArginineCancer PatientCaringClinicalClinical TrialsComplicationConsumptionCystectomyDataDeath RateDietary InterventionDouble-Blind MethodDual-Energy X-Ray AbsorptiometryFaceFatty AcidsFutureGoalsGuidelinesImmuneImmune responseImmune systemImmunomodulatorsImpairmentInfectionInflammationInflammatoryInflammatory ResponseInterleukin-6InterventionIntestinesLaboratoriesLettersLymphocyteMalignant neoplasm of urinary bladderMeasuresMetabolismMethodsMuscleMuscular AtrophyMyeloid-derived suppressor cellsNational Cancer InstituteNational Clinical Trials NetworkNucleotidesNutrientNutritional SupportNutritional statusOmega-3 Fatty AcidsOperative Surgical ProceduresOralOutcomePathway interactionsPatient-Focused OutcomesPatientsPerioperativePhasePilot ProjectsPostoperative ComplicationsPostoperative PeriodProceduresPublishingQuality of lifeRadical CystectomyRandomizedResearchRiskRouteRunningSouthwest Oncology GroupSupplementationSurgical complicationTestingTranslationsUrineUrologic OncologyVariantVitamin AWorkarmcancer surgerycancer therapyclinical practicecostcytokinedesigndietaryimmune functionimprovedimproved outcomeinnovationmortalitymulti-site trialneutrophilnutrient metabolismnutritionoperationpilot trialpreservationreadmission ratesreconstructionresponseskeletal muscle wastingstandard caresurgery outcomewound healing
项目摘要
PROJECT SUMMARY/ABSTRACT
Patients undergoing surgery to treat their bladder cancer face very high rates of complications and mortality.
The radical cystectomy operation is fraught with the highest complication rates of all urologic oncology
surgeries performed and is also extremely catabolic. As the National Cancer Institute has identified in its
provocative questions 2 & 11, variations in immune function and nutritional interventions affect the
response to cancer treatment. Radical cystectomy will continue to save lives, but there is a high cost in terms
of persistent surgical complications. The long-term goal of this project is to unlock the potential of nutrition
interventions to improve outcomes, survival, and quality of life in cancer patients. The objective of this project
is to determine the impact of a specialized form of nutritional support on surgical outcomes and to better
understand the mechanisms by which it acts. The hypothesis is that perioperative use of a specialized form of
nutritional support will have greater efficacy than a standard form of nutritional support to reduce post-
operative complications. This hypothesis has been formulated on the basis of published preliminary data
produced in the applicants' laboratories and expert guidelines calling for more rigorous study of this
approach. The rationale is that Specialized IMmunonutrition (SIM) is fortified with nutrients (L-arginine,
omega-3 fatty acids, dietary nucleotides, and vitamin A) that have immediate effects on immune and
inflammatory responses, muscle sparing, and wound healing after surgery. Guided by strong preliminary
data, the hypothesis will be tested in three specific aims: 1) To determine the impact of perioperative SIM
versus an identical Oral Nutrition Support (ONS) lacking the immuno-modulators on post-operative
complications from RC; 2) To compare the impact of SIM to ONS on secondary clinical outcomes after RC
surgery; 3) To evaluate the impact of consuming SIM compared to ONS for restraining myeloid-derived
suppressor cells (MDSCs), decreasing inflammation, and modulating nutrient metabolism. The project is
significant because it offers a high yield, low-risk, low-cost strategy to improve the outcome of patients with
bladder cancer who undergo RC. Our innovative approach could transform clinical practice to reduce post-
operative complications, thereby diminishing the burden of bladder cancer surgery and has the added
potential to help many other surgical patients beyond cystectomy.
项目摘要/摘要
接受手术治疗膀胱癌的患者面临着非常高的并发症和死亡率。
在所有泌尿外科肿瘤中,根治性膀胱切除术的并发症发生率最高。
手术进行的,也是非常分解代谢的。正如国家癌症研究所在其
挑衅性的问题2和11,免疫功能的变化和营养干预影响
对癌症治疗的反应。根治性膀胱切除术将继续挽救生命,但在以下方面代价高昂
持续的手术并发症。这个项目的长期目标是释放营养的潜力
旨在改善癌症患者预后、生存率和生活质量的干预措施。这个项目的目标是
是确定一种特殊形式的营养支持对手术结果的影响,并更好地
了解它的行动机制。假说是围手术期使用一种特殊形式的
营养支持将比标准形式的营养支持更有效地减少术后
手术并发症。这一假设是在已公布的初步数据的基础上提出的
由申请者的实验室和专家指南提出,呼吁对此进行更严格的研究
接近。其基本原理是专门的免疫营养素(SIM)是用营养物质(L-精氨酸,
Omega-3脂肪酸、饮食核苷酸和维生素A),这些物质对免疫和
手术后的炎症反应、肌肉保护和伤口愈合。以强劲的前期工作为指导
数据,这一假设将在三个具体目标上进行检验:1)确定围手术期SIM的影响
与相同的术后缺乏免疫调节剂的口服营养支持(ONS)相比
RC并发症:2)比较SIM和ONS对RC术后二次临床结局的影响
手术;3)评价服用SIM和ONS对抑制髓系来源的影响
抑制细胞(MDSCs),减少炎症,调节营养代谢。该项目是
意义重大,因为它提供了一种高收益、低风险、低成本的策略来改善患者的预后
接受RC的膀胱癌患者。我们的创新方法可以改变临床实践,以减少
手术并发症,从而减轻了膀胱癌手术的负担,增加了
有可能帮助许多其他手术患者超越膀胱切除术。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Jill Hamilton-Reeves其他文献
Jill Hamilton-Reeves的其他文献
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{{ truncateString('Jill Hamilton-Reeves', 18)}}的其他基金
Effect of Immune-Enhancing Nutrition on Radical Cystectomy Outcomes- MERIT extension
免疫增强营养对根治性膀胱切除术结果的影响 - MERIT 扩展
- 批准号:
10517175 - 财政年份:2018
- 资助金额:
$ 55.55万 - 项目类别:
Effect of Immune-Enhancing Nutrition on Radical Cystectomy Outcomes
免疫增强营养对根治性膀胱切除术结果的影响
- 批准号:
10418668 - 财政年份:2018
- 资助金额:
$ 55.55万 - 项目类别:
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