Insights from Asian Populations into Disparities in Breast Cancer Prognosis and Outcomes

亚洲人群对乳腺癌预后和结果差异的见解

• 批准号: 10186715
• 负责人: Scarlett L Gomez
• 金额: $ 106.79万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-08 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10186715
• 关键词: Accounting; Adherence; Algorithms; Asian Americans; Asians; Automobile Driving; Behavior; Biological; Biology; Body Size; Breast Cancer Patient; California; Cancer Biology; Cancer Prognosis; Cells; Characteristics; Chinese People; Clinical; Cohort Studies; Complementary and alternative medicine; Data; Dietary intake; Electronic Health Record; Epidemiology; Ethnic Origin; Ethnic group; Genetic; Health Promotion; Health behavior; Healthcare Systems; Heterogeneity; Immigration; Immune; Immune response; Immunobiology; Immunogenomics; Immunologic Receptors; Individual; Japanese Population; Knowledge; Life Style; Maintenance; Malignant Neoplasms; Mammary Neoplasms; Modeling; Neighborhoods; Outcome; Pathway interactions; Patient Self-Report; Patients; Pattern; Phenotype; Plants; Population; Population Group; Population Heterogeneity; Prevalence; Prognostic Factor; Prognostic Marker; Race; Research; Resources; Sampling; Site; Social Environment; Social support; Socioeconomic Status; Survival Rate; The Cancer Genome Atlas; Time; Tissue Sample; Tissues; Translating; Treatment Factor; Treatment outcome; Tumor Tissue; Tumor-infiltrating immune cells; United States; Woman; Women' s Group; anti-tumor immune response; base; black women; breast cancer diagnosis; breast cancer family registry; breast cancer survival; cancer health disparity; cancer immunobiology; cancer immunotherapy; cancer survival; chemotherapy; cohort; comparison group; contextual factors; data registry; disorder risk; ethnic difference; experience; follow-up; health care availability; hormone therapy; improved; insight; lifestyle factors; malignant breast neoplasm; mortality; multi-ethnic; neoplasm registry; prognostic; prognostic assays; protective factors; racial and ethnic; racial and ethnic disparities; social culture; tissue archive; transcriptome sequencing; treatment adherence; tumor; tumor microenvironment

Abstract Asian American women experience more favorable cancer survival than other US racial/ethnic groups, even after accounting for known prognostic indicators. Breast cancer, which follows this pattern, is a useful model for understanding factors contributing to this intriguing survival advantage, given that it is the most common cancer in Asian American women, and has established clinical, biological/genetic, and lifestyle prognostic factors. Thus, studying the breast cancer survival advantage in Asian American women has the potential to identify protective factors that may benefit all patients. We propose to investigate multilevel factors (health behaviors and contextual factors, clinical characteristics, treatment, and tumor immune response) in relation to overall and breast cancer-specific mortality in Asian American breast cancer cases. However, the Asian American population is heterogeneous, with lifestyle factors and disease risks (e.g., breast cancer survival rates) varying by specific ethnicity and by immigration status. Many studies have shown the importance of population disaggregation to uncovering meaningful differences among Asian American ethnic groups, but no single study to date includes adequate Asian American ethnic group population samples. To overcome this limitation, we will conduct the proposed research in integrated data and biospecimens from four established cohort studies enriched with Asian American breast cancer cases. These studies together include 4,219 Asian American patients (1,848 Chinese, 602 Japanese, 1,538 Filipinas) and 5,386 non-Latina White women with breast cancer as a comparison group. In Specific Aim 1, we will assess contributions of individual-level lifestyle and health behaviors and multilevel neighborhood social context and sociocultural factors to survival differences among the Asian American ethnic groups relative to non-Latina Whites. In Specific Aim 2, we will evaluate how specific treatment factors impact survival for 4,373 Asian Americans compared to 4,373 non- Latina Whites, taking advantage of electronic health record data from an equal-access healthcare system. In Specific Aim 3, we will characterize the immune infiltrates in the breast tumor microenvironment from 1,200 Asian American (from Aim 1) and 714 non-Latina White (from TCGA) patients using immunogenomic profiling, and to determine the associations of immune phenotypes with patient survival among Asian Americans and with exposure factors from Aim 1. Thus, using existing resources, this study will comprehensively assess factors including health behaviors and neighborhood context, lifestyle, treatment, tumor immuno-biology, and their contributions to the survival advantage in Asian American women. The proposed study makes efficient use of data from numerous breast cancer studies to gain insight for strategies that may advance knowledge about the management of breast cancer for all women.

摘要 亚裔美国女性比其他美国种族/民族的癌症存活率更高，甚至 在考虑了已知的预后指标后。遵循这种模式的乳腺癌是治疗乳腺癌的有用模型。 了解导致这种耐人寻味的生存优势的因素，因为这是最常见的 亚裔美国女性中的癌症，并建立了临床、生物/遗传和生活方式预后 各种因素。因此，研究亚裔美国女性的乳腺癌生存优势有可能 确定可能使所有患者受益的保护性因素。我们建议调查多层次的因素(健康 行为和背景因素、临床特征、治疗和肿瘤免疫反应)与 亚裔美国人乳腺癌病例的总体死亡率和特定乳腺癌死亡率。然而，亚洲人 美国人口是异质性的，有生活方式因素和疾病风险(例如，乳腺癌存活率 根据特定种族和移民身份的不同而不同。许多研究都表明了 人口分解以揭示亚裔美国人种族之间的有意义的差异，但没有 到目前为止，只有一项研究包括足够的亚裔美国人族群样本。要克服这一点 有限，我们将从四个已建立的数据和生物谱系中进行拟议的研究 队列研究丰富了亚裔美国人的乳腺癌病例。这些研究总共包括4,219名亚洲人 美国患者(1848名中国人，602名日本人，1538名菲律宾人)和5386名非拉丁裔白人女性 乳腺癌作为对照组。在具体目标1中，我们将评估个人层面的生活方式的贡献 健康行为与多层次邻里社会背景和社会文化因素对生存的影响 亚裔美国人族群与非拉美裔白人之间的差异。在具体目标2中，我们将 评估特定治疗因素如何影响4373名亚裔美国人的生存率，而非亚裔美国人为4373人 拉丁裔白人，利用来自平等访问的医疗保健系统的电子健康记录数据。在……里面 特定目标3，我们将从1,200开始表征乳腺肿瘤微环境中的免疫浸润物 使用免疫基因组图谱的亚裔美国人(来自AIM 1)和714名非拉丁裔白人(来自TCGA)患者， 并确定免疫表型与亚裔美国人和 目标1的暴露因素。因此，利用现有资源，本研究将全面评估 因素包括健康行为和邻里环境，生活方式，治疗，肿瘤免疫生物学，以及 他们对亚裔美国女性生存优势的贡献。拟议中的研究使效率 使用来自众多乳腺癌研究的数据来洞察可能促进知识进步的策略 关于所有女性乳腺癌的管理。