Risk prediction of breast cancer treatment-related cardiotoxicity to guide clinical decision making
乳腺癌治疗相关心脏毒性的风险预测以指导临床决策
基本信息
- 批准号:10191034
- 负责人:
- 金额:$ 37.82万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-07-01 至 2024-06-30
- 项目状态:已结题
- 来源:
- 关键词:Acute myocardial infarctionAddressAdjuvantAdjuvant ChemotherapyAdjuvant TherapyAdoptionAdultAffectAftercareAgeAgingAntidiabetic DrugsAntihypertensive AgentsBiological ProductsBody mass indexBreast Cancer Risk FactorBreast Cancer TreatmentBreast Cancer survivorBreast Cancer therapyCaliforniaCancer ControlCardiologyCardiomyopathiesCardiotoxicityCardiovascular DiseasesCardiovascular systemCaringCause of DeathCessation of lifeCharacteristicsCholesterolClinicalCombined Modality TherapyCommunitiesDataDiabetes MellitusDiagnosisEarly DiagnosisElectronic Health RecordEthnic OriginEventGeneral PopulationGuidelinesHealthHeart failureHigh Risk WomanHormonalHospitalsHyperlipidemiaHypertensionImpaired healthIndividualInterventionLeadLengthLife ExpectancyLife Style ModificationLinkLongitudinal cohort studyLow incomeMalignant NeoplasmsManaged CareMeasuresMedicare/MedicaidModelingMonitorMorbidity - disease rateMyocardial IschemiaNational Cancer InstituteNational Heart, Lung, and Blood InstituteNewly DiagnosedOncologyOutcomePatient CarePersonsPharmaceutical PreparationsPractice GuidelinesPreventionPreventivePrognosisPublic HealthQuality of lifeRaceRadiationRadiation therapyRecordsReportingRiskRisk EstimateRisk FactorsSmokingSocietiesStrokeSurvivorsToxic effectTransient Ischemic AttackTreatment-Related CancerUncertaintyWomanWorkWorld Healthalternative treatmentbaseburden of illnesscancer diagnosiscancer therapycardioprotectioncardiovascular disorder preventioncardiovascular disorder riskcardiovascular imagingcardiovascular risk factorcerebrovascularchemotherapyclinical decision-makingclinical practicecohortethnic minority populationevidence basefollow-uphealth care settingshealth planhealth related quality of lifehigh riskhormone therapymalignant breast neoplasmmembermortalitypredictive modelingprematurepreservationprogramsracial and ethnicrisk predictionrisk prediction modelroutine imagingsocioeconomicsstandard caretreatment planningtreatment risktreatment strategytumorvenous thromboembolism
项目摘要
PROJECT SUMMARY
Nearly 20% of the 3 million breast cancer survivors in the U.S. have cardiovascular disease (CVD). The
National Cancer Institute, NHLBI, and professional oncology and cardiology societies have all endorsed the
importance of reducing CVD burden in breast cancer survivors through earlier recognition and intervention.
Although women diagnosed with stages I to III breast cancer have an excellent prognosis with 5-year relative
survival >90%, specific adjuvant therapies have been reported to lead to cardiovascular (CV) events that impair
health-related quality of life and/or lead to premature CVD death. CV events including acute myocardial
infarction, stroke, and venous thromboembolism have been reported to be associated with adjuvant
chemotherapy, biological agents, radiation therapy, and/or hormonal therapies. These treatment-related CV
events pose a significant public health problem because they will affect the increasing number of breast cancer
survivors’ health-related quality of life over a long-life expectancy. Currently, no standard risk model exists to
predict the risk of CV events associated with multiple adjuvant breast cancer therapies in the presence
of established CV risk factors (such as hypertension, hyperlipidemia, smoking) to inform practice
guidelines and promote shared clinical decision-making. Such models can inform women before treatment
about the potential risks of CVD from alternative treatment strategies while maintaining the best chances for
cancer cure. These models can also help to identify women at highest risk of CVD after therapy who would
potentially benefit from earlier and more intensive CV monitoring via routine imaging and/or use of preventive
medications to mitigate risk of CV events. To address this gap, our study will create risk prediction models by
analyzing a large, demographically heterogeneous cohort of adult women (N=40,500) with newly diagnosed
stages I to III invasive breast cancer in real-world health care settings. We will study women diagnosed from
2008-2020 and followed up to 15 years using the comprehensive electronic records of one of the largest health
plans in the U.S., Kaiser Permanente. In Aim 1, we will assess incident CV events (acute myocardial infarction,
stroke, heart failure) following adjuvant breast cancer therapies, adjusting for tumor characteristics and CVD risk
factors such as age, race/ethnicity, pre-existing CVD, CVD medications (statins, anti-hypertensives, anti-
diabetics), hypertension, diabetes, BMI, and smoking. We will then estimate whether the risk of CV events is
greater in the breast cancer cohort versus an age, race- matched cancer-free cohort. In Aim 2, we will create
and validate risk prediction models for early (<1 year) and late (up to 15 years) CV events. Our project will be
the first to estimate the association of multiple established CVD risk factors with the risk of breast cancer adjuvant
treatment-related CV events in a real-world, ethnically and socioeconomically diverse community-based cohort.
Our risk prediction models will provide new information to guide evidence-based clinical decision-making
concerning adjuvant therapy use for breast cancer and concurrent and post-treatment cardio-oncology care.
项目概要
在美国 300 万乳腺癌幸存者中,近 20% 患有心血管疾病 (CVD)。这
美国国家癌症研究所、NHLBI 以及专业肿瘤学和心脏病学会均已认可
通过早期识别和干预来减轻乳腺癌幸存者的 CVD 负担的重要性。
尽管诊断为 I 至 III 期乳腺癌的女性预后良好,5 年亲属
生存率 >90%,据报道,特定辅助治疗会导致心血管 (CV) 事件,从而损害患者的健康
健康相关的生活质量和/或导致 CVD 过早死亡。心血管事件,包括急性心肌梗死
据报道,梗塞、中风和静脉血栓栓塞与辅助治疗有关
化疗、生物制剂、放射疗法和/或激素疗法。这些与治疗相关的简历
这些事件会造成重大的公共卫生问题,因为它们会影响不断增加的乳腺癌数量
幸存者在漫长的预期寿命期间与健康相关的生活质量。目前,不存在标准的风险模型
预测与多种乳腺癌辅助治疗相关的心血管事件风险
确定的心血管危险因素(如高血压、高脂血症、吸烟)以指导实践
指南并促进共同的临床决策。这种模型可以在治疗前告知女性
关于替代治疗策略的 CVD 潜在风险,同时保持最佳机会
癌症治愈。这些模型还可以帮助识别治疗后心血管疾病风险最高的女性
通过常规成像和/或使用预防性措施进行早期和更密集的 CV 监测可能会受益
降低心血管事件风险的药物。为了解决这一差距,我们的研究将通过以下方式创建风险预测模型:
分析一大群具有人口统计学异质性的新诊断成年女性 (N=40,500)
现实世界医疗保健环境中的 I 至 III 期浸润性乳腺癌。我们将研究被诊断患有以下疾病的女性
2008 年至 2020 年,并使用最大的健康中心之一的综合电子记录进行了长达 15 年的追踪
美国的计划,Kaiser Permanente。在目标 1 中,我们将评估心血管事件事件(急性心肌梗死、
乳腺癌辅助治疗后,根据肿瘤特征和 CVD 风险进行调整
因素,如年龄、种族/民族、既往患有 CVD、CVD 药物(他汀类药物、抗高血压药物、抗高血压药物)
糖尿病患者)、高血压、糖尿病、BMI 和吸烟。然后我们将估计心血管事件的风险是否是
与年龄、种族匹配的无癌症队列相比,乳腺癌队列中的这一比例更高。在目标 2 中,我们将创建
并验证早期(<1 年)和晚期(长达 15 年)心血管事件的风险预测模型。我们的项目将是
第一个评估多个已确定的 CVD 危险因素与乳腺癌佐剂风险之间的关联
在现实世界中,种族和社会经济多样化的社区队列中与治疗相关的心血管事件。
我们的风险预测模型将提供新信息来指导基于证据的临床决策
关于乳腺癌的辅助治疗以及治疗期间和治疗后心脏肿瘤护理。
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)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Reina Haque其他文献
Reina Haque的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Reina Haque', 18)}}的其他基金
Longitudinal assessment of benefits and harms of cannabis use among community-based cancer patients during initial cancer treatment
对社区癌症患者在初始癌症治疗期间使用大麻的益处和危害的纵向评估
- 批准号:
10790738 - 财政年份:2023
- 资助金额:
$ 37.82万 - 项目类别:
Risk prediction of breast cancer treatment-related cardiotoxicity to guide clinical decision making
乳腺癌治疗相关心脏毒性的风险预测以指导临床决策
- 批准号:
10452489 - 财政年份:2020
- 资助金额:
$ 37.82万 - 项目类别:
Risk prediction of breast cancer treatment-related cardiotoxicity to guide clinical decision making
乳腺癌治疗相关心脏毒性的风险预测以指导临床决策
- 批准号:
10062695 - 财政年份:2020
- 资助金额:
$ 37.82万 - 项目类别:
Risk prediction of breast cancer treatment-related cardiotoxicity to guide clinical decision making
乳腺癌治疗相关心脏毒性的风险预测以指导临床决策
- 批准号:
10689025 - 财政年份:2020
- 资助金额:
$ 37.82万 - 项目类别:
ABC: Antidepressants and Breast Cancer Pharmacoepidemiology
ABC:抗抑郁药和乳腺癌药物流行病学
- 批准号:
7897224 - 财政年份:2010
- 资助金额:
$ 37.82万 - 项目类别:
ABC: Antidepressants and Breast Cancer Pharmacoepidemiology
ABC:抗抑郁药和乳腺癌药物流行病学
- 批准号:
8059706 - 财政年份:2010
- 资助金额:
$ 37.82万 - 项目类别:
ABC: Antidepressants and Breast Cancer Pharmacoepidemiology
ABC:抗抑郁药和乳腺癌药物流行病学
- 批准号:
8250850 - 财政年份:2010
- 资助金额:
$ 37.82万 - 项目类别:
相似海外基金
Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
- 批准号:
MR/S03398X/2 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Fellowship
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
- 批准号:
2338423 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Continuing Grant
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
- 批准号:
EP/Y001486/1 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Research Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
- 批准号:
MR/X03657X/1 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
- 批准号:
2348066 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
- 批准号:
AH/Z505481/1 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
- 批准号:
10107647 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
EU-Funded
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
- 批准号:
2341402 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Standard Grant
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
- 批准号:
10106221 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
- 批准号:
AH/Z505341/1 - 财政年份:2024
- 资助金额:
$ 37.82万 - 项目类别:
Research Grant