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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

基本信息

批准号：
10413022
负责人：
Scarlett L Gomez
金额：
$ 103.15万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
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：
2020-06-08 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10413022
关键词：
Accounting Adherence Algorithms Asian Americans Asian population Automobile Driving Behavior Biological Biology Body Size Breast Cancer Patient California Cancer Biology Cancer Prognosis Cells Characteristics Chinese 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 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 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&apos 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 prognostic indicator protective factors racial and ethnic racial and ethnic disparities social culture tissue archive transcriptome sequencing treatment adherence tumor tumor microenvironment

项目摘要

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