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Understanding and Predicting Fatigue, CV Decline & Events After Breast CA Treatment

了解和预测疲劳、CV 下降

基本信息

批准号：
10481826
负责人：
William Gregory Hundley
金额：
$ 21.29万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2024-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10481826
关键词：
Acute Address Adjuvant Adjuvant Chemotherapy Adjuvant Therapy Age American Heart Association Anthracycline Behavioral Biological Markers Breast Breast Cancer Patient Breast Cancer Treatment Breast Cancer survivor Breast Cancer therapy Cancer Survivor Cardiac Death Cardiopulmonary Cardiotoxicity Cardiovascular Diseases Cardiovascular Physiology Cardiovascular system Categories Chronic Disease Clinical Cohort Studies Communities Community Clinical Oncology Program Community Hospitals Consumption Data Databases Development EFRAC Early Diagnosis Echocardiography Enrollment Epidemiology Equation Ethnic Origin Etiology Event Exercise Test FarGo Fatigue Fibrosis Functional disorder Funding Future Guidelines Healthcare Heart failure Image Impairment Incidence Inflammation Infrastructure Intervention Knowledge Left Left Ventricular Dysfunction Left Ventricular Ejection Fraction Left Ventricular Function Life Longitudinal Studies Magnetic Resonance Imaging Malignant Neoplasms Measures Mediating Mental Health Modeling Morbidity - disease rate Multicenter Studies Myocardial Myocardial Infarction Natural History Neoadjuvant Therapy Network-based Patient Self-Report Patients Physiologic pulse Population Preventive Quality of life Race Radiation Radiation therapy Research Research Design Research Personnel Risk Risk Factors SF-36 Savings Schedule Secure Serum Structure Surveillance Program Survival Rate Survivors Thick Time Toxic effect Ventricular Walking Woman base breast cancer diagnosis cancer therapy cardiovascular injury cardiovascular risk factor chemotherapy clinical center cohort cost design detection method exercise capacity exercise intolerance experience forest health related quality of life high risk hospital utilization improved malignant breast neoplasm mortality normal aging physical conditioning prediction algorithm predictive modeling prevent programs prospective psychosocial public health relevance risk prediction therapy design

项目摘要

DESCRIPTION (provided by applicant): Though the use of chemotherapy and early detection methods have greatly increased survival rates for women with Stage I-III breast cancer, this progress is threatened by a significant increase in cardiovascular (CV) events for survivors. Over 35% of women experience CV injury, left ventricular (LV) dysfunction, exercise intolerance, or fatigue after receipt of adjuvant chemotherapy (Adj-C) for Stage I-III breast cancer. In addition, CV events are the leading cause of morbidity and mortality for those surviving 5 to 8 years after their breast cancer diagnosis. Currently, little is understood about te origins of CV dysfunction, exercise intolerance, or fatigue in these women, and risk prediction algorithms for CV events do not incorporate breast cancer treatment in their models. We propose a study of baseline and serial longitudinal measures that will determine the influence of Adj-C with and without concomitant radiation treatment on 3 general categories: (1) CV function, (2) exercise capacity and fatigue, and (3) future development of CV events in a cohort of 1,000 women (840 with Stage I-III Breast Cancer and 160 healthy comparators). We also seek to answer questions about the relationship of alterations in LV and aortic function, what demographic risk factors and changes in serum biomarkers precede LV dysfunction, and if risk factor prediction models forecast development of CV events in the same cohort. Our longitudinal study design accounts for pre-existing and dynamic changes in risk factors during receipt of Adj-C and assesses subsequent CV events. This study has secured robust financial and infrastructure support through the Wake Forest NCI Community Oncology Research Program. This partnership reduces the overall cost of the current proposal by funding enrollment, staff reimbursement, regulatory oversight, study database development, echocardiograms, and an active surveillance program to ascertain the occurrence of CV events. This will be the first epidemiologic cohort study designed to fully characterize the time course and define the correlates of subclinical CV dysfunction, exercise intolerance, fatigue and CV events in women treated with Adj-C for breast cancer. A study of this magnitude is important to assess a variety of subjects so that the scientific community may better understand who is at risk and how we can prevent future CV damage. By enrolling patients in community hospitals and utilizing the unique expertise of each Co-Investigator, this study can capture the data needed to make such predictions. The immediate impact of this research will reduce the gaps in knowledge that prevent treatment design and generate risk prediction algorithms to avert CV events in breast cancer survivors. New knowledge from this study will quantify the risk of developing subclinical CV disease and exercise intolerance in this population, identify potential mechanisms, and inform future study development to reduce CV disease and improve overall survival in women with breast cancer.