Diabetes, Metformin and Breast Cancer Prognosis

糖尿病、二甲双胍和乳腺癌预后

• 批准号: 8574417
• 负责人: Juhua Luo
• 金额: $ 41.46万
• 依托单位: TRUSTEES OF INDIANA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8574417
• 关键词: Accounting; Address; Adverse effects; Affect; Breast Cancer Detection; Breast Cancer Risk Factor; Breast Cancer Treatment; Cancer Patient; Cancer Prognosis; Cardiovascular Diseases; Cause of Death; Characteristics; Clinical; Code; Cohort Studies; Comorbidity; Complex; Data; Diabetes Mellitus; Diagnosis; Diet; Disease; Epidemiology; Future; Glucose; Health; Hyperglycemia; Hyperinsulinism; Incidence; Insulin; Knowledge; Lead; Link; Malignant Neoplasms; Measures; Medicare claim; Metformin; Methods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Oral; Outcome; Patient Care; Patients; Pharmaceutical Preparations; Physicians; Physiological; Prospective Studies; Protocols documentation; Provider; Relative (related person); Relative Risks; Research; Review Literature; Risk; Risk Factors; Screening for cancer; Students; Sulfonylurea Compounds; Woman; Women' s Health; Work; adjudicate; cancer risk; cancer therapy; cancer type; career; cohort; diabetes management; diabetes mellitus therapy; diabetic; high risk; improved; interest; malignant breast neoplasm; mortality; non-diabetic; novel; outcome forecast; population based; prospective; psychosocial; public health relevance; saturated fat; tumor; tumor progression

DESCRIPTION (provided by applicant): Diabetes and cancer are common diseases that have a tremendous impact on health worldwide. A number of studies have indicated that diabetes is associated with higher overall mortality in patients with breast cancer. However, it is unclear whether the higher overall mortality seen in breast cancer patients with diabetes compared to those without diabetes is related to a poorer breast cancer prognosis, to other causes such as cardiovascular disease, or to different management of breast cancer, including tumor characteristics and treatment choices. In addition, metformin, an oral drug widely used as a first-line therapy for type 2 diabetes, is also under consideration for use in non-diabetic cancer patients as an adjunctive therapy. However, there is no study examining its potential effect on cancer prognosis in a population-based setting. Answering these questions will have direct influence on diabetes management and cancer treatment to improve breast cancer outcomes for women with diabetes and is critical to inform the proper care of these patients. We will use data from the Women's Health Initiative (WHI), a large prospective cohort study, to assess influence of pre-existing diabetes (specific aim 1) and diabetes treatment, particularly metformin (specific aim 2), on prognosis of patients with breast cancer. This is the first prospective study o use a well-established cohort to address these questions. The Women's Health Initiative includes detailed and comprehensive data on demographic and psychosocial characteristics, breast cancer screening, breast cancer risk factors, diabetes medication treatments, tumor characteristics that are physician-adjudicated and coded using SEER protocols and physician-adjudicated causes of death. We expect the proposed analyses to advance understanding of whether and how pre-existing diabetes and diabetes treatment influences survival following breast cancer. In addition, the novel analyses and methods used for this study can be expanded in the future to a more comprehensive examination of other types of cancer in relation to diabetes or other co-morbidities. Additionally, this project will provide great opportunities for exposing students to research and stimulating their interests in pursuing careers in academic fields.

描述(申请人提供)：糖尿病和癌症是对全球健康有巨大影响的常见疾病。许多研究表明，糖尿病与乳腺癌患者的总体死亡率较高有关。然而，目前尚不清楚患有糖尿病的乳腺癌患者的总死亡率高于没有糖尿病的患者，这是与乳腺癌预后较差有关，还是与心血管疾病等其他原因有关，还是与乳腺癌的不同治疗有关，包括肿瘤特征和治疗选择。此外，被广泛用作2型糖尿病一线治疗的口服药物二甲双胍也在考虑作为辅助治疗用于非糖尿病癌症患者。然而，在以人群为基础的环境下，还没有研究考察它对癌症预后的潜在影响。回答这些问题将对糖尿病管理和癌症治疗产生直接影响，以改善糖尿病女性患者的乳腺癌预后，并对这些患者的适当护理至关重要。我们将使用妇女健康倡议(WHI)的数据，这是一项大型前瞻性队列研究，以评估既往糖尿病(特定目标1)和糖尿病治疗，特别是二甲双胍(特定目标2)对乳腺癌患者预后的影响。这是第一次使用公认的队列来解决这些问题的前瞻性研究。妇女健康倡议包括关于以下方面的详细和全面的数据：人口和心理社会特征、乳腺癌筛查、乳腺癌风险因素、糖尿病药物治疗、使用SEER方案进行医生判定和编码的肿瘤特征以及医生判定的死因。我们期望拟议的分析能够促进对既往糖尿病和糖尿病治疗是否以及如何影响乳腺癌后生存率的理解。此外，用于这项研究的新分析和方法未来可以扩展到更全面地检查与糖尿病或其他合并症有关的其他类型的癌症。此外，这个项目将为学生提供接触研究的机会，并激发他们在学术领域追求职业生涯的兴趣。

项目成果

Diabetes, diabetes treatment and breast cancer prognosis.

糖尿病，糖尿病治疗和乳腺癌预后。

• DOI: 10.1007/s10549-014-3146-9
• 发表时间: 2014-11
• 期刊: BREAST CANCER RESEARCH AND TREATMENT
• 影响因子: 3.8
• 作者: Luo, Juhua;Virnig, Beth;Hendryx, Michael;Wen, Sijin;Chelebowski, Rowan;Chen, Chu;Rohan, Tomas;Tinker, Lesley;Wactawski-Wende, Jean;Lessin, Lawrence;Margolis, Karen
• 通讯作者: Margolis, Karen

Metabolic Phenotype and Risk of Colorectal Cancer in Normal-Weight Postmenopausal Women.

• DOI: 10.1158/1055-9965.epi-16-0761
• 发表时间: 2017-02
• 期刊: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
• 作者: Liang X;Margolis KL;Hendryx M;Rohan TE;Groessl EJ;Thomson CA;Kroenke CH;Simon MS;Lane D;Stefanick M;Luo J
• 通讯作者: Luo J

Pre-existing diabetes and lung cancer prognosis.

• DOI: 10.1038/bjc.2016.141
• 发表时间: 2016-06-28
• 期刊: British journal of cancer
• 影响因子: 8.8
• 作者: Luo J;Hendryx M;Qi L;Ho GY;Margolis KL
• 通讯作者: Margolis KL

Physical activity and weight gain after smoking cessation in postmenopausal women.

• DOI: 10.1097/gme.0000000000001168
• 发表时间: 2019-01
• 期刊: Menopause (New York, N.Y.)
• 作者: Luo J;Manson JE;Hendryx M;Shadyab AH;Johnson KC;Dinh PC Jr;Going SB;Chlebowski R;Stefanick ML;Margolis KL
• 通讯作者: Margolis KL