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Prevention of Anthracycline Chemotherapy Cardiotoxicity

预防蒽环类化疗心脏毒性

基本信息

批准号：
9976244
负责人：
Jenica Upshaw
金额：
$ 16.37万
依托单位：
TUFTS MEDICAL CENTER
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：
2020-04-15 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/9976244
关键词：
Adult Affect Age Anthracycline Apoptosis Cardiac Cardiac Myocytes Cardiology Cardiomyopathies Cardiotoxicity Cardiovascular system Cessation of life Clinical Practice Guideline Clinical Research Clinical Trials Clinical Trials Design Continuous Infusion Data Data Set Databases Dexrazoxane Diagnosis Disease remission Elderly Formulation Funding Future Geography Goals Health Personnel Health Policy Health system Heart Diseases Heart failure Hematological Disease Individual Infusion procedures Institutes Interview Iron Chelating Agents K-Series Research Career Programs Knowledge Life Link Liposomes Logistic Regressions Lung diseases Lymphoma Malignant Neoplasms Medical center Medicare Mentors Mentorship Modeling National Heart, Lung, and Blood Institute Newly Diagnosed Obesity Oncology Outcome Outcome Study Outcomes Research Patient Preferences Patient risk Patients Pattern Pharmaceutical Preparations Physician Executives Population Prevalence Prevention Primary Prevention Program Development Provider Regimen Registries Research Research Methodology Research Personnel Risk Risk Estimate Risk Factors Role SEER Program Science Surveys Testing Toxic effect Training Universities Validation Variant Work administrative database base cancer clinical trial cancer risk cancer therapy cardioprotection career career development chemotherapeutic agent chemotherapy clinical practice clinical risk comorbidity coronary fibrosis design experience experimental study high risk improved improved outcome informant medical schools off-label use older patient oncology program outcome forecast patient oriented preference prevent professor randomized trial risk prediction model routine practice skills socioeconomics tool

项目摘要

This proposal presents a five-year research career development program, focused on the prediction and prevention of life-threatening anthracycline chemotherapy cardiotoxicity in older adults with lymphoma through: 1) improved prediction tools, 2) analysis of current cardioprotection use and 3) ascertainment of patient and provider treatment preferences. The candidate is an Assistant Professor at Tufts University School of Medicine and the Medical Director of the Cardio-Oncology Program in the Division of Cardiology at Tufts Medical Center. Under the mentorship of Dr. David Kent and Dr. Susan Parsons, researchers in the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, the training plan builds on the candidate's prior clinical and research experience to develop expertise in 1) designing impactful cardio-oncology outcomes studies using large administrative databases; 2) oncology clinical trial design and 3) qualitative and decision analytic research methods. Each year in the US, more than 40,000 individuals 65 years and older are diagnosed with lymphoma with anthracycline-containing regimens recommended as first-line treatment in the majority of lymphoma subtypes. While anthracycline chemotherapeutic agents help induce lymphoma remission, they also increase the risk of heart failure (HF). These effects are worsened in older adults, as age is a potent risk factor for HF in both non-cancer and cancer populations. However, omission of anthracyclines, even in elderly patients at high risk of toxicity, may be associated with worse outcomes. Thus, strategies to better predict and prevent anthracycline cardiotoxicity are needed to improve outcomes in older patients with lymphoma. Small randomized trials in predominately non-lymphoma populations have identified several promising strategies to prevent HF in patients receiving anthracyclines; however, neither clinical practice guidelines nor the FDA endorse any of these therapies due to insufficient evidence for the prevention of HF in newly diagnosed adults with lymphoma. The objective of this proposal is to advance the science of anthracycline cardiotoxicity prediction and prevention by: 1) developing and validating a HF risk prediction model in older individuals with newly diagnosed lymphoma; 2) determining which cardioprotective strategies are currently used in practice and 3)eliciting treatment preferences for cardioprotection from patients and providers. This research will lead to improved knowledge of anthracycline cardiotoxicity prevention, provide preliminary data for a study of cardioprotection in high-risk individuals with lymphoma and provide the candidate with the necessary skills and experience to become a successful independent investigator.

本提案提出了一个为期五年的研究职业发展计划，重点关注