CAUSAL: Cohort to Augment the Understanding of Sarcoma Survivorship Across the Lifespan

因果关系：增强对整个生命周期肉瘤幸存者的理解的队列

• 批准号: 10900883
• 负责人: Debra L. Friedman
• 金额: $ 193.68万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-22 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10900883
• 关键词: 15 year old; Abstinence; Academic Medical Centers; Address; Adjuvant Chemotherapy; Affect; Alcohol consumption; Biological Assay; Biology; Blood specimen; Cancer Survivor; Caring; Cessation of life; Chemotherapy and/or radiation; Clinical; Clinical Data; Cohort Studies; Connective Tissue; DNA Repair Gene; DNA analysis; Data; Dedications; Diagnosis; Diet; Disease; Electronic Health Record; Exercise; Foundations; Future; Gene Expression; Genetic Polymorphism; Genetic Predisposition to Disease; Genomics; Goals; Grant; Health; Heart Diseases; Incidence; Individual; Infrastructure; Investigation; Kidney Diseases; Knowledge; Life; Life Style; Liver diseases; Longevity; Lung diseases; Medical Oncologist; Mesenchymal; Micrometastasis; Monitor; Neoadjuvant Therapy; Newly Diagnosed; Normal tissue morphology; Oncogenes; Organ; Orthopedics; Outcome; Participant; Patient Outcomes Assessments; Patients; Pediatric Oncologist; Population; Precision therapeutics; Predictive Factor; Prevalence; Prognostic Factor; Prognostic Marker; Prospective cohort; Quality of life; Radiation Oncologist; Radiation therapy; Recurrence; Relapse; Research; Residual Neoplasm; Risk Factors; Role; Sampling; Severities; Somatic Mutation; Specialist; Surveys; Survivors; Tennessee; Therapeutic Intervention; Time; Toxic effect; Treatment Efficacy; Treatment-Related Cancer; Treatment-related toxicity; Tumor Biology; Tumor Subtype; Tumor Tissue; United States; Variant; cancer diagnosis; cancer therapy; childhood cancer survivor; cigarette smoking; circulating biomarkers; cohort; design; drug metabolism; epidemiologic data; financial toxicity; follow-up; functional status; genetic risk factor; genome sequencing; healthy lifestyle; improved; improved outcome; indexing; lifestyle factors; liquid biopsy; molecular marker; mortality; next generation sequencing; peripheral blood; physical conditioning; polygenic risk score; predictive marker; prognostic value; programs; prospective; psychologic; psychosocial; rare cancer; recruit; response; sarcoma; social; sociodemographics; surveillance strategy; survivorship; tool; transcriptomics; treatment center; treatment response; tumor; tumor DNA; whole genome

PROJECT SUMMARY Sarcomas represent a rare and highly heterogeneous subtype of tumors that may develop across the lifespan. In the United States (US), there are approximately 14,000 new cases annually, with approximately 65% survival. Aside from those included in pediatric cancer survivor cohort studies, there are no sarcoma survivor cohorts in which to systematically study recurrence, organ toxicity, function, quality of life, and survival as well as their predictors. We propose to address these critical gaps in knowledge by establishing a cohort of approximately 2100 sarcoma survivors through the Vanderbilt University Medical Center (VUMC) Sarcoma Treatment Center, which is amongst the largest sarcoma programs in the US, in existence since 1987. In this cohort, we will systematically collect repeated information on disease, treatment, response, relapse, treatment-related toxicity, sociodemographics, lifestyle, functional status, quality of life, physical health outcomes, and survival, together with biospecimens (tumor tissue and peripheral blood samples). We hypothesize that: 1) extrinsic factors, tumor biology, and germline genomics contribute to oncologic outcomes and long-term organ toxicity; 2) healthy lifestyle, e.g., high quality of diet, exercise, abstinence from cigarette smoking and alcohol drinking mitigate the adverse health consequences, improve survival and quality of life among sarcoma survivors; and 3) liquid biopsy tools, developed through identifying genomic drivers of sarcoma, will be of predictive and prognostic utility. Our aims for current grant period are to evaluate1) the impact of disease, treatment, sociodemographic and lifestyle contributors on adverse oncologic and non-oncologic outcomes and mortality in the cohort; 2) the role of drug metabolism and DNA repair gene functional polymorphisms, genetically predicted gene expression levels, and polygenic risk scores, on treatment efficacy and therapy-induced normal tissue toxicity; and 3) genomic drivers of sarcoma to develop personalized liquid biopsy assays for monitoring treatment response, recurrence, and minimal residual disease. Establishment of a prospective cohort of sarcoma survivors across the lifespan, with extensive and well characterized clinical and epidemiologic data, patient reported outcomes, tumor tissue and serial blood samples builds a foundation for a long-term prospective investigation on life after sarcoma. This effort is critically important to improve the understanding of a rare tumor affecting the lifespan but seriously underrepresented in research. Identification of health outcomes and their predictive and prognostic factors can lead to precision treatment and survivorship care, which are currently clinically unmet needs.

项目概要 肉瘤代表一种罕见且高度异质性的肿瘤亚型，可能在整个生命周期中发展。 在美国 (US)，每年约有 14,000 例新病例，存活率约为 65%。 除了儿科癌症幸存者队列研究中包含的研究外，没有肉瘤幸存者队列研究 系统地研究复发、器官毒性、功能、生活质量和生存及其影响 预测因子。我们建议通过建立一个大约 范德比尔特大学医学中心 (VUMC) 肉瘤治疗中心治疗 2100 名肉瘤幸存者， 这是美国最大的肉瘤项目之一，自 1987 年以来一直存在。在这个队列中，我们将 系统地收集有关疾病、治疗、反应、复发、治疗相关毒性的重复信息， 社会人口统计学、生活方式、功能状态、生活质量、身体健康结果和生存 与生物样本（肿瘤组织和外周血样本）。我们假设：1）外在因素，肿瘤 生物学和种系基因组学有助于肿瘤结果和长期器官毒性； 2）健康 生活方式，例如高质量的饮食、锻炼、戒烟和饮酒可以减轻 不良健康后果，提高肉瘤幸存者的生存率和生活质量； 3) 液体活检 通过识别肉瘤的基因组驱动因素开发的工具将具有预测和预后作用。我们的 当前资助期的目标是评估1) 疾病、治疗、社会人口和生活方式的影响 队列中不良肿瘤和非肿瘤结果以及死亡率的影响因素； 2）药物的作用 代谢和DNA修复基因功能多态性，基因预测的基因表达水平，以及 关于治疗效果和治疗引起的正常组织毒性的多基因风险评分； 3）基因组驱动因素 肉瘤开发个性化液体活检检测，用于监测治疗反应、复发和 微小残留病。建立整个生命周期肉瘤幸存者的前瞻性队列， 广泛且特征明确的临床和流行病学数据、患者报告的结果、肿瘤组织和 系列血液样本为肉瘤后生活的长期前瞻性研究奠定了基础。这 努力对于提高对影响寿命的罕见肿瘤的认识至关重要，但严重的是 研究中代表性不足。确定健康结果及其预测和预后因素可以 导致精准治疗和生存护理，这是目前临床上未满足的需求。