Bio-behavioral Research At The Intersection of Cancer and Aging

 描述(由申请人提供)：由于人口老龄化、早期发现的更多使用、治疗的进步和寿命的延长，我们正在经历患癌症风险或患有癌症的人数的前所未有的增长。到2030年，4500万新病例中的近50%和2000万癌症幸存者中的75%将是60岁以上的老年人。这些老年幸存者中的大多数人都对系统治疗感兴趣，并将从中受益。然而，这些治疗通常会对功能产生不利影响，尽管数据主要来自对年轻幸存者的研究。由于只有4%的NCI资助的生存研究专门检查老年幸存者的预后，我们对老龄化过程中的实质性异质性(“生物年龄”)如何影响与年龄相当的人的不良功能结局风险知之甚少。这些数据很重要，因为它们可能会影响治疗决定、生存护理计划和独立生活的能力。这一杰出研究者奖将使用生物行为框架在癌症和老龄化的交叉点进行人口科学研究，以填补这些空白。数据、基础设施、 现有的由NCI资助的老年队列建立的合作将被用来反复建立新的研究，以测试新的假设。这样的群体相当于人口科学中用于一系列实验的基础科学实验室。高风险/高回报研究的目标是：身体、情感、社会和角色功能；1)定义长期 认知功能衰退的轨迹，确定衰退的生物行为风险；并检查系统治疗和生活方式因素如何调节这些关系；2)对生物年龄标记物进行探索性研究，以确定预测RIS和功能衰退轨迹的可行性和临床实用性；3)进行生活方式影响的先导性随机试验 关于生物年龄标记物和功能结果的干预措施；以及4)通过将数据纳入政策建模、让幸存者参与成果的设计和交流以及支持培训，加强长期的临床和政策影响。这项研究在使用生物行为框架和纳入政策建模方面具有创新性。这些发现将通过以下方式推动该领域的发展：改变不断增长的老年人口的研究和护理模式；确定生物年龄标记物是否能够识别功能衰退风险最大的幸存者；为未来的干预试验提供信息；扩大有限的癌症和老龄研究人员的数量。PIS生产力的历史以及强有力的机构和协作支持将确保研究产生预期的影响。总体而言，这些研究的独特人口科学观点将为减少老年幸存者癌症负担所需的多学科方法增加重要的多样性。

 DESCRIPTION (provided by applicant): We are experiencing unprecedented growth in the numbers of individuals at risk for, or living with cancer due to population aging, greater use of early detection, advances in treatment, and increasing lifespan. By 2030, nearly 50% of the 45 million new cases and 75% of the 20 million cancer survivors will be aged 60 or older ("older"). Most of these older survivors are interested in and will benefit from systemic therapies. However, these treatments often have adverse effects on function, although data are largely from studies with younger survivors. Since only 4% of NCI-funded survivorship research specifically examines outcomes among older survivors, we know little about how the substantial heterogeneity in aging processes ("biological age") affects risk for adverse functional outcomes among those of comparable chronological age. These data are important because they could affect treatment decisions, survivorship care planning, and ability to live independently. This Outstanding Investigator Award will use a bio-behavioral framework to conduct population sciences research at the intersection of cancer and aging to fill these gaps. Data, infrastructure, and established collaborations from an extant NCI-funded older cohort will be leveraged to iteratively build new studies to test novel hypotheses. Such cohorts are the population science equivalent of a basic science laboratory used for a series of experiments. The goals of the high-risk/high-reward studies are to: physical, emotional, social and role function; 1) define long-term trajectories of decline in cognitive, determine bio-behavioral risks for decline; and examine how systemic therapy and lifestyle factors moderate these relationships; 2) conduct exploratory research on biological age markers to determine feasibility and clinical utility for predicting ris and trajectory of functional decline; 3) conduct pilot randomized trials of the impact of lifestyle interventions on biological age markers and functional outcomes; and 4) enhance long-term clinical and policy impact by incorporating data into policy modeling, engaging survivors in design and communication of results, and supporting training. This research is innovative in use of a bio-behavioral framework and inclusion of policy modeling. The findings will move the field forward by shifting the paradigms of research and care for the growing older population; determining whether biological age markers can identify survivors at greatest risk for functional declines; informing future intervention trials; and expanding the limited number of cancer and aging researchers. The PIs history of productivity and strong institutional and collaborative support will ensure that the research will have the intended impact. Overall, the unique population science perspectives of these studies will add important diversity to the multi-disciplinary approaches needed for reducing the burden of cancer in older survivors.