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，早期检测的更多使用，治疗的进步和寿命的延长，我们正在经历癌症风险或癌症患者数量的前所未有的增长。到2030年，4500万新发病例中的近50%和2000万癌症幸存者中的75%将年龄在60岁或以上（“老年人”）。这些老年幸存者中的大多数对系统治疗感兴趣并将从中受益。然而，这些治疗往往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%的国家癌症研究所资助的生存研究专门研究老年幸存者的结果，我们知道很少的老化过程中的实质性异质性（“生物年龄”）如何影响不良功能结果的风险之间的可比实足年龄。这些数据很重要，因为它们可能影响治疗决策，生存护理计划和独立生活的能力。该杰出研究者奖将使用生物行为框架在癌症和衰老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， 和现有的国家癌症研究所资助的老年队列建立的合作将被用来迭代建立新的研究，以测试新的假设。这些群体在人口科学中相当于一个基础科学实验室，用于进行一系列实验。高风险/高回报研究的目标是：身体、情感、社会和角色功能; 1）定义长期的 认知能力下降的轨迹，确定下降的生物行为风险;并检查系统治疗和生活方式因素如何调节这些关系; 2）对生物年龄标记进行探索性研究，以确定预测RIS和功能下降轨迹的可行性和临床效用; 3）对生活方式的影响进行试点随机试验 对生物年龄标志物和功能结果的干预;以及4）通过将数据纳入政策建模，让幸存者参与设计和结果交流以及支持培训，增强长期临床和政策影响。本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。这些发现将通过改变研究和护理日益增长的老年人口的范式来推动该领域的发展;确定生物年龄标志物是否可以识别功能下降风险最大的幸存者;为未来的干预试验提供信息;以及扩大癌症和衰老研究人员的数量。PI的生产力历史和强大的机构和协作支持将确保研究产生预期的影响。总体而言，这些研究独特的人口科学视角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.