Mentored Patient Oriented Research in Lymphoma

项目总结 弥漫性大B细胞淋巴瘤(DLBCL)是美国最常见的淋巴瘤，每年影响约22,000人 对于以癌症患者为导向的研究来说，这是一个重大的临床问题，因为它是一种可以治愈的疾病，但 结果各不相同。尽管58%的患者仍活着，并在5年内用现代化疗治愈. 免疫治疗，对于非裔美国人(AA)、未参保或 那些激活了B细胞样细胞(ABC)生物学亚型或国际预后指数评分较高的患者。 弗劳尔斯博士描述了DLBCL生物学亚型的患者结局，确定了种族和 DLBCL的社会经济差异，并模拟了种族/民族、生物学和社会经济因素 相互作用影响DLBCL的存活率。然而，目前还没有统一的、全面的预测。 包含这些参数的系统。为了解决当前和长期未得到满足的卫生需求， 淋巴瘤患者群体，Flowers和Cerhan博士建立了淋巴瘤流行病学结局 (LEO)队列研究(U01CA195568)，这将支持旨在识别小说的广泛研究议程 临床、流行病学、宿主遗传、肿瘤和治疗因素显著影响预后和 生存能力。Leo将：1)招募12,000名新诊断的淋巴瘤患者(包括1,000名再生障碍性贫血和1,400名 拉美裔参与者和3,700名DLBCL)；2)用提取的肿瘤DNA和RNA建立组织库， 外周血DNA、血清和血浆；3)对所有病例进行临床、流行病学、病理学和 治疗数据；4)前瞻性跟踪患者以确定疾病进展/复发、再次治疗、第二 癌症、存活率和患者报告的结果；以及5)促进使用这一点的研究项目 基础设施。此外，Flowers博士将利用LEO协议和佐治亚州SEER注册来 构建一项基于人群的癌症差异队列研究，该研究将：1)检查 DLBCL基因组学，ABC亚型，种族，表现模式，治疗和生存；2)开发计算机 微模拟模型，将这些数据合并到DLBCL的在线预测工具中作为决策 患者、临床医生和其他研究人员的支持工具。弗劳尔斯博士将在他的国家领导地位的基础上 美国临床肿瘤学协会促进多样性血液学委员会 健康差异委员会，以及ASH和淋巴瘤的临床研究指导计划 研究基金会，利用这些资源来招聘，培养和发展一支初级教职干部， 血液学/肿瘤学研究员、家政人员和医学生，从事以癌症患者为导向的研究 特别注重培养将领导该领域的少数族裔调查人员。

PROJECT SUMMARY Diffuse large B-cell lymphoma (DLBCL), the most common lymphoma in the US, affects ~22,000 people/year and is a significant clinical problem for cancer patient-oriented research in that it is a curable disease, but one with heterogeneous outcomes. Despite >58% of patients being alive and cured at 5 years with modern chemo- immunotherapy, outcomes are significantly worse for patients who are African American (AA), uninsured, or those who have activated B-cell-like (ABC) biological subtype or a high international prognostic index score. Dr. Flowers has described patient outcomes for biological subtypes of DLBCL, identified racial and socioeconomic disparities in DLBCL, and modeled how race/ethnicity, biological, and socioeconomic factors interact to influence DLBCL survival. However, at present there is no unifying, comprehensive prognostic system that incorporates these parameters. To address the current and long-term unmet health needs of the lymphoma patient population, Drs. Flowers and Cerhan established the Lymphoma Epidemiology of Outcomes (LEO) cohort study (U01CA195568), which will support a broad research agenda aimed at identifying novel clinical, epidemiologic, host genetic, tumor, and treatment factors that significantly influence prognosis and survivorship. LEO will: 1) Recruit >12,000 newly diagnosed lymphoma patients (including 1,000 AA and 1,400 Hispanic participants and 3,700 DLBCLs); 2) Build a tissue bank with extracted tumor DNA and RNA, peripheral blood DNA, serum and plasma; 3) Annotate all cases with clinical, epidemiologic, pathology, and treatment data; 4) Prospectively follow patients to ascertain disease progression/relapse, retreatment, second cancers, survival, and patient-reported outcomes; and 5) Facilitate research projects that use this infrastructure. In addition, Dr. Flowers will utilize LEO protocols and the Georgia state SEER registry to construct a population-based cancer disparities cohort study that will: 1) examine the relationships between DLBCL genomics, ABC subtype, race, pattern of presentation, treatment and survival; 2) develop a computer micro-simulation model that incorporates these data into an online prognostic tool for DLBCL as a decision support tool for patients, clinicians, and other investigators. Dr. Flowers will build on his national leadership on the American Society Hematology Committee on Promoting Diversity, American Society Clinical Oncology Health Disparities Committee, and in clinical research mentorship programs for ASH and the Lymphoma Research Foundation and utilize these resources to recruit, train, and develop a cadre of junior faculty, hematology/oncology fellows, housestaff, and medical students in cancer patient-oriented research with a particular focus on developing minority investigators who will lead the field.