Mentored Patient Oriented Research in Lymphoma

项目摘要 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 并且对于癌症患者为导向的研究而言是重要的临床问题，因为它是可治愈的疾病，但是 不同的结果。尽管>58%的患者存活并在5年内通过现代化疗治愈， 免疫治疗，结果是显着恶化的患者是非洲裔美国人（AA），没有保险，或 具有活化的B细胞样（ABC）生物亚型或高国际预后指数评分的患者。 博士Flowers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，生物和社会经济因素 相互作用以影响DLBCL存活。然而，目前还没有一个统一的，全面的预测， 该系统包含这些参数。解决当前和长期未得到满足的保健需求， 在淋巴瘤患者人群中，Flowers和Cerhan博士建立了淋巴瘤流行病学结局 (LEO)队列研究（U 01 CA 195568），该研究将支持一项旨在确定新的 临床、流行病学、宿主遗传、肿瘤和治疗因素显著影响预后， 生存。LEO将：1）招募> 12，000名新诊断的淋巴瘤患者（包括1，000名AA和1，400名 西班牙裔参与者和3，700个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）Prosthesis随访患者以确定疾病进展/复发、再治疗、第二次治疗、第三次治疗和第四次治疗。 癌症，生存率和患者报告的结果;和5）促进使用此方法的研究项目 基础设施演进此外，弗劳尔斯博士将利用LEO协议和格鲁吉亚州SEER登记， 构建一个基于人群的癌症差异队列研究，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 一个微观模拟模型，将这些数据整合到DLBCL的在线预后工具中，作为决策 为患者、临床医生和其他研究者提供支持工具。弗劳尔斯博士将继续发挥他在全国的领导作用， 美国社会血液学促进多样性委员会，美国社会临床肿瘤学 健康差距委员会，并在临床研究指导计划，为灰和淋巴瘤 研究基金会，并利用这些资源，招聘，培训和发展青年教师的干部， 血液学/肿瘤学研究员，内务人员和医学生在癌症患者为导向的研究与 特别注重培养领导该领域的少数族裔调查员。

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.