Chronic Kidney Disease Development in Cancer Treatment and Survival

慢性肾病在癌症治疗和生存中的发展

基本信息

批准号：
10289430
负责人：
Deirdre Hill
金额：
$ 38.95万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-16 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10289430
关键词：
Acute Renal Failure with Renal Papillary Necrosis Address Adult Affect Aftercare Antineoplastic Agents Antineoplastic Protocols Awareness Cancer Patient Carboplatin Chemotherapy-Oncologic Procedure Chronic Kidney Failure Cisplatin Clinical Colorectal Cancer Data Data Set Development Diabetes Mellitus Diagnosis Disease Progression Dose-Limiting End stage renal failure Ensure Etiology Etoposide Frequencies Goals Health Heart Diseases Incidence Individual Kidney Diseases Link Literature Longterm Follow-up Malignant Neoplasms Malignant neoplasm of lung Medicare Modeling Monitor National Cancer Institute Nephrology Oncologist Oncology Outcome Patients Prognosis Publishing Regimen Renal carcinoma Risk Risk Factors SEER Program Time Treatment Protocols United States cancer diagnosis cancer risk cancer survival cancer therapy capecitabine chemotherapy clinically relevant colorectal cancer treatment comorbidity disorder risk effective therapy evidence base experience high body mass index insight interest irinotecan mortality nephrotoxicity personalized medicine population based side effect

项目摘要

Project Summary/Abstract Chronic kidney disease (CKD), defined as Stages 3-5, including end stage renal disease (ESRD)) at the time of cancer diagnosis is believed to influence cancer outcomes, but the base of evidence for such effects is limited. We seek in this proposal to extend the understanding of CKD as a risk factor for cancer mortality, and to quantify the development of incident CKD in patients treated with specific potentially nephrotoxic cancer regimens. In particular, cisplatin, carboplatin, capecitabine, irinotecan, and etoposide are components of standard cancer treatment protocols, and treated individuals have had an increased CKD risk in some cancers, but the risk following standard lung or colorectal cancer treatment is unknown. Approximately 15% of adults in the United States are estimated to be affected with CKD as of 2020. There is a pressing need to understand the risks of CKD incidence, progression and mortality in the setting of cancer treatment. We will utilize a large, population-based dataset, that of the Surveillance Epidemiology End Results (SEER) program of the National Cancer Institute, linked to Medicare (SEER-Medicare), to address question of import to prognosis in both CKD and cancer. Surprisingly little of the existing literature concerns long-term follow-up. Such evidence could be crucial to reduce nephrotoxicity, acute kidney injury, and ensure that dose-limiting side effects of antineoplastic agents do not prevent effective therapy of the cancer of interest. We will analyze claims data to evaluate whether those with CKD are at greater risk of cancer or CKD-related mortality after cancer treatment, and whether particular therapies might increase the risk of CKD incidence. These analyses should greatly heighten awareness of CKD at diagnosis and that which develops during therapy, leading to additional monitoring, personalized therapy, and potential survival benefits for patients with cancer and CKD alike.

项目概要/摘要慢性肾病 (CKD)，定义为 3-5 期，包括终末期肾病 (ESRD)) 在癌症诊断时被认为会影响癌症结果，但基础此类影响的证据有限。我们在本提案中寻求扩大对以下方面的理解： CKD 作为癌症死亡的危险因素，并量化 CKD 事件的发展接受特定潜在肾毒性癌症治疗方案治疗的患者。特别是顺铂、卡铂、卡培他滨、伊立替康和依托泊苷是标准癌症的组成部分治疗方案以及接受治疗的个体在某些癌症中的 CKD 风险增加，但标准肺癌或结直肠癌治疗后的风险尚不清楚。大约截至 2020 年，美国估计有 15% 的成年人受到 CKD 的影响。迫切需要了解该环境下 CKD 发病、进展和死亡率的风险的癌症治疗。我们将利用一个基于人口的大型数据集，即监视数据集美国国家癌症研究所的流行病学最终结果 (SEER) 计划与 Medicare 相关 (SEER-Medicare)，解决 CKD 和癌症预后的重要问题。令人惊讶的是，现有文献很少涉及长期随访。这样的证据可以是对于减少肾毒性、急性肾损伤并确保剂量限制性副作用至关重要抗肿瘤药物不会阻止目标癌症的有效治疗。我们将分析索赔数据用于评估 CKD 患者是否面临更高的癌症风险或 CKD 相关风险癌症治疗后的死亡率，以及特定疗法是否可能增加 CKD 的风险发生率。这些分析应大大提高诊断时对 CKD 的认识，并且它在治疗过程中发展，导致额外的监测、个性化治疗和对于癌症和 CKD 患者来说，这具有潜在的生存益处。