Insights from Asian Populations into Disparities in Breast Cancer Prognosis and Outcomes

亚洲人群对乳腺癌预后和结果差异的见解

基本信息

批准号：
10413022
负责人：
Scarlett L Gomez
金额：
$ 103.15万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-08 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10413022
关键词：
Accounting Adherence Algorithms Asian Americans Asian population Automobile Driving Behavior Biological Biology Body Size Breast Cancer Patient California Cancer Biology Cancer Prognosis Cells Characteristics Chinese Clinical Cohort Studies Complementary and alternative medicine Data Dietary intake Electronic Health Record Epidemiology Ethnic Origin Ethnic group Genetic Health Promotion Health behavior Healthcare Systems Heterogeneity Immigration Immune Immune response Immunobiology Immunogenomics Immunologic Receptors Individual Japanese Knowledge Life Style Maintenance Malignant Neoplasms Mammary Neoplasms Modeling Neighborhoods Outcome Pathway interactions Patient Self-Report Patients Pattern Phenotype Plants Population Population Group Population Heterogeneity Prevalence Prognostic Factor Race Research Resources Sampling Site Social Environment Social support Socioeconomic Status Survival Rate The Cancer Genome Atlas Time Tissue Sample Tissues Translating Treatment Factor Treatment outcome Tumor Tissue Tumor-infiltrating immune cells United States Woman Women&apos s Group anti-tumor immune response base black women breast cancer diagnosis breast cancer family registry breast cancer survival cancer health disparity cancer immunobiology cancer immunotherapy cancer survival chemotherapy cohort comparison group contextual factors data registry disorder risk ethnic difference experience follow-up health care availability hormone therapy improved insight lifestyle factors malignant breast neoplasm mortality multi-ethnic neoplasm registry prognostic prognostic assays prognostic indicator protective factors racial and ethnic racial and ethnic disparities social culture tissue archive transcriptome sequencing treatment adherence tumor tumor microenvironment

项目摘要

Abstract Asian American women experience more favorable cancer survival than other US racial/ethnic groups, even after accounting for known prognostic indicators. Breast cancer, which follows this pattern, is a useful model for understanding factors contributing to this intriguing survival advantage, given that it is the most common cancer in Asian American women, and has established clinical, biological/genetic, and lifestyle prognostic factors. Thus, studying the breast cancer survival advantage in Asian American women has the potential to identify protective factors that may benefit all patients. We propose to investigate multilevel factors (health behaviors and contextual factors, clinical characteristics, treatment, and tumor immune response) in relation to overall and breast cancer-specific mortality in Asian American breast cancer cases. However, the Asian American population is heterogeneous, with lifestyle factors and disease risks (e.g., breast cancer survival rates) varying by specific ethnicity and by immigration status. Many studies have shown the importance of population disaggregation to uncovering meaningful differences among Asian American ethnic groups, but no single study to date includes adequate Asian American ethnic group population samples. To overcome this limitation, we will conduct the proposed research in integrated data and biospecimens from four established cohort studies enriched with Asian American breast cancer cases. These studies together include 4,219 Asian American patients (1,848 Chinese, 602 Japanese, 1,538 Filipinas) and 5,386 non-Latina White women with breast cancer as a comparison group. In Specific Aim 1, we will assess contributions of individual-level lifestyle and health behaviors and multilevel neighborhood social context and sociocultural factors to survival differences among the Asian American ethnic groups relative to non-Latina Whites. In Specific Aim 2, we will evaluate how specific treatment factors impact survival for 4,373 Asian Americans compared to 4,373 non- Latina Whites, taking advantage of electronic health record data from an equal-access healthcare system. In Specific Aim 3, we will characterize the immune infiltrates in the breast tumor microenvironment from 1,200 Asian American (from Aim 1) and 714 non-Latina White (from TCGA) patients using immunogenomic profiling, and to determine the associations of immune phenotypes with patient survival among Asian Americans and with exposure factors from Aim 1. Thus, using existing resources, this study will comprehensively assess factors including health behaviors and neighborhood context, lifestyle, treatment, tumor immuno-biology, and their contributions to the survival advantage in Asian American women. The proposed study makes efficient use of data from numerous breast cancer studies to gain insight for strategies that may advance knowledge about the management of breast cancer for all women.

抽象的亚裔美国女性比其他美国种族/族裔群体的癌症生存率更高，甚至在考虑了已知的预后指标后。遵循这种模式的乳腺癌是一个有用的模型了解促成这种有趣的生存优势的因素，因为它是最常见的亚裔美国女性的癌症，并已建立临床、生物/遗传和生活方式预后因素。因此，研究亚裔美国女性的乳腺癌生存优势有可能确定可能使所有患者受益的保护因素。我们建议调查多层次因素（健康行为和背景因素、临床特征、治疗和肿瘤免疫反应）亚裔美国乳腺癌病例的总体死亡率和乳腺癌特异性死亡率。然而，亚洲美国人口具有异质性，受生活方式因素和疾病风险（例如乳腺癌生存率）的影响率）因特定种族和移民身份而异。许多研究表明了重要性人口分类以揭示亚裔美国族群之间有意义的差异，但没有迄今为止的一项研究包括足够的亚裔美国人群体人口样本。为了克服这个限制，我们将在四个已建立的综合数据和生物样本中进行拟议的研究队列研究丰富了亚裔美国人乳腺癌病例。这些研究总共包括 4,219 名亚洲人美国患者（1,848 名中国人、602 名日本人、1,538 名菲律宾人）和 5,386 名非拉丁裔白人女性患有乳腺癌作为对照组。在具体目标 1 中，我们将评估个人生活方式的贡献健康行为以及多层次邻里社会背景和社会文化因素对生存的影响亚裔美国人与非拉丁裔白人之间的差异。在具体目标 2 中，我们将评估特定治疗因素如何影响 4,373 名亚裔美国人与 4,373 名非亚裔美国人的生存率拉丁裔白人利用平等医疗保健系统的电子健康记录数据。在具体目标 3，我们将表征 1,200 个乳腺肿瘤微环境中的免疫浸润使用免疫基因组分析对亚裔美国人（来自目标 1）和 714 名非拉丁白人（来自 TCGA）患者进行分析，并确定亚裔美国人和亚裔患者免疫表型与患者生存率的关系与目标 1 中的暴露因素。因此，利用现有资源，本研究将全面评估因素包括健康行为和邻里环境、生活方式、治疗、肿瘤免疫生物学以及她们对亚裔美国女性生存优势的贡献。拟议的研究使有效使用大量乳腺癌研究的数据来深入了解可能推进知识的策略关于所有女性乳腺癌的管理。