Cancer-related cognitive impairment: Real-time evaluation and assessment of long-term impact of treatment on young adult survivors (CRCI REALITY)

癌症相关认知障碍：实时评估和评估治疗对年轻成年幸存者的长期影响（CRCI REALITY）

• 批准号: 10427965
• 负责人: Danielle Tometich
• 金额: $ 11万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10427965
• 关键词: Acute; Address; Adherence; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Advisory Committees; Affect; Age; Attention; Behavior Therapy; Behavior assessment; Behavioral; Brain region; Breast Cancer survivor; Cancer Center; Cancer Control; Cancer Survivor; Case-Control Studies; Cognition; Cognitive; Cognitive deficits; Communities; Comprehensive Cancer Center; Controlled Environment; Cross-Sectional Studies; Data; Data Analyses; Dementia; Depressed mood; Development; Development Plans; Diagnosis; Ecological momentary assessment; Education; Evaluation; Executive Dysfunction; Exposure to; Fatigue; Future; Gender; Goals; Impaired cognition; Informal Social Control; Intervention; Interview; Knowledge; Life; Literature; Long-Term Survivors; Low Prevalence; Malignant Neoplasms; Measures; Memory; Mentorship; Methodology; Methods; Neuropsychological Tests; Neuropsychology; Occupational; Occupations; Participant; Patient Self-Report; Personal Satisfaction; Phase; Physical activity; Population; Positioning Attribute; Prevalence; Problem Solving; Procedures; Prospective Studies; Puberty; Quality of life; Recording of previous events; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Schools; Short-Term Memory; Sleep; Sleep disturbances; Stress; Surveys; Survivors; Time; Training; Traumatic Brain Injury; United States; Vulnerable Populations; Work; Wrist; acceptability and feasibility; actigraphy; base; cancer diagnosis; cancer therapy; cancer-related cognitive impairment; career development; cognitive function; cognitive performance; cognitive testing; critical period; design; experience; high school; improved; innovation; middle age; modifiable risk; neurodevelopment; neurotoxic; neurotoxicity; physical symptom; programs; psychological symptom; recruit; skills; survivorship; young adult

Project Summary/Abstract Of over 80,000 adolescents and young adults (AYA) diagnosed with cancer in the United States each year, 85% live for at least five years after their cancer diagnosis. Adolescence and early young adulthood is a critical period for frontal neurodevelopment, and cancer treatments potentially disrupt this neurodevelopment, leading to cognitive deficits known as cancer-related cognitive impairment (CRCI). An estimated 53% of these long-term early young adult (YA) survivors experience CRCI that interferes with their work and educational goals. However, sparse research using objective neuropsychological assessment does not detect CRCI as reported by YA survivors. Therefore, the goal of this K99/R00 application is to take the first step in an innovative program of research to characterize CRCI among this vulnerable survivorship population using ecologically valid assessments. Career Development Plan: The overall training objective is to provide Dr. Tometich with additional training and mentorship to become a highly qualified independent investigator with expertise in CRCI in the understudied population of AYA cancer survivors. Dr. Tometich’s training goals are to: 1) enhance her knowledge of cancer and cognition in AYAs, 2) acquire skills in cognitive and behavioral assessment methodologies, 3) develop proficiency in real-time longitudinal data analysis, and 4) continue professional development. During the K99 phase, Dr. Tometich will work under the primary mentorship of Dr. Heather Jim at Moffitt Cancer Center (an NCI-designated comprehensive cancer center) and co-mentorship of Dr. Brent Small. Experts in CRCI among AYA survivors are lacking nationally; therefore, a mentorship and advisory team will provide complementary expertise to address each aspect of the training and research content (additional advisors are Drs. Andrew Galligan, Martin Sliwinski, and Dinorah Martinez Tyson). Research Plan: The goal of this study is to evaluate long-term CRCI and potentially modifiable risk factors in YA survivors (i.e., age 18-30) using ecologically valid assessments. An existing cognitive ecological momentary assessment (EMA) has been developed and used by our research team in middle-aged breast cancer survivors, but it has not yet been applied in YA survivors. Furthermore, actigraphy can objectively measure two modifiable risk factors for CRCI (physical activity and sleep). In the K99 phase (i.e., Aims 1 and 2), we will use an iterative mixed-methods approach to tailor an EMA of CRCI and situational, behavioral, and contextual risk factors (SBCF) to the experience of YAs based on qualitative interviews with 20 YA survivors who report CRCI. We will then pilot the EMA and actigraphy in 25 YA survivors and make revisions as needed. In the R00 phase (i.e., Aim 3), we will recruit 150 YA survivors and 150 community controls matched on gender, age, and education for a cross-sectional study to evaluate CRCI and SBCF. Impact: The combined training and research plan will position Dr. Tometich to transition to independence as one of the few cancer control investigators specializing in CRCI in the vulnerable and unique population of AYA survivors.

项目概要/摘要 在美国，每年有超过 80,000 名青少年和年轻人 (AYA) 被诊断患有癌症，其中 85% 癌症诊断后至少存活五年是关键时期。 额神经发育，癌症治疗可能会破坏这种神经发育，导致 据估计，其中 53% 存在长期认知缺陷，称为癌症相关认知障碍 (CRCI)。 早期年轻成人 (YA) 幸存者会经历 CRCI，这会干扰他们的工作和教育目标。 YA 报告称，使用客观神经心理学评估的稀疏研究并未检测到 CRCI 因此，K99/R00 应用程序的目标是迈出创新计划的第一步。 研究利用生态有效的方法来描述这一弱势幸存者群体中的 CRCI 特征 职业发展计划：总体培训目标是为托梅蒂奇博士提供额外的帮助。 培训和指导，成为一名具有 CRCI 专业知识的高素质独立调查员 Tometich 博士的培训目标是：1) 增强她的知识。 AYA 中癌症和认知的研究，2) 获得认知和行为评估方法的技能，3) 提高实时纵向数据分析的能力，以及 4) 继续专业发展。 K99 阶段，Tometich 博士将在莫菲特癌症中心 (Moffitt Cancer Center) Heather Jim 博士的主要指导下工作。 NCI 指定的综合癌症中心）以及 CRCI 专家 Brent Small 博士的共同指导。 全国范围内缺乏 AYA 幸存者；因此，指导和咨询团队将提供补充。 解决培训和研究内容各个方面的专业知识（额外顾问是安德鲁博士 Galligan、Martin Sliwinski 和 Dinorah Martinez Tyson 研究计划：本研究的目的是评估。 使用生态有效的方法对 YA 幸存者（即 18-30 岁）进行长期 CRCI 和潜在可改变的风险因素 现有的认知生态瞬时评估（EMA）已被开发并使用。 我们的研究团队在中年乳腺癌幸存者中进行了研究，但尚未应用于 YA 幸存者。 此外，体动记录仪可以客观地测量 CRCI 的两个可改变的风险因素（体力活动和 在 K99 阶段（即目标 1 和 2），我们将使用迭代混合方法来定制 EMA。 CRCI 和情境、行为和背景风险因素 (SBCF) 与 YA 经验的比较 对报告 CRCI 的 20 名青少年年幸存者进行定性访谈，然后我们将在 25 名青少年年试行 EMA 和体动记录仪。 在R00阶段（即目标3），我们将招募150名YA幸存者和150名幸存者。 社区控制与性别、年龄和教育程度相匹配，进行横断面研究，以评估 CRCI 和 SBCF。影响：联合培训和研究计划将使托梅蒂奇博士过渡到独立 作为少数专门针对弱势和独特人群进行 CRCI 的癌症控制研究人员之一 阿雅幸存者。