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.

项目摘要/摘要 每年在美国诊断出癌症的80,000多名青少年和年轻人中，有85％ 癌症诊断后至少五年。青少年和成年初是一个关键时期 对于额叶神经发育，癌症治疗可能会破坏这种神经发育，导致 认知缺陷被称为癌症相关的认知障碍（CRCI）。这些长期估计有53％ 早期的年轻成人（YA）生存经历了CRCI，会干扰他们的工作和教育目标。然而， 使用客观神经心理学评估的稀疏研究无法检测到YA报告的CRCI 幸存者。因此，该K99/R00应用程序的目标是在创新计划中迈出第一步 使用生态有效的研究以表征CRCI的CRCI 评估。职业发展计划：总体培训目标是为Tometic博士提供其他 培训和心态成为一名高素质的独立研究者，在CRCI中具有专业知识 了解AYA癌症存活的人群。 Tometich博士的培训目标是：1）增强她的知识 AYA中的癌症和认知，2）获得认知和行为评估方法的技能，3） 发展实时纵向数据分析的水平，以及4）持续专业发展。在 K99阶段，Tometich博士将在Moffitt癌症中心的Heather Jim博士的主要心理下工作（一个 NCI指定的综合癌症中心）和Brent Small博士的会议制度。 CRCI的专家 艾雅冲浪者在全国范围内缺乏；因此，Mentalship和咨询团队将提供完整的 解决培训和研究内容的各个方面的专业知识（其他顾问是安德鲁博士 Galligan，Martin Sliwinski和Dinorah Martinez Tyson）。研究计划：本研究的目的是评估 长期CRCI使用生态有效 评估。现有的认知生态瞬时评估（EMA）已被开发和使用 我们的中年乳腺癌生存研究团队尚未应用于YA幸存。 此外，行动学可以客观地衡量CRCI的两个可修改的危险因素（体育活动和 睡觉）。在K99阶段（即目标1和2），我们将使用迭代的混合方法来量身定制EMA 基于YA的经验 报告CRCI的20个YA旁边的定性访谈。然后，我们将在25 ya中驾驶EMA和Actiography 幸存者并根据需要进行修订。在R00阶段（即AIM 3），我们将招募150名YA幸存者和150个 社区控制与性别，年龄和教育相匹配，以评估CRCI和 SBCF。影响：联合培训和研究计划将使Tometic博士定位到过渡到独立性 作为少数专门从事CRCI的癌症控制调查员之一 Aya表面。