The Influence of Diet and Lifestyle on Patients with Advanced Colorectal Cancer

饮食和生活方式对晚期结直肠癌患者的影响

基本信息

批准号：
8096702
负责人：
JEFFREY A MEYERHARDT
金额：
$ 50.67万
依托单位：
DANA-FARBER CANCER INST
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8096702
关键词：
Address Area Aspirin Blood specimen Body mass index C-Peptide Cancer Biology Cancer Patient Cancer and Leukemia Group B Cardiovascular system Cetuximab Characteristics Colon Carcinoma Colorectal Cancer Combination Drug Therapy Comorbidity Data Databases Development Diagnosis Diet Dietary Intervention Disease Epidemiology Epidermal Growth Factor Receptor Future Glycemic Index Health Personnel Human Insulin Insulin-Like Growth Factor Binding Protein 3 Insulin-Like Growth Factor I Integration Host Factors Knowledge Lead Leptin Life Life Style Malignant Neoplasms Molecular Mutate NIH Program Announcements National Cancer Institute Neoplasm Metastasis Newly Diagnosed Non-Steroidal Anti-Inflammatory Agents Obesity Outcome Paraffin Embedding Pathway interactions Patients Pattern Performance Status Pharmaceutical Preparations Physical activity Plasma Proteins Proto-Oncogene Proteins c-akt Recommendation Research Residual state Risk Specimen Staging Time Toxic effect Vitamin D Vitamin D3 Receptor adiponectin angiogenesis bevacizumab celecoxib chemotherapy cohort cyclooxygenase 2 density disease characteristic energy balance experience follow-up improved indexing lifestyle factors lifestyle intervention metastatic colorectal mortality outcome forecast overexpression pre-clinical prevent prospective public health relevance randomized trial response tumor tumor growth tumor progression

项目摘要

DESCRIPTION (provided by applicant): Epidemiologic and scientific research indicates that diet and other lifestyle factors have a significant influence on the risk of developing colorectal cancer. Emerging data suggest some of these factors impact on the outcomes of patients with early stage colon cancer. However, there are no data on the influence of diet, lifestyle and other host factors on the outcomes of patients with more advanced colorectal cancer. At the time of initial diagnosis, 20% of colorectal cancer patients have evidence of metastases and another 15- 20% will recur with metastatic disease within a few years of initial diagnosis. In the past 10 years, there have been substantial improvements in chemotherapy options for these patients, with median survival exceeding 2 years and increasing number of patients living 4 or more years. Patients often seek to understand what, if any, diet and lifestyle will improve their outcomes, both survival and tolerability of therapy. Moreover, how diet and lifestyle influence prognosis may depend, in part, on molecular characteristics of the tumor. In response to a NIH Program Announcement, PA-09-148, "Studies of Energy Balance and Cancer in Humans," we propose to address these gaps in knowledge by utilizing data from 2 National Cancer Institute-sponsored chemotherapy trials in newly diagnosed patients with stage IV colorectal cancer (CALGB 80203 and 80405) which provide a) prospective assessments of diet, medication, lifestyle and comorbidities; b) paraffin-embedded tumor specimens to examine how such factors interact with specific molecular alterations; c) blood samples for research purposes; and d) comprehensive data on cancer progression, mortality, and chemotherapy-related toxicity. Since stage, performance status, use of combination chemotherapy and follow-up were carefully defined in this trial, residual confounding by disease characteristics and use of chemotherapy should be minimized. This database will provide the unique opportunity to examine the influence of energy balance (Aim 1), diet and vitamin D (Aim 2) and aspirin/NSAIDs (Aim 3) on the outcomes of patients with advanced colorectal cancer. Beyond the aforementioned hypotheses, this cohort will allow for the rapid examination of future hypotheses as they emerge. Ultimately, this database will permit us to ascertain the influence of numerous factors on colorectal cancer survival, improve our understanding of colorectal cancer biology, and potentially offer substantive diet and lifestyle recommendations for patients and health care providers. PUBLIC HEALTH RELEVANCE: Patients with cancer often seek information of diet and lifestyle as part of their therapy. Data generated from this application will help understand whether such factors influence the outcomes of patients. These data may influence treatment recommendations to future patients or lead to the development of a randomized trial to further knowledge in this area.

描述（由申请人提供）：流行病学和科学研究表明，饮食和其他生活方式因素对患结直肠癌的风险有重大影响。新兴数据表明，其中一些因素会影响早期结肠癌患者的结局。但是，没有关于饮食，生活方式和其他宿主因素对更晚期结直肠癌患者结果的影响的数据。在最初诊断时，有20％的大肠癌患者有转移的证据，另外15-20％的患者将在初次诊断的几年内复发转移性疾病。在过去的10年中，这些患者的化学疗法选择有了很大的改善，中位生存期超过2年，居住4年或更长时间的患者人数增加。患者经常寻求了解饮食和生活方式会改善其效果，包括治疗的生存和耐受性。此外，饮食和生活方式如何影响预后可能部分取决于肿瘤的分子特征。为了响应NIH计划公告，PA-09-148“人类能量平衡与癌症的研究”，我们建议通过利用来自新诊断的2例国家癌症研究所赞助的化学疗法试验的数据来解决知识中的这些差距IV期结直肠癌（CALGB 80203和80405）提供a）对饮食，药物，生活方式和合并症的前瞻性评估； b）石蜡包裹的肿瘤标本，以检查这些因素如何与特定的分子改变相互作用； c）用于研究目的的血液样本； d）有关癌症进展，死亡率和与化学疗法有关的毒性的综合数据。自阶段以来，在本试验中仔细地定义了性能状况，使用组合化疗和随访，因此应最小化疾病特征和使用化疗的混淆。该数据库将提供独特的机会来检查能量平衡（AIM 1），饮食和维生素D（AIM 2）和阿司匹林/NSAID（AIM 3）对晚期结直肠癌患者的结果。除了上述假设之外，该队列还可以快速检查未来的假设。最终，该数据库将使我们能够确定众多因素对大肠癌生存的影响，提高我们对大肠癌生物学的理解，并可能为患者和医疗保健提供者提供实质性饮食和生活方式建议。公共卫生相关性：癌症患者通常寻求饮食和生活方式的信息，作为其治疗的一部分。该应用程序产生的数据将有助于了解此类因素是否影响患者的结果。这些数据可能会影响对未来患者的治疗建议，或者导致在该领域的进一步知识中发展随机试验。