Biobehavioral predictors of fatigue in newly-diagnosed breast cancer patients

新诊断乳腺癌患者疲劳的生物行为预测因子

• 批准号: 8481524
• 负责人: JULIENNE E BOWER
• 金额: $ 59.13万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-05 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8481524
• 关键词: Adjuvant Chemotherapy; Adverse effects; Aftercare; Behavior Therapy; Behavioral; Biologic Characteristic; Biological; Blood; Body mass index; Breast Cancer Treatment; Cancer Patient; Cancer Survivor; Cytokine Gene; Detection; Development; Diagnosis; Diagnostic; Distress; Early identification; Education; Ethnic group; Evaluation; Fatigue; Future; Gene Mutation; Genes; Genetic; Genetic Polymorphism; Glucocorticoids; Goals; Hydrocortisone; IL6 gene; Inflammation; Inflammatory; Interleukin-1; Intervention; Interview; Life; Life Stress; Long Term Survivorship; Longitudinal Studies; Malignant Neoplasms; Measures; Mediating; Mental Depression; Newly Diagnosed; Operative Surgical Procedures; Participant; Patient Self-Report; Patients; Prevalence; Process; Promoter Regions; Prospective Studies; Psychosocial Factor; Quality of life; Questionnaires; Radiation; Radiation therapy; Recording of previous events; Recruitment Activity; Reporting; Research; Research Design; Risk; Risk Factors; Saliva; Sampling; Signal Transduction; Single Nucleotide Polymorphism; Staging; Survival Rate; Symptoms; TNF gene; Trastuzumab; United States; Woman; base; biobehavior; cancer prevention; cancer therapy; chemotherapy; clinical practice; cytokine; experience; follow-up; hormone therapy; hypothalamic-pituitary-adrenal axis; inflammatory marker; malignant breast neoplasm; prevent; prospective; psychologic; psychosocial; therapy development; tumor

DESCRIPTION (provided by applicant): Fatigue is one of the most common and distressing side effects of breast cancer treatment and may persist for months or years after successful treatment completion. Approximately one-third of breast cancer survivors report moderate to severe symptoms of fatigue, which has a negative impact on all aspects of quality of life. Although the prevalence and impact of cancer-related fatigue has now been well established, very little is known about predictors and mechanisms for the development and persistence of fatigue post-treatment. Accordingly, the primary goal of this prospective, longitudinal study is to identify biological and psychological risk factors for post-treatment fatigue, with intensive evaluation of mechanisms, in women newly diagnosed with early stage breast cancer. In particular, this application focuses on vulnerability factors that increase risk for inflammatory processes given evidence suggesting an inflammatory basis for cancer-related fatigue. Specific aims are to: 1) determine whether inflammatory risk genes, hypothalamic-pituitary-adrenal axis dysregulation, and body mass index at treatment onset predict post-treatment fatigue in breast cancer patients assessed longitudinally for 18 months after treatment completion; 2) evaluate whether history of depression and early life stress at treatment onset predict post-treatment fatigue in breast cancer patients assessed longitudinally for 18 months after treatment onset; 3) investigate the contribution of measured proinflammatory cytokine activity to the association between biological and psychological risk factors and post-treatment fatigue. We will recruit 360 women with newly-diagnosed, early-stage breast cancer before initiation of treatment with radiation, chemotherapy, trastuzumab or endocrine therapy. At baseline, participants will complete self-report questionnaires, diagnostic interview for depression, blood draw for cytokine gene polymorphisms and markers of inflammation, and saliva samples for diurnal cortisol slope. Follow-up assessments conducted at treatment completion and at 6, 12, and 18 months post-treatment will determine the trajectory of post-treatment fatigue and associated changes in inflammatory processes. This research is a critical next step in the early identification of patients who are at risk for persistent fatigue as a long term side effect of cancer treatment and for the development and implementation of targeted interventions to prevent and treat this disabling symptom.

描述（由申请人提供）：疲劳是乳腺癌治疗的最常见和令人痛苦的副作用之一，成功完成治疗后可能会持续数月或数年。大约三分之一的乳腺癌幸存者报告了疲劳的中度至重度症状，这对生活质量的各个方面都有负面影响。尽管现在已经确定了与癌症相关的疲劳的患病率和影响，但对于疲劳后治疗的发展和持久性的预测因素和机制知之甚少。因此，这项前瞻性，纵向研究的主要目标是确定治疗后疲劳的生物学和心理危险因素，并对新诊断为早期乳腺癌的妇女进行大量评估。特别是，该应用集中于增加炎症过程风险的脆弱性因素，这表明证据表明与癌症相关的疲劳有炎症基础。具体目的是：1）确定炎症风险基因，下丘脑 - 垂体 - 肾上腺轴失调和治疗时的体重指数是否预测乳腺癌患者的治疗后疲劳在治疗完成后纵向评估了18个月； 2）评估治疗发作时抑郁症和早期生活压力的病史是否可以预测乳腺癌患者的治疗后疲劳，在治疗发作后纵向评估了18个月； 3）研究测得的促炎细胞因子活性对生物学和心理危险因素与治疗后疲劳之间关联的贡献。我们将招募360名患有新诊断的，早期乳腺癌的女性，然后再进行放疗，化学疗法，曲妥珠单抗或内分泌治疗。在基线时，参与者将完成自我报告问卷，抑郁症的诊断访谈，细胞因子基因多态性和炎症标志物以及昼夜皮质醇斜率的唾液样本。治疗完成时进行的随访评估，治疗后6、12和18个月将决定治疗后疲劳的轨迹以及炎症过程的相关变化。这项研究是早期确定有持续疲劳风险的患者的重要下一步，是癌症治疗的长期副作用，以及开发和实施有针对性的干预措施以预防和治疗这种残疾症状。