HIV's Effects on Breast Cancer Treatment and Outcomes in South Africa

艾滋病毒对南非乳腺癌治疗和结果的影响

基本信息

批准号：
9107412
负责人：
JUDITH S JACOBSON
金额：
$ 34.48万
依托单位：
WITS HEALTH CONSORTIUM (PTY), LTD
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-15 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9107412
关键词：
Academic Medical Centers Accounting Acquired Immunodeficiency Syndrome Address Adherence Adverse effects Africa Africa South of the Sahara African American Age Age of Onset Anti-Retroviral Agents Biological Assay Biological Markers Breast Breast Cancer Patient Breast Cancer Treatment CD4 Lymphocyte Count Cancer Control Cancer Etiology Cancer Patient Case Series Catchment Area Cells Cessation of life Characteristics Chronic Disease Clinic Clinical Collaborations Data Data Analyses Databases Developed Countries Development Diagnosis Diagnostic Diagnostic Neoplasm Staging Disease Disease-Free Survival Epithelial Estrogen receptor negative Female Future Gene Expression Genomics HIV Health High Prevalence Hospitals Human immunodeficiency virus test Immune Incidence Individual Institution International Agency for Research on Cancer Lead Letters Malignant Neoplasms Molecular Profiling Network-based Newly Diagnosed Oncologist Patients Phenotype Population Prevalence Prognostic Factor Prospective Studies Psychosocial Factor Publications Recruitment Activity Reporting Reproductive Behavior Research Research Personnel Resources Retrospective Studies Risk Rural Schedule Site South Africa South African Stage at Diagnosis Staging Surgeon Survival Rate Technology Testing Time Toxic effect Treatment outcome Tumor Biology Tumor stage Uganda Universities Viral Load result Virus Diseases Wit Woman Work age related antiretroviral therapy breast cancer diagnosis breast cancer survival cancer diagnosis cancer therapy compliance behavior data sharing evidence based guidelines experience follow-up improved insight lifestyle factors mHealth malignant breast neoplasm meetings mortality nano-string neoplasm registry outcome forecast patient subsets programs receptor socioeconomics therapy adherence tumor

项目摘要

DESCRIPTION (provided by applicant): As antiretroviral therapy (ART) improves survival among HIV-infected individuals, they become susceptible to the diseases of middle and older ages, including epithelial malignancies. In sub-Saharan Africa, where HIV prevalence approaches 20%, breast cancer has become the most common malignancy and cause of cancer-related death among women. Few studies have addressed the effects of HIV infection and ART on the clinical presentation, treatment, and prognosis of breast cancer. We propose to investigate those effects amongst women in South Africa. We plan to compare HIV-infected and -uninfected breast cancer patients with respect to the presentation (including stage) of the cancer, tolerance and toxicity of treatment, and ultimately survival, taking ART and other prognostic factors into account. In our prior work, we studied demographic and clinical characteristics of 1200 breast cancer patients, of whom 18% were HIV+, diagnosed between 2007 and 2012 at the Chris Hani Baragwanath Academic Hospital Breast Clinic (CHBBC) located in Soweto, Johannesburg. This collaborative research program involving University of the Witwatersrand (Wits), Columbia University Medical Center (CUMC) and International Agency for Research on Cancer (IARC) partners has yielded 3 publications to date (the Wits contact PI and PD are former CUMC D43 trainees). We are now adding to our collaboration breast surgeons and oncologists at 5 other South African urban, peri-urban, and rural academic hospital centers where 3000 subjects will be recruited and followed for treatment and survival. Biomarkers relevant to HIV and aggressive tumor biology will be studied in a subset of patients using the PAM50 genomic assay on the NanoString Counter Platform. The Consortium constitutes a pan-South African network and base for further research on HIV and breast (and other) cancers. The CUMC collaborators will continue to provide guidance, especially for new investigators in the Consortium. Senior biostatisticians from Wits and CUMC will develop and guide the data analysis plan. Experienced CHBBC database developers in collaboration with our IARC consultant and m-Health Mobenzi platform developer in South Africa will integrate the standardized data collected from real-time m-Health technologies with existing databases at the 6 hospital sites to enable access-controlled data sharing. Two Wits PIs and the CUMC PI will lead the Consortium and meet on a regular schedule as will other senior investigators, as detailed in the proposal. Letters confirming enthusiastic participation and of support from Wits, the U KwaZulu- Natal, U Cape Town IARC and CANSA South Africa are attached.

描述（由申请人提供）：随着抗逆转录病毒疗法（ART）提高了 HIV 感染者的生存率，他们变得容易患上中老年疾病，包括上皮恶性肿瘤。在撒哈拉以南非洲地区，HIV 感染率接近 20%，乳腺癌已成为女性中最常见的恶性肿瘤和癌症相关死亡的原因，很少有研究探讨艾滋病毒感染和抗逆转录病毒治疗对乳腺癌临床表现、治疗和预后的影响。我们计划对南非女性的癌症表现（包括分期）、耐受性和治疗毒性以及最终生存情况进行比较。考虑到 ART 和其他预后因素，在我们之前的工作中，我们研究了 2007 年至 2012 年间在 Chris Hani 诊断的 1200 名乳腺癌患者的人口统计和临床特征，其中 18% 为 HIV 阳性。 Baragwanath 学术医院乳腺诊所 (CHBBC) 位于约翰内斯堡索韦托。该合作研究项目涉及威特沃特斯兰德大学 (Wits)、哥伦比亚大学医学中心 (CUMC) 和国际癌症研究机构 (IARC) 合作伙伴，已发表 3 篇出版物。日期（Wits 联系人 PI 和 PD 是前 CUMC D43 实习生）我们现在正在与南非其他 5 个城市的乳腺外科医生和肿瘤科医生合作。城郊和农村学术医院中心将招募 3000 名受试者，并使用 NanoString Counter 平台上的 PAM50 基因组测定对一部分患者进行治疗和生存的跟踪研究。联盟构成了一个泛南非网络和艾滋病毒和乳腺癌（及其他）癌症进一步研究的基础，CUMC 合作者将继续提供指导，特别是为联盟的新研究人员提供指导。 Wits 和 CUMC 将与我们在南非的 IARC 顾问和移动医疗 Mobenzi 平台开发商合作，制定和指导经验丰富的 CHBBC 数据库开发人员将从实时移动医疗技术收集的标准化数据与现有数据库集成。两个 Wits PI 和 CUMC PI 将领导该联盟，并与其他高级研究人员定期会面，以实现访问控制的数据共享，正如提案中详细说明的热情参与和支持。附上来自 Wits 的 U KwaZulu-Natal、U Cape Town IARC 和 CANSA South Africa。