Sociobiological Responses to Stress in Prostate Cancer Survivors

前列腺癌幸存者对压力的社会生物学反应

• 批准号: 9145865
• 负责人: Chanita A. Hughes-Halbert
• 金额: $ 18.95万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-08 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9145865
• 关键词: Accounting; Acute; African American; Biological; Biological Factors; Biological Markers; Cancer Patient; Cancer Survivor; Chronic; Clinical; Clinical Trials; Collaborations; Companions; Correlative Study; Data; Development; Disease; Disease Progression; Economics; Emotional; Event; Feedback; Frequencies; Funding; Future; Generations; Genetic; Genetic Polymorphism; Genomics; Genotype; Glucocorticoid Receptor; Glucocorticoids; Growth; High-Risk Cancer; Histologic; Hypersensitivity; Immune response; Immunologics; Immunology; Immunotherapy; Individual; Intervention; Laboratories; Life; Malignant Neoplasms; Malignant neoplasm of prostate; Measurement; Measures; Mediating; Medical; Methods; Minority; Molecular; Operative Surgical Procedures; Outcome; Patients; Phase II Clinical Trials; Physiological; Play; Population; Poxviridae; Prostate; Psychologist; Psychosocial Factor; Radical Prostatectomy; Receptor Gene; Recruitment Activity; Recurrence; Relapse; Research; Research Personnel; Research Project Grants; Risk; Rodent; Role; Social Perception; Socioeconomic Status; South Carolina; Stress; Study Subject; Toxic effect; Treatment outcome; Universities; Vaccine Clinical Trial; Vaccines; allostatic load; base; biological adaptation to stress; cancer health disparity; cancer recurrence; cancer therapy; design; experience; high risk; human disease; hypothalamic-pituitary-adrenal axis; indexing; male health; men; novel; older men; precision medicine; psychologic; racial disparity; relapse risk; research study; response; social; social stress; stress reactivity; stressor; tumor; tumor growth; vaccine trial; willingness

RESEARCH PROJECT 1: PROJECT SUMMARY Dysregulation of the hypothalamic-pituitary-adrenal axis has been suggested as a mechanism through which social and biological factors contribute to racial disparities in cancer outcomes. A prolonged and elevated glucocorticoid (GC) response following a social stressor predicts tumor growth rates and the development of rodent cancers that histologically and etiologically resembles human disease. The GC response is a key biomarker for allostatic load, which is a measure of biological responses to stressors. Many African Americans experience stressful life events and circumstances, including economic, discriminatory, and other stressors. These psychosocial factors may contribute to the well-documented poorer outcomes experienced by African American men with prostate cancer. However stress reactivity (SR), or one's physiological and psychological responses to a stressor, is highly individualized and dependent on psychological and social determinants as well as genetic factors. Investigators at MUSC will investigate the role of SR in the development of immune responses to prostate cancer among subjects participating in a prostate vaccine trial. The trial itself will be conducted to document the effects of a poxvirus vaccine (PROSTVAC) on the cancer growth and immune responses of patients immediately after radical prostatectomy. MUSC investigators will be able to study these subjects to determine the levels of stress and stressors and the feasibility of using validated psychologic methods to characterize these parameters in older men. The specific aims of this study are to: (1) conduct a Phase II clinical trial of PROSTVAC vaccine in subjects at high risk of relapse after radical prostatectomy for prostate cancer as a platform to evaluate the effects of SR on the development of an effective anti-tumor immune response; (2) measure stress reactivity among prostate cancer patients at risk for relapse based on socioeconomic status, glucocorticoid receptor (GR) polymorphisms, perceptions of social stressors, and allostatic load; and (3) compare the magnitude and distribution of stress responses with clinical and immunologic measures of vaccine effect. This clinical trial will provide a “real world” setting of immunotherapy and immune response development in prostate cancer patients as they are experiencing an acute cancer- related stressor (e.g., risk for recurrence). In addition, this research will provide novel empirical data on the frequency and kinds of stress in prostate cancer survivors, their physiological responses to a validated laboratory stressor, and the associations between SR and clinical, genomic, and immunologic parameters important in immunotherapy.

研究项目1：项目摘要 已提出下丘脑 - 垂体 - 肾上腺轴的失调，作为一种机制 社会和生物学因素导致癌症结局的种族差异。延长和抬高 在社会压力源预测肿瘤生长率和发展的发展之后，糖皮质激素（GC）反应 在组织学和病因上类似于人类疾病的啮齿动物癌。 GC响应是关键 同种异体负荷的生物标志物，这是对压力源的生物反应的量度。许多非裔美国人 体验压力大的生活事件和环境，包括经济，歧视性和其他压力源。 这些社会心理因素可能有助于有据可查的较差的非洲人的结果 前列腺癌的美国男性。但是压力反应性（SR）或一个人的生理和心理 对压力源的反应，高度个性化，并且取决于心理和社会决定者 以及遗传因素。 MUSC的研究人员将研究SR在免疫发展中的作用 参与前列腺疫苗试验的受试者中对前列腺癌的反应。审判本身将是 进行记录痘病毒疫苗（Prostvac）对癌症生长和免疫的影响 根治性前列腺切除术后立即对患者的反应。 MUSC调查人员将能够研究这些 受试者确定压力和压力源的水平以及使用经过验证的心理学的可行性 在老年男性中表征这些参数的方法。这项研究的具体目的是：（1）进行一次 从根治性前列腺切除术后，前列腺疫苗的II期临床试验，可缓解的受试者。 前列腺癌是评估SR对有效抗肿瘤发展的影响的平台 免疫反应； （2）测量前列腺癌患者的应力反应性，以缓解风险 社会经济状况，糖皮质激素受体（GR）多态性，对社会压力源的看法和 同性载荷； （3）将压力反应的大小和分布与临床和 疫苗作用的免疫学测量。该临床试验将为免疫疗法提供“现实世界” 前列腺癌患者正在经历急性癌 - 相关压力源（例如，复发风险）。此外，这项研究将提供有关有关的新的经验数据 前列腺癌存活中的频率和压力，它们对经过验证的身体反应 实验室压力源以及SR与临床，基因组和免疫学参数之间的关联 在免疫疗法中很重要。