Grant Details
Grant Number: |
5R01CA241125-05 Interpret this number |
Primary Investigator: |
Gomez, Scarlett |
Organization: |
University Of California, San Francisco |
Project Title: |
Insights From Asian Populations Into Disparities in Breast Cancer Prognosis and Outcomes |
Fiscal Year: |
2024 |
Abstract
Abstract
Asian American women experience more favorable cancer survival than other US racial/ethnic groups, even
after accounting for known prognostic indicators. Breast cancer, which follows this pattern, is a useful model for
understanding factors contributing to this intriguing survival advantage, given that it is the most common
cancer in Asian American women, and has established clinical, biological/genetic, and lifestyle prognostic
factors. Thus, studying the breast cancer survival advantage in Asian American women has the potential to
identify protective factors that may benefit all patients. We propose to investigate multilevel factors (health
behaviors and contextual factors, clinical characteristics, treatment, and tumor immune response) in relation to
overall and breast cancer-specific mortality in Asian American breast cancer cases. However, the Asian
American population is heterogeneous, with lifestyle factors and disease risks (e.g., breast cancer survival
rates) varying by specific ethnicity and by immigration status. Many studies have shown the importance of
population disaggregation to uncovering meaningful differences among Asian American ethnic groups, but no
single study to date includes adequate Asian American ethnic group population samples. To overcome this
limitation, we will conduct the proposed research in integrated data and biospecimens from four established
cohort studies enriched with Asian American breast cancer cases. These studies together include 4,219 Asian
American patients (1,848 Chinese, 602 Japanese, 1,538 Filipinas) and 5,386 non-Latina White women with
breast cancer as a comparison group. In Specific Aim 1, we will assess contributions of individual-level lifestyle
and health behaviors and multilevel neighborhood social context and sociocultural factors to survival
differences among the Asian American ethnic groups relative to non-Latina Whites. In Specific Aim 2, we will
evaluate how specific treatment factors impact survival for 4,373 Asian Americans compared to 4,373 non-
Latina Whites, taking advantage of electronic health record data from an equal-access healthcare system. In
Specific Aim 3, we will characterize the immune infiltrates in the breast tumor microenvironment from 1,200
Asian American (from Aim 1) and 714 non-Latina White (from TCGA) patients using immunogenomic profiling,
and to determine the associations of immune phenotypes with patient survival among Asian Americans and
with exposure factors from Aim 1. Thus, using existing resources, this study will comprehensively assess
factors including health behaviors and neighborhood context, lifestyle, treatment, tumor immuno-biology, and
their contributions to the survival advantage in Asian American women. The proposed study makes efficient
use of data from numerous breast cancer studies to gain insight for strategies that may advance knowledge
about the management of breast cancer for all women.
Publications
A validation study for measuring Asian- and Hispanic-serving sociocultural institutions in neighborhoods using business listing data and potential implications for health.
Authors: Morey B.N.
, Garcia S.
, Lin K.
, Canchola A.J.
, Alexeeff S.E.
, Kurtovich E.M.
, Uong S.
, Aoki R.F.
, Guan A.
, Torres J.M.
, et al.
.
Source: Social Science & Medicine (1982), 2024 Sep; 356, p. 117143.
EPub date: 2024-07-17 00:00:00.0.
PMID: 39032193
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