Grant Number:	1R01CA149222-01A1 Interpret this number
Primary Investigator:	Meyerhardt, Jeffrey
Organization:	Dana-Farber Cancer Inst
Project Title:	The Influence of Diet and Lifestyle on Patients with Advanced Colorectal Cancer
Fiscal Year:	2010

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.




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Dietary fat intake after colon cancer diagnosis in relation to cancer recurrence and survival: CALGB 89803 (Alliance).
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Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance).
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Marine ω-3 Polyunsaturated Fatty Acid and Fish Intake after Colon Cancer Diagnosis and Survival: CALGB 89803 (Alliance).
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Associations of artificially sweetened beverage intake with disease recurrence and mortality in stage III colon cancer: Results from CALGB 89803 (Alliance).
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Effect of First-Line Chemotherapy Combined With Cetuximab or Bevacizumab on Overall Survival in Patients With KRAS Wild-Type Advanced or Metastatic Colorectal Cancer: A Randomized Clinical Trial.
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Association Of Weight Change After Colorectal Cancer Diagnosis And Outcomes In The Kaiser Permanente Northern California Population
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Obesity And Energy Balance In Gi Cancer
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Vitamin D And Physical Activity In Patients With Colorectal Cancer: Epidemiological Evidence And Therapeutic Implications
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Prognostic Utility of Molecular Factors by Age at Diagnosis of Colorectal Cancer.
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Diet and lifestyle in survivors of colorectal cancer.
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Relationships between KRAS mutation status and baseline radiographic distribution of disease in patients with stage IV colorectal cancer.
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Sugar-sweetened beverage intake and cancer recurrence and survival in CALGB 89803 (Alliance).
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Post diagnosis diet quality and colorectal cancer survival in women.
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Predictive and prognostic analysis of PIK3CA mutation in stage III colon cancer intergroup trial.
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Comparison of dietary and lifestyle habits among stage III and metastatic colorectal cancer patients: findings from CALGB 89803 and CALGB 80405.
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Insulin-like growth factor 2 messenger RNA binding protein 3 (IGF2BP3) is a marker of unfavourable prognosis in colorectal cancer.
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Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803.
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Aspirin use, tumor PIK3CA mutation, and colorectal-cancer survival.
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Reported behavior of eating anything at anytime and risk of colorectal cancer in women.
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Body mass index and risk of colorectal cancer according to fatty acid synthase expression in the nurses' health study.
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Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting.
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Predictive and prognostic roles of BRAF mutation in stage III colon cancer: results from intergroup trial CALGB 89803.
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Panitumumab in patients with KRAS wild-type colorectal cancer after progression on cetuximab.
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Beyond standard adjuvant therapy for colon cancer: role of nonstandard interventions.
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TGFBR2 and BAX mononucleotide tract mutations, microsatellite instability, and prognosis in 1072 colorectal cancers.
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