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Grant Details

Grant Number: 5R35CA197289-04 Interpret this number
Primary Investigator: Mandelblatt, Jeanne
Organization: Georgetown University
Project Title: Bio-Behavioral Research at the Intersection of Cancer and Aging
Fiscal Year: 2018
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 DESCRIPTION (provided by applicant): We are experiencing unprecedented growth in the numbers of individuals at risk for, or living with cancer due to population aging, greater use of early detection, advances in treatment, and increasing lifespan. By 2030, nearly 50% of the 45 million new cases and 75% of the 20 million cancer survivors will be aged 60 or older ("older"). Most of these older survivors are interested in and will benefit from systemic therapies. However, these treatments often have adverse effects on function, although data are largely from studies with younger survivors. Since only 4% of NCI-funded survivorship research specifically examines outcomes among older survivors, we know little about how the substantial heterogeneity in aging processes ("biological age") affects risk for adverse functional outcomes among those of comparable chronological age. These data are important because they could affect treatment decisions, survivorship care planning, and ability to live independently. This Outstanding Investigator Award will use a bio-behavioral framework to conduct population sciences research at the intersection of cancer and aging to fill these gaps. Data, infrastructure, and established collaborations from an extant NCI-funded older cohort will be leveraged to iteratively build new studies to test novel hypotheses. Such cohorts are the population science equivalent of a basic science laboratory used for a series of experiments. The goals of the high-risk/high-reward studies are to: physical, emotional, social and role function; 1) define long-term trajectories of decline in cognitive, determine bio-behavioral risks for decline; and examine how systemic therapy and lifestyle factors moderate these relationships; 2) conduct exploratory research on biological age markers to determine feasibility and clinical utility for predicting ris and trajectory of functional decline; 3) conduct pilot randomized trials of the impact of lifestyle interventions on biological age markers and functional outcomes; and 4) enhance long-term clinical and policy impact by incorporating data into policy modeling, engaging survivors in design and communication of results, and supporting training. This research is innovative in use of a bio-behavioral framework and inclusion of policy modeling. The findings will move the field forward by shifting the paradigms of research and care for the growing older population; determining whether biological age markers can identify survivors at greatest risk for functional declines; informing future intervention trials; and expanding the limited number of cancer and aging researchers. The PIs history of productivity and strong institutional and collaborative support will ensure that the research will have the intended impact. Overall, the unique population science perspectives of these studies will add important diversity to the multi-disciplinary approaches needed for reducing the burden of cancer in older survivors.

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Biological Hallmarks of Cancer in Alzheimer's Disease.
Authors: Nudelman K.N.H. , McDonald B.C. , Lahiri D.K. , Saykin A.J. .
Source: Molecular neurobiology, 2019 Oct; 56(10), p. 7173-7187.
EPub date: 2019-04-16.
PMID: 30993533
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Functional Decline and Resilience in Older Women Receiving Adjuvant Chemotherapy for Breast Cancer.
Authors: Hurria A. , Soto-Perez-de-Celis E. , Allred J.B. , Cohen H.J. , Arsenyan A. , Ballman K. , Le-Rademacher J. , Jatoi A. , Filo J. , Mandelblatt J. , et al. .
Source: Journal of the American Geriatrics Society, 2019 May; 67(5), p. 920-927.
EPub date: 2018-08-26.
PMID: 30146695
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Expected Monetary Impact of Oncotype DX Score-Concordant Systemic Breast Cancer Therapy Based on the TAILORx Trial.
Authors: Mariotto A. , Jayasekerea J. , Petkov V. , Schechter C.B. , Enewold L. , Helzlsouer K.J. , Feuer E.J. , Mandelblatt J.S. .
Source: Journal of the National Cancer Institute, 2019-04-24; , .
EPub date: 2019-04-24.
PMID: 31165854
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Development of a Human APOE Knock-in Mouse Model for Study of Cognitive Function After Cancer Chemotherapy.
Authors: Speidell A.P. , Demby T. , Lee Y. , Rodriguez O. , Albanese C. , Mandelblatt J. , Rebeck G.W. .
Source: Neurotoxicity research, 2019 Feb; 35(2), p. 291-303.
EPub date: 2018-10-04.
PMID: 30284204
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The impact of gene expression profile testing on confidence in chemotherapy decisions and prognostic expectations.
Authors: Panattoni L. , Lieu T.A. , Jayasekera J. , O'Neill S. , Mandelblatt J.S. , Etzioni R. , Phelps C.E. , Ramsey S.D. .
Source: Breast cancer research and treatment, 2019 Jan; 173(2), p. 417-427.
EPub date: 2018-10-10.
PMID: 30306429
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The Impact of Using Different Reference Populations on Measurement of Breast Cancer-Related Cognitive Impairment Rates.
Authors: Clapp J.D. , Luta G. , Small B.J. , Ahles T.A. , Root J.C. , Graham D. , Hurria A. , Jacobsen P.B. , Jim H. , McDonald B.C. , et al. .
Source: Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, 2018-12-01; 33(8), p. 956-963.
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Authors: Caswell-Jin J.L. , Plevritis S.K. , Tian L. , Cadham C.J. , Xu C. , Stout N.K. , Sledge G.W. , Mandelblatt J.S. , Kurian A.W. .
Source: JNCI cancer spectrum, 2018 Nov; 2(4), p. pky062.
EPub date: 2018-12-24.
PMID: 30627694
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Pretreatment Psychoneurological Symptoms and Their Association With Longitudinal Cognitive Function and Quality of Life in Older Breast Cancer Survivors.
Authors: Tometich D.B. , Small B.J. , Carroll J.E. , Zhai W. , Luta G. , Zhou X. , Kobayashi L.C. , Ahles T. , Saykin A.J. , Clapp J.D. , et al. .
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EPub date: 2018-11-23.
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Effects of Radiotherapy in Early-Stage, Low-Recurrence Risk, Hormone-Sensitive Breast Cancer.
Authors: Jayasekera J. , Schechter C.B. , Sparano J.A. , Jagsi R. , White J. , Chapman J.W. , Whelan T. , Anderson S.J. , Fyles A.W. , Sauerbrei W. , et al. .
Source: Journal of the National Cancer Institute, 2018-12-01; 110(12), p. 1370-1379.
PMID: 30239794
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Multilevel Influences on Patient-Oncologist Communication about Genomic Test Results: Oncologist Perspectives.
Authors: O'Neill S.C. , Taylor K.L. , Clapp J. , Jayasekera J. , Isaacs C. , Mary Atieh Graham D. , Goldberg S.L. , Mandelblatt J. .
Source: Journal of health communication, 2018; 23(7), p. 679-686.
EPub date: 2018-08-21.
PMID: 30130477
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Common Model Inputs Used in CISNET Collaborative Breast Cancer Modeling.
Authors: Mandelblatt J.S. , Near A.M. , Miglioretti D.L. , Munoz D. , Sprague B.L. , Trentham-Dietz A. , Gangnon R. , Kurian A.W. , Weedon-Fekjaer H. , Cronin K.A. , et al. .
Source: Medical decision making : an international journal of the Society for Medical Decision Making, 2018 04; 38(1_suppl), p. 9S-23S.
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Cost Effectiveness of Gene Expression Profile Testing in Community Practice.
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Lymphedema, musculoskeletal events and arm function in older patients receiving adjuvant chemotherapy for breast cancer (Alliance A171302).
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Personality, coping, and social support as predictors of long-term quality-of-life trajectories in older breast cancer survivors: CALGB protocol 369901 (Alliance).
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Source: Psycho-oncology, 2017 Nov; 26(11), p. 1914-1921.
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Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance).
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Frailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance).
Authors: Mandelblatt J.S. , Cai L. , Luta G. , Kimmick G. , Clapp J. , Isaacs C. , Pitcher B. , Barry W. , Winer E. , Sugarman S. , et al. .
Source: Breast cancer research and treatment, 2017 Jul; 164(1), p. 107-117.
EPub date: 2017-03-31.
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Using ePrognosis to estimate 2-year all-cause mortality in older women with breast cancer: Cancer and Leukemia Group B (CALGB) 49907 and 369901 (Alliance A151503).
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Evaluating Frameworks That Provide Value Measures for Health Care Interventions.
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