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Grant Details

Grant Number: 5R01CA219389-03 Interpret this number
Primary Investigator: Jim, Heather
Organization: H. Lee Moffitt Cancer Ctr & Res Inst
Project Title: Improving Prediction of Chemotherapy-Induced Nausea: Integrating Genes, Behavior, and the Microbiome
Fiscal Year: 2020


Abstract

PROJECT SUMMARY Moderate to severe nausea is reported by up to 38% of cancer patients receiving moderately- or highly- emetogenic chemotherapy despite international antiemetic guidelines. Chemotherapy-induced nausea is associated with worse quality of life, increased healthcare utilization, and greater costs of care. Previous research has identified clinical and personal risk factors for nausea (e.g., disease stage, emetogenicity of chemotherapy, age, sex, history of motion sickness, anxiety, alcohol use), but risk-prediction algorithms based on these factors demonstrate room for improvement. Recent methodologies for studying the human genome and microbiome enable us for the first time to develop a more comprehensive understanding of the pathophysiology of chemotherapy-induced nausea and develop better algorithms. The goal of the current study is to improve understanding of risk of chemotherapy-induced nausea through integrated examination of genetic and microbiome variables with well-established clinical and personal risk factors. We will conduct the first GWAS of chemotherapy-induced nausea, then use pathway analysis to place results into functional context. Significant variants will be incorporated with clinical and personal factors into a clinical risk prediction algorithm. This study will also be among the first to examine the association of the gut microbiome with chemotherapy-induced nausea. Importantly, this study is one of the first to truly integrate biological, clinical, and patient-reported data to predict risk of treatment toxicity. This groundbreaking study will be a model for similar efforts in other side effects of chemotherapy such as cognitive impairment, fatigue, and peripheral neuropathy. Updated risk algorithms from the current study will be made publicly available and will inform a future randomized trial of risk-based antiemetic cancer care delivery. Positive results will spur integration of the risk algorithms into the electronic medical record with provider alerts to identify patients at risk of chemotherapy-induced nausea. Microbiome analyses conducted in the first two years of the study will provide rapid knowledge about its contributions to chemotherapy-induced nausea. Positive results will generate additional studies to determine whether microbial manipulation can prevent chemotherapy-induced nausea. Microbiome data are particularly exciting because they focus on an entirely new mechanism in chemotherapy-related toxicity. In summary, this rigorous, comprehensive study provides an integrated new approach to chemotherapy-induced nausea that is expected to significantly advance our understanding of pathophysiology and risk of this important clinical problem.



Publications

Acute cancer-related symptoms and concerns among patients receiving chemotherapy: current state of the science.
Authors: Smith K.S. , Hoogland A.I. , Welniak T. , Nguyen O.L. , Rodriguez Y. , Li X. , Crowder S.L. , Oswald L.B. , Carpenter K.M. , Fischer S.M. , et al. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024-02-23; 32(3), p. 184.
EPub date: 2024-02-23.
PMID: 38393418
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Diet quality indices and changes in cognition during chemotherapy.
Authors: Crowder S.L. , Welniak T.L. , Hoogland A.I. , Small B.J. , Rodriguez Y. , Carpenter K.M. , Fischer S.M. , Li D. , Kinney A.Y. , Rotroff D. , et al. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2022-12-22; 31(1), p. 75.
EPub date: 2022-12-22.
PMID: 36544032
Related Citations

Associations among frailty and quality of life in older patients with cancer treated with chemotherapy.
Authors: Crowder S.L. , Hoogland A.I. , Small B.J. , Carpenter K.M. , Fischer S.M. , Li D. , Kinney A.Y. , Welniak T.L. , Brownstein N. , Reich R.R. , et al. .
Source: Journal of geriatric oncology, 2022 Nov; 13(8), p. 1149-1155.
EPub date: 2022-08-23.
PMID: 36008271
Related Citations

Patient-reported symptom burden in routine oncology care: Examining racial and ethnic disparities.
Authors: Bulls H.W. , Chang P.H. , Brownstein N.C. , Zhou J.M. , Hoogland A.I. , Gonzalez B.D. , Johnstone P. , Jim H.S.L. .
Source: Cancer reports (Hoboken, N.J.), 2022 Mar; 5(3), p. e1478.
EPub date: 2021-06-24.
PMID: 34165256
Related Citations

Metagenomics and chemotherapy-induced nausea: A roadmap for future research.
Authors: Crowder S.L. , Hoogland A.I. , Welniak T.L. , LaFranchise E.A. , Carpenter K.M. , Li D. , Rotroff D.M. , Mariam A. , Pierce C.M. , Fischer S.M. , et al. .
Source: Cancer, 2022-02-01; 128(3), p. 461-470.
EPub date: 2021-10-13.
PMID: 34643945
Related Citations

Living with Metastatic Cancer: A Roadmap for Future Research.
Authors: Tometich D.B. , Hyland K.A. , Soliman H. , Jim H.S.L. , Oswald L. .
Source: Cancers, 2020-12-08; 12(12), .
EPub date: 2020-12-08.
PMID: 33302472
Related Citations

Innovations in research and clinical care using patient-generated health data.
Authors: Jim H.S.L. , Hoogland A.I. , Brownstein N.C. , Barata A. , Dicker A.P. , Knoop H. , Gonzalez B.D. , Perkins R. , Rollison D. , Gilbert S.M. , et al. .
Source: CA: a cancer journal for clinicians, 2020 May; 70(3), p. 182-199.
EPub date: 2020-04-20.
PMID: 32311776
Related Citations

Symptom burden among older breast cancer survivors: The Thinking and Living With Cancer (TLC) study.
Authors: Mandelblatt J.S. , Zhai W. , Ahn J. , Small B.J. , Ahles T.A. , Carroll J.E. , Denduluri N. , Dilawari A. , Extermann M. , Graham D. , et al. .
Source: Cancer, 2020-03-15; 126(6), p. 1183-1192.
EPub date: 2019-12-20.
PMID: 31860135
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