Gerotherapeutics: Aging Mechanism-based Pharmaceutical and Behavioral Interventions to Reduce Cancer Racial and Ethnic Disparities.

IF 9.9 1区 医学 Q1 ONCOLOGY JNCI Journal of the National Cancer Institute Pub Date : 2024-08-28 DOI:10.1093/jnci/djae211
Jeanne S Mandelblatt, Michael H Antoni, Traci N Bethea, Steve Cole, Barry I Hudson, Frank J Penedo, Amelie G Ramirez, G William Rebeck, Swarnavo Sarkar, Ann G Schwartz, Erica K Sloan, Yun-Ling Zheng, Judith E Carroll, Mina S Sedrak
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Abstract

The central premise of this article is that a portion of the established relationships between social determinants of health and racial/ethnic disparities in cancer morbidity and mortality are mediated through differences in rates of biological aging processes. We further posit that using knowledge about aging could enable discovery and testing of new mechanism-based pharmaceutical and behavioral interventions ("gerotherapeutics") to differentially improve the health of minoritized cancer survivors and reduce cancer disparities. These hypotheses are based on evidence that lifelong differences in adverse social determinants of health contribute to disparities in rates of biological aging ("social determinants of aging"), with minoritized groups having accelerated aging (ie, a steeper slope or trajectory of biological aging over time relative to chronological age) more often than non-minoritized groups. Acceleration of biological aging can increase the risk, age of onset, aggressivity and/or stage of many adult cancers. There are also documented negative feedback loops whereby the cellular damage caused by cancer and its therapies act as drivers of additional biological aging. Together, these dynamic intersectional forces can contribute to differences in cancer outcomes between minoritized vs non-minoritized survivor populations. We highlight key targetable biological aging mechanisms with potential applications to reducing cancer disparities and discuss methodological considerations for pre-clinical and clinical testing of the impact of gerotherapeutics on cancer outcomes in minoritized populations. Ultimately, the promise of reducing cancer disparities will require broad societal policy changes that address the structural causes of accelerated biological aging and ensure equitable access to all new cancer control paradigms.

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老年治疗:基于衰老机制的药物和行为干预,减少癌症的种族和民族差异。
本文的核心前提是,健康的社会决定因素与癌症发病率和死亡率的种族/民族差异之间的既定关系,有一部分是通过生物衰老过程的速率差异来调节的。我们进一步假设,利用有关衰老的知识可以发现和测试新的基于机制的药物和行为干预措施("老年治疗"),从而有区别地改善少数族裔癌症幸存者的健康状况,减少癌症差异。这些假设基于以下证据:不利的社会健康决定因素的终生差异导致生物衰老率("衰老的社会决定因素")的差异,与非少数群体相比,少数群体更容易加速衰老(即随着时间的推移,生物衰老的斜率或轨迹相对于实际年龄而言更陡)。生物衰老的加速会增加许多成人癌症的风险、发病年龄、侵袭性和/或分期。此外,有文献记载,癌症及其疗法造成的细胞损伤会产生负反馈循环,导致更多的生物衰老。这些动态的交叉作用力共同导致了少数群体与非少数群体幸存者之间癌症结果的差异。我们强调了可能应用于减少癌症差异的关键可靶向生物老化机制,并讨论了临床前和临床测试老年疗法对少数群体癌症预后影响的方法学注意事项。最终,减少癌症差异的希望需要广泛的社会政策变革,以解决加速生物衰老的结构性原因,并确保公平地获得所有新的癌症控制范例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
17.00
自引率
2.90%
发文量
203
审稿时长
4-8 weeks
期刊介绍: The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.
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