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Commentary: Health disparities across the cancer care continuum and implications for microsimulation modeling. 评论:癌症治疗连续性中的健康差异及其对微刺激模型的影响。
Pub Date : 2023-11-08 DOI: 10.1093/jncimonographs/lgad031
Chyke A Doubeni, Zinzi D Bailey, Robert A Winn
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引用次数: 0
A health equity framework to support the next generation of cancer population simulation models. 支持下一代癌症人口模拟模型的健康公平框架。
Pub Date : 2023-11-08 DOI: 10.1093/jncimonographs/lgad017
Christina Chapman, Jinani Jayasekera, Chiranjeev Dash, Vanessa Sheppard, Jeanne Mandelblatt

Over the past 2 decades, population simulation modeling has evolved as an effective public health tool for surveillance of cancer trends and estimation of the impact of screening and treatment strategies on incidence and mortality, including documentation of persistent cancer inequities. The goal of this research was to provide a framework to support the next generation of cancer population simulation models to identify leverage points in the cancer control continuum to accelerate achievement of equity in cancer care for minoritized populations. In our framework, systemic racism is conceptualized as the root cause of inequity and an upstream influence acting on subsequent downstream events, which ultimately exert physiological effects on cancer incidence and mortality and competing comorbidities. To date, most simulation models investigating racial inequity have used individual-level race variables. Individual-level race is a proxy for exposure to systemic racism, not a biological construct. However, single-level race variables are suboptimal proxies for the multilevel systems, policies, and practices that perpetuate inequity. We recommend that future models designed to capture relationships between systemic racism and cancer outcomes replace or extend single-level race variables with multilevel measures that capture structural, interpersonal, and internalized racism. Models should investigate actionable levers, such as changes in health care, education, and economic structures and policies to increase equity and reductions in health-care-based interpersonal racism. This integrated approach could support novel research approaches, make explicit the effects of different structures and policies, highlight data gaps in interactions between model components mirroring how factors act in the real world, inform how we collect data to model cancer equity, and generate results that could inform policy.

在过去20年中,人口模拟模型已发展成为一种有效的公共卫生工具,用于监测癌症趋势和估计筛查和治疗策略对发病率和死亡率的影响,包括记录持续存在的癌症不公平现象。这项研究的目标是提供一个框架来支持下一代癌症人群模拟模型,以确定癌症控制连续体中的杠杆点,从而加速实现少数民族癌症护理的公平。在我们的框架中,系统性种族主义被概念化为不公平的根本原因和对随后的下游事件的上游影响,最终对癌症发病率和死亡率以及竞争性合并症产生生理影响。迄今为止,大多数调查种族不平等的模拟模型都使用了个人层面的种族变量。个人层面的种族是暴露于系统性种族主义的代表,而不是生物学结构。然而,单一层面的种族变量是使不平等长期存在的多层面系统、政策和实践的次优代理。我们建议,未来旨在捕捉系统性种族主义与癌症结果之间关系的模型,用捕捉结构性、人际性和内在种族主义的多层次测量来取代或扩展单层次种族变量。模型应调查可操作的杠杆,如医疗保健、教育、经济结构和政策的变化,以提高公平性,减少基于医疗保健的人际种族主义。这种综合方法可以支持新的研究方法,明确不同结构和政策的影响,突出模型组成部分之间相互作用的数据差距,反映现实世界中因素的作用,为我们如何收集数据以模拟癌症公平提供信息,并产生可以为政策提供信息的结果。
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引用次数: 0
Using simulation modeling to guide policy to reduce disparities and achieve equity in cancer outcomes: state of the science and a road map for the future. 使用模拟模型指导政策,以减少癌症结果的差异并实现公平:科学现状和未来路线图。
Pub Date : 2023-11-08 DOI: 10.1093/jncimonographs/lgad033
Jeanne Mandelblatt, Rafael Meza, Amy Trentham-Dietz, Brandy Heckman-Stoddard, Eric Feuer
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引用次数: 0
Population simulation modeling of disparities in US breast cancer mortality. 美国癌症死亡率差异的人口模拟模型。
Pub Date : 2023-11-08 DOI: 10.1093/jncimonographs/lgad023
Jeanne S Mandelblatt, Clyde B Schechter, Natasha K Stout, Hui Huang, Sarah Stein, Christina Hunter Chapman, Amy Trentham-Dietz, Jinani Jayasekera, Ronald E Gangnon, John M Hampton, Linn Abraham, Ellen S O'Meara, Vanessa B Sheppard, Sandra J Lee

Background: Populations of African American or Black women have persistently higher breast cancer mortality than the overall US population, despite having slightly lower age-adjusted incidence.

Methods: Three Cancer Intervention and Surveillance Modeling Network simulation teams modeled cancer mortality disparities between Black female populations and the overall US population. Model inputs used racial group-specific data from clinical trials, national registries, nationally representative surveys, and observational studies. Analyses began with cancer mortality in the overall population and sequentially replaced parameters for Black populations to quantify the percentage of modeled breast cancer morality disparities attributable to differences in demographics, incidence, access to screening and treatment, and variation in tumor biology and response to therapy.

Results: Results were similar across the 3 models. In 2019, racial differences in incidence and competing mortality accounted for a net ‒1% of mortality disparities, while tumor subtype and stage distributions accounted for a mean of 20% (range across models = 13%-24%), and screening accounted for a mean of 3% (range = 3%-4%) of the modeled mortality disparities. Treatment parameters accounted for the majority of modeled mortality disparities: mean = 17% (range = 16%-19%) for treatment initiation and mean = 61% (range = 57%-63%) for real-world effectiveness.

Conclusion: Our model results suggest that changes in policies that target improvements in treatment access could increase breast cancer equity. The findings also highlight that efforts must extend beyond policies targeting equity in treatment initiation to include high-quality treatment completion. This research will facilitate future modeling to test the effects of different specific policy changes on mortality disparities.

背景:非裔美国人或黑人女性的乳腺癌症死亡率持续高于美国总人口,尽管经年龄调整的发病率略低。方法:三个癌症干预和监测建模网络模拟小组模拟了黑人女性人口与美国总体人口之间的癌症死亡率差异。模型输入使用了来自临床试验、国家登记、全国代表性调查和观察性研究的特定种族群体数据。分析从总体人群中癌症死亡率开始,依次替换黑人人群的参数,以量化由于人口统计学、发病率、获得筛查和治疗的机会以及肿瘤生物学和治疗反应的差异而导致的癌症道德差异模型的百分比。结果:3个模型的结果相似。2019年,发病率和竞争死亡率的种族差异占死亡率差异的净1%,而肿瘤亚型和分期分布平均占20%(各模型范围 = 13%-24%),筛查平均占3%(范围 = 3%-4%)。治疗参数占建模死亡率差异的大部分:平均值 = 17%(范围 = 16%-19%)用于治疗开始和平均值 = 61%(范围 = 57%-63%)的真实世界有效性。结论:我们的模型结果表明,以改善治疗机会为目标的政策变化可以增加癌症的公平性。研究结果还强调,努力必须超越针对治疗开始公平的政策,包括高质量的治疗完成。这项研究将有助于未来的建模,以测试不同具体政策变化对死亡率差异的影响。
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引用次数: 0
Opportunities, challenges, and future directions for simulation modeling the effects of structural racism on cancer mortality in the United States: a scoping review. 美国结构性种族主义对癌症死亡率影响的模拟建模的机遇、挑战和未来方向:范围界定综述。
Pub Date : 2023-11-08 DOI: 10.1093/jncimonographs/lgad020
Jinani Jayasekera, Safa El Kefi, Jessica R Fernandez, Kaitlyn M Wojcik, Jennifer M P Woo, Adaora Ezeani, Jennifer L Ish, Manami Bhattacharya, Kemi Ogunsina, Che-Jung Chang, Camryn M Cohen, Stephanie Ponce, Dalya Kamil, Julia Zhang, Randy Le, Amrita L Ramanathan, Gisela Butera, Christina Chapman, Shakira J Grant, Marquita W Lewis-Thames, Chiranjeev Dash, Traci N Bethea, Allana T Forde

Purpose: Structural racism could contribute to racial and ethnic disparities in cancer mortality via its broad effects on housing, economic opportunities, and health care. However, there has been limited focus on incorporating structural racism into simulation models designed to identify practice and policy strategies to support health equity. We reviewed studies evaluating structural racism and cancer mortality disparities to highlight opportunities, challenges, and future directions to capture this broad concept in simulation modeling research.

Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension guidelines. Articles published between 2018 and 2023 were searched including terms related to race, ethnicity, cancer-specific and all-cause mortality, and structural racism. We included studies evaluating the effects of structural racism on racial and ethnic disparities in cancer mortality in the United States.

Results: A total of 8345 articles were identified, and 183 articles were included. Studies used different measures, data sources, and methods. For example, in 20 studies, racial residential segregation, one component of structural racism, was measured by indices of dissimilarity, concentration at the extremes, redlining, or isolation. Data sources included cancer registries, claims, or institutional data linked to area-level metrics from the US census or historical mortgage data. Segregation was associated with worse survival. Nine studies were location specific, and the segregation measures were developed for Black, Hispanic, and White residents.

Conclusions: A range of measures and data sources are available to capture the effects of structural racism. We provide a set of recommendations for best practices for modelers to consider when incorporating the effects of structural racism into simulation models.

目的:结构性种族主义通过其对住房、经济机会和医疗保健的广泛影响,可能导致癌症死亡率的种族和民族差异。然而,将结构性种族主义纳入旨在确定支持卫生公平的实践和政策战略的模拟模型的关注有限。我们回顾了评估结构性种族主义和癌症死亡率差异的研究,以强调在模拟建模研究中捕捉这一广泛概念的机会、挑战和未来方向。方法:我们使用系统评价的首选报告项目和荟萃分析范围界定审查扩展指南。检索了2018年至2023年间发表的文章,包括与种族、民族、癌症特异性和全因死亡率以及结构性种族主义相关的术语。我们纳入了评估结构性种族主义对美国癌症死亡率种族和民族差异影响的研究。结果:共发现8345篇文章,纳入183篇文章。研究采用了不同的衡量标准、数据来源和方法。例如,在20项研究中,种族居住隔离是结构性种族主义的一个组成部分,是通过不同性、极端集中度、红线或隔离指数来衡量的。数据来源包括癌症登记、索赔或与美国人口普查或历史抵押贷款数据中的区域级别指标相关的机构数据。隔离与较差的生存率相关。九项研究针对特定地点,针对黑人、西班牙裔和白人居民制定了隔离措施。结论:有一系列措施和数据来源可用于捕捉结构性种族主义的影响。我们为建模人员在将结构性种族主义的影响纳入模拟模型时提供了一套最佳实践建议。
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引用次数: 0
Muscle loss during cancer therapy is associated with poor outcomes in advanced ovarian cancer. 癌症治疗期间肌肉损失与晚期卵巢癌预后不良相关。
Pub Date : 2023-05-04 DOI: 10.1093/jncimonographs/lgad007
Clarissa Polen-De, Smith Giri, Priyal Fadadu, Amy Weaver, Michaela E Mcgree, Michael Moynagh, Naoki Takahashi, Aminah Jatoi, Nathan K Lebrasseur, William Cliby, Grant Williams, Amanika Kumar

Data evaluating change in body composition during treatment of advanced cancer are limited. Here we evaluated computed tomography (CT)-based changes in muscle mass during treatment for advanced ovarian cancer (OC) and association with outcomes. We analyzed the preoperative and posttreatment skeletal muscle index (SMI), skeletal muscle area normalized for height of 109 patients with advanced OC who underwent primary surgery and platinum-based chemotherapy from 2006 to 2016. Based on an SMI less than 39 cm2/m2, 54.1% of patients were never sarcopenic, 24.8% were sarcopenic on both CT scans, and 21.1% were newly sarcopenic upon treatment completion. Patients who lost muscle during treatment had the worst survival of the 3 groups identified: median survival 2.6 years vs 4.6 years if sarcopenic on both CT scans and 4.8 years if never sarcopenic. Loss of muscle portends a poor prognosis among patients with OC. Additional research is needed to better understand and best mitigate these changes.

评估晚期癌症治疗期间身体成分变化的数据有限。在此,我们评估了晚期卵巢癌(OC)治疗期间基于计算机断层扫描(CT)的肌肉质量变化及其与预后的关系。我们分析了2006年至2016年109例接受原发性手术和铂基化疗的晚期OC患者的术前和治疗后骨骼肌指数(SMI)、骨骼肌面积归一化高度。基于SMI小于39 cm2/m2, 54.1%的患者从未出现过肌肉减少,24.8%的患者在两次CT扫描中都出现了肌肉减少,21.1%的患者在治疗完成后出现了新的肌肉减少。在治疗期间失去肌肉的患者在三组中生存最差:中位生存期为2.6年,而CT扫描均出现肌肉减少的患者为4.6年,而从未出现肌肉减少的患者为4.8年。肌肉的丧失预示着OC患者预后不良。需要进一步的研究来更好地理解和最好地缓解这些变化。
{"title":"Muscle loss during cancer therapy is associated with poor outcomes in advanced ovarian cancer.","authors":"Clarissa Polen-De,&nbsp;Smith Giri,&nbsp;Priyal Fadadu,&nbsp;Amy Weaver,&nbsp;Michaela E Mcgree,&nbsp;Michael Moynagh,&nbsp;Naoki Takahashi,&nbsp;Aminah Jatoi,&nbsp;Nathan K Lebrasseur,&nbsp;William Cliby,&nbsp;Grant Williams,&nbsp;Amanika Kumar","doi":"10.1093/jncimonographs/lgad007","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgad007","url":null,"abstract":"<p><p>Data evaluating change in body composition during treatment of advanced cancer are limited. Here we evaluated computed tomography (CT)-based changes in muscle mass during treatment for advanced ovarian cancer (OC) and association with outcomes. We analyzed the preoperative and posttreatment skeletal muscle index (SMI), skeletal muscle area normalized for height of 109 patients with advanced OC who underwent primary surgery and platinum-based chemotherapy from 2006 to 2016. Based on an SMI less than 39 cm2/m2, 54.1% of patients were never sarcopenic, 24.8% were sarcopenic on both CT scans, and 21.1% were newly sarcopenic upon treatment completion. Patients who lost muscle during treatment had the worst survival of the 3 groups identified: median survival 2.6 years vs 4.6 years if sarcopenic on both CT scans and 4.8 years if never sarcopenic. Loss of muscle portends a poor prognosis among patients with OC. Additional research is needed to better understand and best mitigate these changes.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2023 61","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intermittent fasting interventions to leverage metabolic and circadian mechanisms for cancer treatment and supportive care outcomes. 间歇性禁食干预,利用新陈代谢和昼夜节律机制促进癌症治疗和支持性护理效果。
Pub Date : 2023-05-04 DOI: 10.1093/jncimonographs/lgad008
Faiza Kalam, Dara L James, Yun Rose Li, Michael F Coleman, Violet A Kiesel, Elizabeth M Cespedes Feliciano, Stephen D Hursting, Dorothy D Sears, Amber S Kleckner

Intermittent fasting entails restricting food intake during specific times of day, days of the week, religious practice, or surrounding clinically important events. Herein, the metabolic and circadian rhythm mechanisms underlying the proposed benefits of intermittent fasting for the cancer population are described. We summarize epidemiological, preclinical, and clinical studies in cancer published between January 2020 and August 2022 and propose avenues for future research. An outstanding concern regarding the use of intermittent fasting among cancer patients is that fasting often results in caloric restriction, which can put patients already prone to malnutrition, cachexia, or sarcopenia at risk. Although clinical trials do not yet provide sufficient data to support the general use of intermittent fasting in clinical practice, this summary may be useful for patients, caregivers, and clinicians who are exploring intermittent fasting as part of their cancer journey for clinical outcomes and symptom management.

间歇性禁食是指在一天中的特定时间、一周中的特定日子、宗教活动或临床重要事件的前后限制食物摄入量。本文介绍了间歇性禁食对癌症患者有益的代谢和昼夜节律机制。我们总结了 2020 年 1 月至 2022 年 8 月间发表的癌症流行病学、临床前和临床研究,并提出了未来的研究方向。在癌症患者中使用间歇性禁食疗法的一个突出问题是,禁食通常会导致热量限制,这可能会使原本就容易出现营养不良、恶病质或肌肉疏松症的患者面临风险。尽管临床试验尚未提供足够的数据来支持在临床实践中普遍使用间歇性禁食,但本摘要可能对正在探索将间歇性禁食作为癌症治疗过程的一部分以改善临床疗效和控制症状的患者、护理人员和临床医生有所帮助。
{"title":"Intermittent fasting interventions to leverage metabolic and circadian mechanisms for cancer treatment and supportive care outcomes.","authors":"Faiza Kalam, Dara L James, Yun Rose Li, Michael F Coleman, Violet A Kiesel, Elizabeth M Cespedes Feliciano, Stephen D Hursting, Dorothy D Sears, Amber S Kleckner","doi":"10.1093/jncimonographs/lgad008","DOIUrl":"10.1093/jncimonographs/lgad008","url":null,"abstract":"<p><p>Intermittent fasting entails restricting food intake during specific times of day, days of the week, religious practice, or surrounding clinically important events. Herein, the metabolic and circadian rhythm mechanisms underlying the proposed benefits of intermittent fasting for the cancer population are described. We summarize epidemiological, preclinical, and clinical studies in cancer published between January 2020 and August 2022 and propose avenues for future research. An outstanding concern regarding the use of intermittent fasting among cancer patients is that fasting often results in caloric restriction, which can put patients already prone to malnutrition, cachexia, or sarcopenia at risk. Although clinical trials do not yet provide sufficient data to support the general use of intermittent fasting in clinical practice, this summary may be useful for patients, caregivers, and clinicians who are exploring intermittent fasting as part of their cancer journey for clinical outcomes and symptom management.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2023 61","pages":"84-103"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metabolic and bariatric surgery and obesity pharmacotherapy for cancer prevention: current status and future possibilities. 代谢和减肥手术以及预防癌症的肥胖症药物疗法:现状和未来的可能性。
Pub Date : 2023-05-04 DOI: 10.1093/jncimonographs/lgad003
Mary C Playdon, Sheetal Hardikar, Prasoona Karra, Rachel Hoobler, Anna R Ibele, Katherine L Cook, Amanika Kumar, Joseph E Ippolito, Justin C Brown

Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of developing at least 13 types of cancer. This report provides a concise review of the current state of the science regarding metabolic and bariatric surgery and obesity pharmacotherapy related to cancer risk. Meta-analyses of cohort studies report that metabolic and bariatric surgery is independently associated with a lower risk of incident cancer than nonsurgical obesity care. Less is known regarding the cancer-preventive effects of obesity pharmacotherapy. The recent approval and promising pipeline of obesity drugs will provide the opportunity to understand the potential for obesity therapy to emerge as an evidence-based cancer prevention strategy. There are myriad research opportunities to advance our understanding of how metabolic and bariatric surgery and obesity pharmacotherapy may be used for cancer prevention.

肥胖症是一种慢性、复发性、进行性的脂肪过多疾病,会增加至少 13 种癌症的患病风险。本报告简明扼要地回顾了代谢和减肥手术以及肥胖症药物治疗与癌症风险相关的科学现状。队列研究的元分析表明,与非外科肥胖治疗相比,代谢和减肥手术与较低的癌症发病风险有独立关联。至于肥胖症药物疗法的癌症预防效果,目前还知之甚少。最近批准的肥胖症药物和前景广阔的肥胖症药物管线将为了解肥胖症疗法作为一种循证癌症预防策略的潜力提供机会。我们有无数的研究机会来促进我们对代谢和减肥手术以及肥胖药物疗法如何用于预防癌症的了解。
{"title":"Metabolic and bariatric surgery and obesity pharmacotherapy for cancer prevention: current status and future possibilities.","authors":"Mary C Playdon, Sheetal Hardikar, Prasoona Karra, Rachel Hoobler, Anna R Ibele, Katherine L Cook, Amanika Kumar, Joseph E Ippolito, Justin C Brown","doi":"10.1093/jncimonographs/lgad003","DOIUrl":"10.1093/jncimonographs/lgad003","url":null,"abstract":"<p><p>Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of developing at least 13 types of cancer. This report provides a concise review of the current state of the science regarding metabolic and bariatric surgery and obesity pharmacotherapy related to cancer risk. Meta-analyses of cohort studies report that metabolic and bariatric surgery is independently associated with a lower risk of incident cancer than nonsurgical obesity care. Less is known regarding the cancer-preventive effects of obesity pharmacotherapy. The recent approval and promising pipeline of obesity drugs will provide the opportunity to understand the potential for obesity therapy to emerge as an evidence-based cancer prevention strategy. There are myriad research opportunities to advance our understanding of how metabolic and bariatric surgery and obesity pharmacotherapy may be used for cancer prevention.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2023 61","pages":"68-76"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Preface: Engaging Older Adults in Cancer Clinical Trials Conducted in the National Cancer Institute Clinical Trials Network: Opportunities to Enhance Accrual. 对前言的更正:在国家癌症研究所临床试验网络中进行的癌症临床试验中参与老年人:提高应计收益的机会。
Pub Date : 2023-05-04 DOI: 10.1093/jncimonographs/lgac030
{"title":"Correction to: Preface: Engaging Older Adults in Cancer Clinical Trials Conducted in the National Cancer Institute Clinical Trials Network: Opportunities to Enhance Accrual.","authors":"","doi":"10.1093/jncimonographs/lgac030","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgac030","url":null,"abstract":"","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2023 61","pages":"e3"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157774/pdf/lgac030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A review of the impact of energy balance on triple-negative breast cancer. 能量平衡对三阴性乳腺癌影响的综述。
Pub Date : 2023-05-04 DOI: 10.1093/jncimonographs/lgad011
Ngozi D Akingbesote, Dennis Owusu, Ryan Liu, Brenda Cartmel, Leah M Ferrucci, Michelle Zupa, Maryam B Lustberg, Tara Sanft, Kim R M Blenman, Melinda L Irwin, Rachel J Perry

Cancer cells cannot proliferate without sufficient energy to generate biomass for rapid cell division, as well as to fuel their functions at baseline. For this reason, many recent observational and interventional studies have focused on increasing energy expenditure and/or reducing energy intake during and after cancer treatment. The impact of variance in diet composition and in exercise on cancer outcomes has been detailed extensively elsewhere and is not the primary focus of this review. Instead, in this translational, narrative review we examine studies of how energy balance impacts anticancer immune activation and outcomes in triple-negative breast cancer (TNBC). We discuss preclinical, clinical observational, and the few clinical interventional studies on energy balance in TNBC. We advocate for the implementation of clinical studies to examine how optimizing energy balance-through changes in diet and/or exercise-may optimize the response to immunotherapy in people with TNBC. It is our conviction that by taking a holistic approach that includes energy balance as a key factor to be considered during and after treatment, cancer care may be optimized, and the detrimental effects of cancer treatment and recovery on overall health may be minimized.

如果没有足够的能量来产生用于快速细胞分裂的生物量,癌细胞就无法增殖,也无法在基线上为其功能提供燃料。因此,最近的许多观察性和介入性研究都侧重于在癌症治疗期间和之后增加能量消耗和/或减少能量摄入。饮食组成和运动的差异对癌症结果的影响已经在其他地方进行了广泛的详细研究,这不是本综述的主要焦点。相反,在这篇翻译的叙述性综述中,我们研究了能量平衡如何影响三阴性乳腺癌(TNBC)的抗癌免疫激活和结果。我们讨论临床前,临床观察和少数临床介入性研究的能量平衡TNBC。我们提倡实施临床研究,以检查如何通过改变饮食和/或运动来优化能量平衡,从而优化TNBC患者对免疫治疗的反应。我们坚信,通过采取整体方法,将能量平衡作为治疗期间和治疗后考虑的关键因素,可以优化癌症护理,并将癌症治疗和康复对整体健康的有害影响降至最低。
{"title":"A review of the impact of energy balance on triple-negative breast cancer.","authors":"Ngozi D Akingbesote,&nbsp;Dennis Owusu,&nbsp;Ryan Liu,&nbsp;Brenda Cartmel,&nbsp;Leah M Ferrucci,&nbsp;Michelle Zupa,&nbsp;Maryam B Lustberg,&nbsp;Tara Sanft,&nbsp;Kim R M Blenman,&nbsp;Melinda L Irwin,&nbsp;Rachel J Perry","doi":"10.1093/jncimonographs/lgad011","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgad011","url":null,"abstract":"<p><p>Cancer cells cannot proliferate without sufficient energy to generate biomass for rapid cell division, as well as to fuel their functions at baseline. For this reason, many recent observational and interventional studies have focused on increasing energy expenditure and/or reducing energy intake during and after cancer treatment. The impact of variance in diet composition and in exercise on cancer outcomes has been detailed extensively elsewhere and is not the primary focus of this review. Instead, in this translational, narrative review we examine studies of how energy balance impacts anticancer immune activation and outcomes in triple-negative breast cancer (TNBC). We discuss preclinical, clinical observational, and the few clinical interventional studies on energy balance in TNBC. We advocate for the implementation of clinical studies to examine how optimizing energy balance-through changes in diet and/or exercise-may optimize the response to immunotherapy in people with TNBC. It is our conviction that by taking a holistic approach that includes energy balance as a key factor to be considered during and after treatment, cancer care may be optimized, and the detrimental effects of cancer treatment and recovery on overall health may be minimized.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2023 61","pages":"104-124"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of the National Cancer Institute. Monographs
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