The purpose of this Notice of Special Interest (NOSI) is to solicit investigator-initiated applications that aim to better understand the effects of a cancer diagnosis and subsequent cancer treatment on aging trajectories and aging outcomes.
Background
With the advent of successful screening strategies and more effective treatments, cancer survivors are now living longer. However, this success has come with a cost: the treatments that cancer survivors are administered have been shown in laboratory studies to cause cell damage through many of the same mechanisms that are thought to underlie the normal aging process. Thus, the treatments that spare cancer survivors from mortality related to their cancer may adversely alter their aging trajectory, putting the cancer survivor at risk for a broad spectrum of aging-related health conditions at a younger age than would occur with the normal aging process. While this is biologically plausible, there is a paucity of studies that have examined whether the molecular and cellular changes resulting from treatment toxicity lead to the emergence of aging-related outcomes and alter aging trajectories throughout survivorship.
In July 2018 and February 2019, National Cancer Institute (NCI) convened two multidisciplinary think tanks, “Measuring Aging and Identifying Aging Phenotypes in Cancer Survivors” and “Strategies to Prevent or Remediate Cancer- and Treatment-Associated Aging”. The purpose of these think tanks was to discuss the state of the science related to cancer, cancer treatments, and aging trajectories. Several research gaps emerged, including a need for longitudinal studies with both cancer treatment and aging-related outcome data to examine aging trajectories, mechanistic studies to better understand the biological mechanisms (such as the hallmarks of aging) underlying the early-onset of aging phenotypes in cancer survivors, long-term surveillance to monitor survivors for late-emerging effects, statistical modeling strategies to support the analysis of data from multiple sources (i.e. data related to cancer and aging), and interventions that prevent, reverse, or mitigate adverse aging-related effects experienced by cancer survivors due to cancer or cancer treatment. Addressing these research needs, as well as other gaps in knowledge in this research area, will improve the evidence base and inform strategies to optimize healthy aging for cancer survivors.
Research Objectives
The National Cancer Institute (NCI) and the National Institute on Aging (NIA) are interested in applications that address one or more of the research gap areas as outlined in Guida et al. (2019), Guida et al. (2020), and above. These include, but are not limited to:
- Investigation of aging trajectories associated with specific cancer treatments and identification of cancer survivors at risk for an “accelerated aging” phenotype;
- Examination of the effects of specific cancer treatments on aging biology that may alter aging trajectories or aging outcomes;
- Development and/or validation of tools, technologies, measures, or techniques for the identification of late-emerging effects and aging phenotypes among cancer survivors;
- Use of old and young animal models to determine the effects of established and newer cancer therapies on aging endpoints;
- Development and/or testing of interventions designed to prevent, mitigate or reverse the adverse aging-related effects of cancer and cancer treatments; and
- Development and/or testing of interventions focused on models and processes of care delivery to intervene at the intersection of cancer treatment and aging.
Investigations in understudied populations, including those that are medically underserved, are encouraged.