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Strategies to Prevent or Remediate Cancer and Treatment-Related Aging.

ABSTRACT: Up to 85% of adult cancer survivors and 99% of adult survivors of childhood cancer live with an accumulation of chronic conditions, frailty, and/or cognitive impairments resulting from cancer and its treatment. Thus, survivors often show an accelerated development of multiple geriatric syndromes and need therapeutic interventions. To advance progress in this area, the National Cancer Institute convened the second of 2 think tanks under the auspices of the Cancer and Accelerated Aging: Advancing Research for Healthy Survivors initiative. Experts assembled to share evidence of promising strategies to prevent, slow, or reverse the aging consequences of cancer and its treatment. The meeting identified research and resource needs, including geroscience-guided clinical trials; comprehensive assessments of functional, cognitive, and psychosocial vulnerabilities to assess and predict age-related outcomes; preclinical and clinical research to determine the optimal dosing for behavioral (eg, diet, exercise) and pharmacologic (eg, senolytic) therapies; health-care delivery research to evaluate the efficacy of integrated cancer care delivery models; optimization of intervention implementation, delivery, and uptake; and patient and provider education on cancer and treatment-related late and long-term adverse effects. Addressing these needs will expand knowledge of aging-related consequences of cancer and cancer treatment and inform strategies to promote healthy aging of cancer survivors.

SUBMITTER: Guida JL

PROVIDER: S-EPMC7850536 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Strategies to Prevent or Remediate Cancer and Treatment-Related Aging.

Guida Jennifer L JL Agurs-Collins Tanya T Ahles Tim A TA Campisi Judith J Dale William W Demark-Wahnefried Wendy W Dietrich Jorg J Fuldner Rebecca R Gallicchio Lisa L Green Paige A PA Hurria Arti A Janelsins Michelle C MC Jhappan Chamelli C Kirkland James L JL Kohanski Ronald R Longo Valter V Meydani Simin S Mohile Supriya S Niedernhofer Laura J LJ Nelson Christian C Perna Frank F Schadler Keri K Scott Jessica M JM Schrack Jennifer A JA Tracy Russell P RP van Deursen Jan J Ness Kirsten K KK

Journal of the National Cancer Institute 20210201 2

Up to 85% of adult cancer survivors and 99% of adult survivors of childhood cancer live with an accumulation of chronic conditions, frailty, and/or cognitive impairments resulting from cancer and its treatment. Thus, survivors often show an accelerated development of multiple geriatric syndromes and need therapeutic interventions. To advance progress in this area, the National Cancer Institute convened the second of 2 think tanks under the auspices of the Cancer and Accelerated Aging: Advancing ...[more]

PMID: 32348501

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Project description:ObjectiveTo synthesise the available evidence and estimate the comparative efficacy of control strategies to prevent total hip replacement (THR)-related surgical site infections (SSIs) using a mixed treatment comparison.DesignSystematic review and mixed treatment comparison.SettingHospital and other healthcare settings.ParticipantsPatients undergoing THR.Primary and secondary outcome measuresThe number of THR-related SSIs occurring following the surgical operation.Results12 studies involving 123 788 THRs and 9 infection control strategies were identified. The strategy of 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation' significantly reduced the risk of THR-related SSI compared with the referent strategy (no systemic antibiotics+plain cement+conventional ventilation), OR 0.13 (95% credible interval (CrI) 0.03-0.35), and had the highest probability (47-64%) and highest median rank of being the most effective strategy. There was some evidence to suggest that 'systemic antibiotics+antibiotic-impregnated cement+laminar airflow' could potentially increase infection risk compared with 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation', 1.96 (95% CrI 0.52-5.37). There was no high-quality evidence that antibiotic-impregnated cement without systemic antibiotic prophylaxis was effective in reducing infection compared with plain cement with systemic antibiotics, 1.28 (95% CrI 0.38-3.38).ConclusionsWe found no convincing evidence in favour of the use of laminar airflow over conventional ventilation for prevention of THR-related SSIs, yet laminar airflow is costly and widely used. Antibiotic-impregnated cement without systemic antibiotics may not be effective in reducing THR-related SSIs. The combination with the highest confidence for reducing SSIs was 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation'. Our evidence synthesis underscores the need to review current guidelines based on the available evidence, and to conduct further high-quality double-blind randomised controlled trials to better inform the current clinical guidelines and practice for prevention of THR-related SSIs.

Dataset Information

Strategies to Prevent or Remediate Cancer and Treatment-Related Aging.

Publications

Strategies to Prevent or Remediate Cancer and Treatment-Related Aging.

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