Applying a Life Course Biological Age Framework to Improving the Care of Individuals With Adult Cancers
Year: 2021
Type: article
Abstract: IMPORTANCE: The practice of oncology will increasingly involve the care of a growing population of individuals with midlife and late-life cancers. Managing cancer in these individuals is complex, based on differences in biological age at diagnosis. Biological age is a measure of accumulated life course damage to biological systems, loss of reserve, and vulnerability to functional deterioration and death. Biological age is important because it affects the ability to manage the rigors of cancer therapy, survivors' function, and cancer progression. However, biological age is not always clinically apparent. This review presents a conceptual framework of life course biological aging, summarizes candidate measures, and describes a research agenda to facilitate clinical translation to oncology practice. OBSERVATIONS: Midlife and late-life cancers are chronic diseases that may arise from cumulative patterns of biological aging occurring over the life course. Before diagnosis, each new patient was on a distinct course of biological aging related to past exposures, life experiences, genetics, and noncancer chronic disease. Cancer and its treatments may also be associated with biological aging. Several measures of biological age, including p16INK4a, epigenetic age, telomere length, and inflammatory and body composition markers, have been used in oncology research. One or more of these measures may be useful in cancer care, either alone or in combination with clinical history and geriatric assessments. However, further research will be needed before biological age assessment can be recommended in routine practice, including determination of situations in which knowledge about biological age would change treatment, ascertaining whether treatment effects on biological aging are short-lived or persistent, and testing interventions to modify biological age, decrease treatment toxic effects, and maintain functional abilities. CONCLUSIONS AND RELEVANCE: Understanding differences in biological aging could ultimately allow clinicians to better personalize treatment and supportive care, develop tailored survivorship care plans, and prescribe preventive or ameliorative therapies and behaviors informed by aging mechanisms.
Source: JAMA Oncology
Institutions: Georgetown University, Georgetown University Medical Center, Georgetown Lombardi Comprehensive Cancer Center, Memorial Sloan Kettering Cancer Center, Indiana University Indianapolis, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indiana University – Purdue University Indianapolis, Duke University, Duke Medical Center, University of California, Los Angeles, UCLA Jonsson Comprehensive Cancer Center
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1024368718, G1174881085, Indiana Alzheimer Disease Center, G1436341924, G1576357080, G1820159704, G3269577218, G358420306, G3845144022, G4239486905, G5519153753, G5826693268, G6245148141, G655634367, Accelerated biological aging in breast cancer and risk for cognitive and physical complaints, G742019397, G8303821639, G8496962235, G8615133363, G888536982, G9000002753, G9000011920, G9000024441, G9000039195, G9000040680, G9000048185, G9000071044, G9000140210, G9000199580, Cancer Center Support Grant, Cancer Center Support Grant (CCSG), 1/2 CCNY-MSK Partnership for Cancer Research, Education and Community Outreach
OpenAlex ID: W3191171369