Gerotherapeutics: aging mechanism–based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities
Year: 2024
Type: article
Abstract: The central premise of this article is that a portion of the established relationships between social determinants of health and racial and ethnic disparities in cancer morbidity and mortality is 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 cancer survivors from minority populations 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 individuals from minoritized groups experiencing accelerated aging (ie, a steeper slope or trajectory of biological aging over time relative to chronological age) more often than individuals from nonminoritized groups. Acceleration of biological aging can increase the risk, age of onset, aggressiveness, and 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 survivors from minoritized vs nonminoritized populations. We highlight key targetable biological aging mechanisms with potential applications to reducing cancer disparities and discuss methodological considerations for preclinical 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.
DOI: 10.1093/jnci/djae211
Institutions: Georgetown University, Georgetown University Medical Center, Georgetown Lombardi Comprehensive Cancer Center, University of Miami, Sylvester Comprehensive Cancer Center, University of California, Los Angeles, The University of Texas at San Antonio Health Science Center, Wayne State University, The Barbara Ann Karmanos Cancer Institute, Monash University, UCLA Jonsson Comprehensive Cancer Center
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: bronze
Awards: G1266211187, G1664104963, G2980868888, G3269577218, G3290320505, G3302794266, G3980976770, G4001955865, G4099853, G4239486905, G4245576124, G4333022893, G5414813931, G6872933667, G6889943974, G701532709, G714066070, G7315229908, Targeting sympathetic nerves to treat metastatic triple negative breast cancer, G9000039195, G9000088008, G9000089719, G9000104855, G9000134390, G9000142926, G9000168116, G9000199580, G9000287902, G9000292161, Targeting Senescence to Mitigate Chemotherapy-induced Functional Decline, Detroit Research on Cancer Survivors (Detroit ROCS), G914364762
OpenAlex ID: W4402026947