Epidemiologic and scientific research indicates that diet and other lifestyle factors have a significant influence on the risk of developing colorectal cancer. Emerging data suggest some of these factors impact on the outcomes of patients with early stage colon cancer. However, there are no data on the influence of diet, lifestyle and other host factors on the outcomes of patients with more advanced colorectal cancer. At the time of initial diagnosis, 20% of colorectal cancer patients have evidence of metastases and another 15- 20% will recur with metastatic disease within a few years of initial diagnosis. In the past 10 years, there have been substantial improvements in chemotherapy options for these patients, with median survival exceeding 2 years and increasing number of patients living 4 or more years. Patients often seek to understand what, if any, diet and lifestyle will improve their outcomes, both survival and tolerability of therapy. Moreover, how diet and lifestyle influence prognosis may depend, in part, on molecular characteristics of the tumor. In response to a NIH Program Announcement, PA-09-148, """"""""Studies of Energy Balance and Cancer in Humans,"""""""" we propose to address these gaps in knowledge by utilizing data from 2 National Cancer Institute-sponsored chemotherapy trials in newly diagnosed patients with stage IV colorectal cancer (CALGB 80203 and 80405) which provide a) prospective assessments of diet, medication, lifestyle and comorbidities;b) paraffin-embedded tumor specimens to examine how such factors interact with specific molecular alterations;c) blood samples for research purposes;and d) comprehensive data on cancer progression, mortality, and chemotherapy-related toxicity. Since stage, performance status, use of combination chemotherapy and follow-up were carefully defined in this trial, residual confounding by disease characteristics and use of chemotherapy should be minimized. This database will provide the unique opportunity to examine the influence of energy balance (Aim 1), diet and vitamin D (Aim 2) and aspirin/NSAIDs (Aim 3) on the outcomes of patients with advanced colorectal cancer. Beyond the aforementioned hypotheses, this cohort will allow for the rapid examination of future hypotheses as they emerge. Ultimately, this database will permit us to ascertain the influence of numerous factors on colorectal cancer survival, improve our understanding of colorectal cancer biology, and potentially offer substantive diet and lifestyle recommendations for patients and health care providers.
Patients with cancer often seek information of diet and lifestyle as part of their therapy. Data generated from this application will help understand whether such factors influence the outcomes of patients. These data may influence treatment recommendations to future patients or lead to the development of a randomized trial to further knowledge in this area.
|Fadelu, Temidayo; Zhang, Sui; Niedzwiecki, Donna et al. (2018) Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance). J Clin Oncol 36:1112-1120|
|Guercio, Brendan J; Zhang, Sui; Niedzwiecki, Donna et al. (2018) Associations of artificially sweetened beverage intake with disease recurrence and mortality in stage III colon cancer: Results from CALGB 89803 (Alliance). PLoS One 13:e0199244|
|Van Blarigan, Erin L; Fuchs, Charles S; Niedzwiecki, Donna et al. (2018) Marine ?-3 Polyunsaturated Fatty Acid and Fish Intake after Colon Cancer Diagnosis and Survival: CALGB 89803 (Alliance). Cancer Epidemiol Biomarkers Prev 27:438-445|
|Van Blarigan, Erin L; Ou, Fang-Shu; Niedzwiecki, Donna et al. (2018) Dietary Fat Intake after Colon Cancer Diagnosis in Relation to Cancer Recurrence and Survival: CALGB 89803 (Alliance). Cancer Epidemiol Biomarkers Prev 27:1227-1230|
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|Venook, Alan P; Niedzwiecki, Donna; Lenz, Heinz-Josef et al. (2017) Effect of First-Line Chemotherapy Combined With Cetuximab or Bevacizumab on Overall Survival in Patients With KRAS Wild-Type Advanced or Metastatic Colorectal Cancer: A Randomized Clinical Trial. JAMA 317:2392-2401|
|Fuchs, Charles S; Niedzwiecki, Donna; Mamon, Harvey J et al. (2017) Adjuvant Chemoradiotherapy With Epirubicin, Cisplatin, and Fluorouracil Compared With Adjuvant Chemoradiotherapy With Fluorouracil and Leucovorin After Curative Resection of Gastric Cancer: Results From CALGB 80101 (Alliance). J Clin Oncol 35:3671-3677|
|Morales-Oyarvide, Vicente; Meyerhardt, Jeffrey A; Ng, Kimmie (2016) Vitamin D and Physical Activity in Patients With Colorectal Cancer: Epidemiological Evidence and Therapeutic Implications. Cancer J 22:223-31|
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|McCleary, Nadine J; Sato, Kaori; Nishihara, Reiko et al. (2016) Prognostic Utility of Molecular Factors by Age at Diagnosis of Colorectal Cancer. Clin Cancer Res 22:1489-98|
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