National Cancer Institute
Cancer Control & Population Sciences Home - NCI's Bridge to Public Health Research, Practice and Policy

Grant Details

Grant Number: 5R01CA139633-04 Interpret this number
Primary Investigator: Bhatia, Smita
Organization: City Of Hope/Beckman Research Institute
Project Title: Role of Genetic Susceptibility in Therapy-Related Subsequent Malignancies
Fiscal Year: 2013
Back to top


Abstract

DESCRIPTION (provided by applicant): By 2010, there will be 12 million cancer survivors in the U.S., with an annual growth rate of 2%. The cumulative incidence of severe or life-threatening chronic health conditions in cancer survivors exceeds 40% at 30 years. This creates an obligation to understand the etiology of these adverse conditions, in order to develop targeted prevention/ intervention strategies and reduce long-term morbidity. Subsequent malignant neoplasms (SMNs) are one of the most devastating adverse events faced by cancer survivors, and are a leading cause of non- relapse mortality. Although, well-defined associations exist between chemoradiotherapy and SMNs (e.g., chemotherapy and therapy-related leukemia; ionizing radiation and subsequent breast or thyroid cancer after Hodgkin lymphoma), there is considerable inter-individual variability, which could be explained by underlying genetic susceptibility - an area that is currently understudied. We have successfully established a mechanism to identify a large number of cancer survivors with SMNs (cases: n=1600) and those without (controls: n=3200). We have also implemented protocols to obtain detailed therapeutic summaries and procure DNA from the cases and controls. Using a case-control study design, this application will explore the role of genetic susceptibility, by examining associations between polymorphisms in specific candidate genes, and the risk of SMN. Because of the well-defined relation between SMNs and specific chemotherapy and ionizing radiation, the focus will be on genes encoding drug metabolizing enzymes, drug-transporter genes, and genes in DNA repair pathways. Based on extensive literature review as well as study of biological pathways involved in DNA repair, and genes involved in drug metabolism and transport of chemotherapeutic agents implicated in SMNs, 771 polymorphisms in 66 genes involved in DNA repair, and 228 polymorphisms in 35 genes involved in drug metabolism/ transport have been selected. The application tests the hypotheses that the risk of treatment-related SMNs is associated with specific therapeutic exposures, variants in drug-metabolizing genes, drug transport genes, DNA repair genes, and the joint effects of specific therapeutic exposures with these susceptibility genes. The application will examine main effects of therapeutic exposures and genes for risk of SMNs and of its histologic and cytogenetic subtypes, and will also examine the role of gene-gene and gene-environment interactions in SMN development. This application's innovation lies in using a comprehensive and biologically plausible candidate gene approach to examine genetic variants in combination with well-known therapeutic exposures associated with SMNs. The application will enhance our understanding of the pathogenesis of SMN, and facilitate identification of cancer survivors at high-risk for development of SMNs, in turn facilitating primary prevention (individualizing therapy in future cancer populations) and secondary prevention (targeted screening, behavior modification, chemoprevention in survivors). Identification of pertinent genes and pathways will provide critical information regarding pathogenesis of SMN, with potential application to de novo cancer. PUBLIC HEALTH RELEVANCE: Second cancers are one of the most devastating long-term complications faced by cancer survivors, and are a common cause of premature death for this vulnerable population. This application aims to understand the role of genetic susceptibility in the development of second cancers. At its completion, the application will enhance our understanding of the pathogenesis of second cancers, and facilitate identification of survivors at high-risk for development of SMNs, in turn facilitating primary prevention (individualizing therapy in future cancer populations) and secondary prevention (targeted screening, behavior modification, chemoprevention in survivors).

Back to top


Publications

Long-term complications of therapeutic exposures in childhood: lessons learned from childhood cancer survivors.
Authors: Bhatia S
Source: Pediatrics, 2012 Dec;130(6), p. 1141-3.
EPub date: 2012 Nov 19.
PMID: 23166341
Related Citations

Grant Numbers:
NCI NIH HHS - R01 CA 139633

MeSH Terms:
Cardiotoxins Ventricular Function, Left Precursor Cell Lymphoblastic Leukemia-Lymphoma
Humans Antibiotics, Antineoplastic Cardiomyopathies
Male Heart Ventricles Female
Doxorubicin

Back to top


Genetically mediated Nf1 loss in mice promotes diverse radiation-induced tumors modeling second malignant neoplasms.
Authors: Choi G, Huang B, Pinarbasi E, Braunstein SE, Horvai AE, Kogan S, Bhatia S, Faddegon B, Nakamura JL
Source: Cancer Res, 2012 Dec 15;72(24), p. 6425-34.
EPub date: 2012 Oct 15.
PMID: 23071067
Related Citations

Grant Numbers:
NCI NIH HHS - R01 CA139633 NCI NIH HHS - R01CA095274

Back to top


Genetic susceptibility to therapy-related leukemia after Hodgkin lymphoma or non-Hodgkin lymphoma: role of drug metabolism, apoptosis and DNA repair.
Authors: Ding Y, Sun CL, Li L, Li M, Francisco L, Sabado M, Hahn B, Gyorffy J, Noe J, Larson GP, Forman SJ, Bhatia R, Bhatia S
Source: Blood Cancer J, 2012 Mar;2(3), p. e58.
EPub date: 2012 Mar 2.
PMID: 22829253
Related Citations

Grant Numbers:
NCI NIH HHS - R01 CA139633

Back to top


Role of genetic susceptibility in development of treatment-related adverse outcomes in cancer survivors.
Authors: Bhatia S
Source: Cancer Epidemiol Biomarkers Prev, 2011 Oct;20(10), p. 2048-67.
PMID: 21980013
Related Citations

Grant Numbers:
NCI NIH HHS - R01 CA139633-01A1 NCI NIH HHS - U24 CA055727-17 PHS HHS - U24 55727
NCI NIH HHS - U10 CA98543 NCI NIH HHS - R01 CA 139633 NCI NIH HHS - U10 CA098543-08

MeSH Terms:
Neoplasms Survival Rate Humans
Prognosis Genetic Predisposition to Disease Survivors
Comorbidity

Back to top


NCI, NHLBI first international consensus conference on late effects after pediatric hematopoietic cell transplantation: etiology and pathogenesis of late effects after HCT performed in childhood--methodologic challenges.
Authors: Bhatia S, Davies SM, Scott Baker K, Pulsipher MA, Hansen JA
Source: Biol Blood Marrow Transplant, 2011 Oct;17(10), p. 1428-35.
EPub date: 2011 Jul 18.
PMID: 21763253
Related Citations

Grant Numbers:
NIAID NIH HHS - R01 AI105914 NCI NIH HHS - R01 CA078938 NHLBI NIH HHS - R01 HL094260-01
NCI NIH HHS - R01 CA139633-01A1 NCI NIH HHS - R13 CA159788-01 NCI NIH HHS - P01 CA030206-22
NCI NIH HHS - P01 CA 30206 NCI NIH HHS - P01 CA030206 NHLBI NIH HHS - U01HL069254
NIAID NIH HHS - P01 AI033484-09A1 NCI NIH HHS - 1R13CA159788-01 NCI NIH HHS - R01 CA078938-01A2
NIAID NIH HHS - P01 AI33484 NHLBI NIH HHS - U01 HL069254-09 NIAID NIH HHS - R01 AI094260
NHLBI NIH HHS - R01 HL105914-01

MeSH Terms:
United States Metabolic Diseases Heart Diseases
Neoplasms, Second Primary Hematologic Neoplasms Humans
Endocrine System Diseases Child Transplantation, Homologous
Child, Preschool Infant Survival Rate
Musculoskeletal Diseases National Cancer Institute (U.S.) Lung Diseases
Hematopoietic Stem Cell Transplantation Consensus Development Conferences as Topic Graft vs Host Disease
Chronic Disease Adolescent Time Factors
Male Female

Back to top


Disparities in cancer outcomes: lessons learned from children with cancer.
Authors: Bhatia S
Source: Pediatr Blood Cancer, 2011 Jun;56(6), p. 994-1002.
EPub date: 2011 Feb 15.
PMID: 21328525
Related Citations

Grant Numbers:
NCI NIH HHS - U10 CA098543-01 NCI NIH HHS - R01 CA096670 NCI NIH HHS - R01 CA 139633

MeSH Terms:
Disease-Free Survival Precursor Cell Lymphoblastic Leukemia-Lymphoma Antineoplastic Agents
Humans SEER Program African Americans
Child Leukemia, Myeloid, Acute Pharmacogenetics
Health Services Accessibility Neuroblastoma Neoplasms
Survival Rate Hispanic Americans European Continental Ancestry Group
Treatment Outcome Asian Americans Hodgkin Disease
Rhabdomyosarcoma

Back to top


Congenital heart disease in Down syndrome: an echocardiographic study.
Authors: Bhatia S, Verma IC, Shrivastava S
Source: Indian Pediatr, 1992 Sep;29(9), p. 1113-6.
PMID: 1452307
Related Citations

Grant Numbers:
NCI NIH HHS - R01 CA139633-02

MeSH Terms:
Humans Echocardiography Infant, Newborn
Child Child, Preschool India
Infant Cross-Sectional Studies Incidence
Developing Countries Down Syndrome Heart Defects, Congenital
Male Female

Back to top




Last Updated: August 24, 2012
NIH - Turning Discovery Into Health
National Cancer InstituteU.S. National Institutes of HealthNational Cancer Institute