Gerotherapeutics: aging mechanism–based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities

作者：Jeanne S. Mandelblatt, Michael H. Antoni, Traci N. Bethea, Steve W. Cole, Barry I. Hudson, Frank J. Penedo, Amelie G. Ramírez, G. William Rebeck, Swarnavo Sarkar, Ann G. Schwartz, Erica K. Sloan, Yun‐Ling Zheng, Judith Carroll, Mina S. Sedrak · 发表于：JNCI Journal of the National Cancer Institute · 年份：2024 · DOI：10.1093/jnci/djae211 · 被引用次数：22 · 研究领域：BRCA gene mutations in cancer、Dietary Effects on Health、Cancer survivorship and care

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 re...