TY - JOUR
T1 - Biology of premature ageing in survivors of cancer
AU - Cupit-Link, Margaret C.
AU - Kirkland, James L.
AU - Ness, Kirsten K.
AU - Armstrong, Gregory T.
AU - Tchkonia, Tamar
AU - Lebrasseur, Nathan K.
AU - Armenian, Saro H.
AU - Ruddy, Kathryn J.
AU - Hashmi, Shahrukh K.
N1 - Publisher Copyright:
© European Society for Medical Oncology (unless otherwise stated in the text of the article) 2017.
PY - 2017/12
Y1 - 2017/12
N2 - Over 30 million cancer survivors exist worldwide. Survivors have an earlier onset and higher incidence of chronic comorbidities, including endocrinopathies, cardiac dysfunction, osteoporosis, pulmonary fibrosis, secondary cancers and frailty than the general population; however, the fundamental basis of these changes at the cellular level is unknown. An electronic search was performed on Embase, Medline In-Process & Other Non-Indexed Citations, and the Cochrane Central Register of Controlled Trials. Original articles addressing the cellular biology of ageing and/or the mechanisms of cancer therapies similar to ageing mechanisms were included, and references of these articles were reviewed for further search. We found multiple biological process of ageing at the cellular level and their association with cancer therapies, as well as with clinical effects. The direct effects of various chemotherapies and radiation on telomere length, senescent cells, epigenetic modifications and microRNA were found. We review the effects of cancer therapies on recognised hallmarks of ageing. Long-term comorbidities seen in cancer survivors mimic the phenotypes of ageing and likely result from the interaction between therapeutic exposures and the underlying biology of ageing. Long-term follow-up of cancer survivors and research on prevention strategies should be pursued to increase the length and quality of life among the growing population of cancer survivors.
AB - Over 30 million cancer survivors exist worldwide. Survivors have an earlier onset and higher incidence of chronic comorbidities, including endocrinopathies, cardiac dysfunction, osteoporosis, pulmonary fibrosis, secondary cancers and frailty than the general population; however, the fundamental basis of these changes at the cellular level is unknown. An electronic search was performed on Embase, Medline In-Process & Other Non-Indexed Citations, and the Cochrane Central Register of Controlled Trials. Original articles addressing the cellular biology of ageing and/or the mechanisms of cancer therapies similar to ageing mechanisms were included, and references of these articles were reviewed for further search. We found multiple biological process of ageing at the cellular level and their association with cancer therapies, as well as with clinical effects. The direct effects of various chemotherapies and radiation on telomere length, senescent cells, epigenetic modifications and microRNA were found. We review the effects of cancer therapies on recognised hallmarks of ageing. Long-term comorbidities seen in cancer survivors mimic the phenotypes of ageing and likely result from the interaction between therapeutic exposures and the underlying biology of ageing. Long-term follow-up of cancer survivors and research on prevention strategies should be pursued to increase the length and quality of life among the growing population of cancer survivors.
KW - aging
KW - anticancer therapeutics
KW - long term side effects
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U2 - 10.1136/esmoopen-2017-000250
DO - 10.1136/esmoopen-2017-000250
M3 - Review article
AN - SCOPUS:85041999978
SN - 2059-7029
VL - 2
JO - ESMO Open
JF - ESMO Open
IS - 5
M1 - e000250
ER -