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Hyman B. Muss, MD
Director, Geriatric Oncology
Lineberger Comprehensive Cancer Center
Professor of Medicine
University of North Carolina
Chapel Hill, North Carolina
Goal: To improve quality of life for breast cancer patients.
Impact: Dr. Muss is studying how chemotherapy ages the immune system and interferes with daily function in breast cancer patients. His findings could lead to interventions that would reduce the side effects of chemotherapy and improve the quality of life of patients who have undergone this treatment.
What’s next: He and his colleagues will continue to study the effects of different chemotherapy regiments on molecular aging. In addition, they will conduct a new study comparing general aging to molecular aging.
Chemotherapy is very effective in killing cancer cells, but it can also have negative effects on healthy tissue. Dr. Muss has found that the use of chemotherapy following breast cancer surgery ages the immune system by about 10-15 years. He is also evaluating whether a molecular marker of aging, p16INK4a, could be used to predict how chemotherapy will affect a patient’s long-term health and survival and whether exercise could moderate the chemotherapy-induced side effects.
Full Research Summary
Research Area: Understanding the effects of chemotherapy on molecular aging.
Impact: While often curative, chemotherapy also has unwanted side effects that endure after treatment has ended. Dr. Muss and his research team are conducting a series of studies to understand the effects of chemotherapy on biological aging and identifying strategies to prevent or attenuate these unwanted side effects.
Current investigation: Dr. Muss’ team is studying how different adjuvant chemotherapy regimens affect a marker of aging called p16INK4a, if the increase in p16INK4a can be moderated by a home-based walking intervention during chemotherapy, and how the increase in p16INK4a during chemotherapy relates to pre-chemotherapy measures of body composition, function, and quality of life. Dr. Muss is also testing whether P16INK4a levels can be used to predict which patients receiving chemotherapy will experience certain side effects.
What he’s learned so far: Dr. Muss has found that currently used adjuvant chemotherapy regimens in both older and younger women with breast cancer rapidly and irreversibly age their immune systems by about ten years as determined by p16INK4a expression. He has also found that p16INK4a can be used to predict which patients receiving chemotherapy are more likely to experience side effects such as fatigue.
What’s next: Dr. Muss will continue his efforts across several studies aimed at improving outcomes and quality of life of breast cancer patients. He will also begin a new study comparing molecular aging measured by p16INK4a levels to general aging measured by DNA methylation patterns. Correlating these two types of measurements will unlock aging information from a wealth of existing breast cancer patient samples in tissue banks.
Dr. Muss is an experienced clinician-scientist, a Professor of Medicine at the University of North Carolina School of Medicine, and the Director of the Geriatric Oncology Program at the UNC Lineberger Comprehensive Cancer Center Program. He has a major interest and research expertise in the care of women with breast cancer and has developed and been PI of multiple clinical and translational trials. He was the lead author of a CALGB trial and seminal NEJM article that compared standard with oral chemotherapy in older women with early stage breast cancer. In addition, he has previously chaired the Breast Committee of the CALGB and currently is co-chair the Alliance (NCI Cooperative Group) Committee on Cancer in the Elderly. He has been Medical Oncology Chair and a member of the board of Directors of the American Board of Internal Medicine, and a member of the Board of Directors of the American Society of Clinical Oncology (ASCO) and the Conquer Cancer Foundation. He was awarded the B.J. Kennedy Award in Geriatric Oncology by ASCO, and was awarded the Susan G. Komen for the Cure Brinker Award for Scientific Distinction in Clinical Research in 2012. He served in the US Army in Vietnam where he was awarded the Bronze Star medal. His current research focuses on geriatric oncology and breast cancer, with a special interest in breast cancer in older women.