Titles and Affiliations
Director, Geriatric Oncology
Lineberger Comprehensive Cancer Center
Professor of Medicine
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, including biological aging. Cellular senescence has an essential role in aging as an indicator and a cause of aging-related functional decline. Senescent cells cannot divide but secrete factors that promote inflammation and induce senescence in healthy cells locally and at distant sites. Dr. Muss and his research team are conducting a series of studies to understand the effects of chemotherapy on aging of the immune system and identifying strategies to prevent or attenuate these unwanted side effects and improve the quality of life of patients who have undergone this treatment.
Progress Thus Far
Dr. Muss and his team have shown that different chemotherapy regimens induce cellular senescence and affect a marker called p16 in both older and younger women with breast cancer. They have also observed that chemotherapy rapidly and irreversibly ages their immune systems by about ten years. This past year, the team’s research has focused on two complementary directions: defining new markers, beyond p16, that more precisely reflect human biological aging, and developing scalable interventions that may slow chemotherapy-induced aging. To identify new markers, the team has an ongoing study measuring blood proteins to determine how individual organs age following chemotherapy. To address the challenge of identifying women at greatest risk for accelerated aging, the team collaborating on a trial testing an anti-aging drug alongside vigorous exercise in women experiencing increased fatigue after adjuvant chemotherapy (NCT06789653).
What’s next
Dr. Muss and his team will focus on deepening their understanding of how chemotherapy accelerates aging and identifying patients most at risk for long-term side effects. He and his team will perform protein and RNA sequencing analysis on immune cells from 40 newly diagnosed patients receiving chemotherapy, examining p16 levels alongside broader immunologic profiles. Together, this research aims to identify reliable biomarkers for cardiac and cognitive decline following chemotherapy, laying the groundwork for testing targeted lifestyle and pharmacologic interventions to mitigate these long-term side effects.
Biography
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.
