University of North Carolina
Chapel Hill, North Carolina
Director, Geriatric Oncology
Lineberger Comprehensive Cancer Center
Professor of Medicine
Understanding the effects of chemotherapy on molecular aging.
While often curative, chemotherapy also has unwanted side effects that endure after treatment has ended, including biological aging. 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.
Dr. Muss’ team has shown that different chemotherapy regimens affect a marker of aging called p16 in both older and younger women with breast cancer and that chemotherapy rapidly and irreversibly ages their immune systems by about ten years. He has also found that p16 can be used to predict which patients receiving chemotherapy are more likely to experience side effects such as fatigue and chemotherapy-induced peripheral neuropathy. Dr. Muss is now working to find ways to slow the effects of chemotherapy-associated aging. He and his team are conducting a study to test the efficacy of strength training exercises and drugs called senolytics, which target and kill old or damaged cells that are no longer normally replicating, in slowing the effects of chemotherapy-associated aging and so far, has found that a home-based, self-monitored walking program during chemotherapy does not mitigate the dramatic rise in p16 expression.
Dr. Muss will continue to analyze the p16 levels of patients who walked during chemotherapy treatment and compare those values to their pre-chemotherapy p16 levels. The next step of this study is to test the effects of more vigorous exercise or increased senolytics. Dr. Muss is now accruing patients for a trial to verify that baseline p16 is a predictor of chemotherapy-induced peripheral neuropathy.
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.
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