B


Workshop Agenda

 

THE ROLE OF OBESITY IN
CANCER SURVIVAL AND RECURRENCE:
A WORKSHOP

 

October 31-November 1, 2011
The Keck Center of the National Academies, Room 100
500 Fifth Street, NW, Washington, DC 20001

DAY 1

8:15 am

Welcome from the IOM National Cancer Policy Forum
Patricia Ganz, University of California, Los Angeles (UCLA), National Cancer Policy Forum Vice Chair

 
8:20 am

Workshop Introduction and Overview
Wendy Demark-Wahnefried, University of Alabama at Birmingham, Workshop Planning Committee Chair

 
8:30 am

Session 1: Role of Obesity and Weight Gain in the Promotion of Various Cancers
Moderator:
Rachel Ballard-Barbash, National Cancer Institute (NCI)

Overview of the role of obesity in cancer risk and progression

–   Susan Gapstur, American Cancer Society

Evidence for the role of obesity in breast cancer progression

–   Pamela Goodwin, Mount Sinai Hospital, University of Toronto



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OCR for page 85
B Workshop Agenda THE ROLE OF OBESITY IN CANCER SURVIVAL AND RECURRENCE: A WORKSHOP October 31-November 1, 2011 The Keck Center of the National Academies, Room 100 500 Fifth Street, NW, Washington, DC 20001 DAY 1 Welcome from the IOM National Cancer Policy Forum 8:15 am Patricia Ganz, University of California, Los Angeles (UCLA), National Cancer Policy Forum Vice Chair Workshop Introduction and Overview 8:20 am Wendy Demark-Wahnefried, University of Alabama at Birmingham, Workshop Planning Committee Chair Session 1: Role of Obesity and Weight Gain in the 8:30 am Promotion of Various Cancers Moderator: Rachel Ballard-Barbash, National Cancer Institute (NCI) Overview of the role of obesity in cancer risk and progression - Susan Gapstur, American Cancer Society Evidence for the role of obesity in breast cancer progression - Pamela Goodwin, Mount Sinai Hospital, University of Toronto 85

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86 THE ROLE OF OBESITY IN CANCER Evidence for the role of obesity in prostate cancer progression - Elizabeth A. Platz, Johns Hopkins Bloomberg School of Public Health Obesity, energy balance, and colorectal cancer survivorship - Jeffrey Meyerhardt, Dana-Farber Cancer Institute The impact of weight loss on cancer incidence and mortality - Bruce M. Wolfe, Oregon Health & Science University Correlations of obesity, comorbidity, and treatment: Implications for survival analysis and interpretation - Rachel Ballard-Barbash, NCI Panel Discussion 10:30 am Questions: • hat is the current state of the evidence? What are the W evidence gaps? • s the evidence strong enough to recommend weight I loss for individuals who are overweight or obese and who are either newly diagnosed with cancer or long- term cancer survivors? • ould such an approach be recommended for all W survivors or a subset of individuals diagnosed with specific cancers? If the latter, which cancers are those? • hat is the downside of recommending weight loss to W cancer survivors who are overweight or obese given the high incidence of comorbidity in this population? • hat are the methodological issues for closing the W evidence gaps? • ow do we adjust data on obesity for other factors such H as physical activity and diet? Lunch Break 11:15 am Session 2: Mechanisms by Which Obesity May 12:15 pm Influence Cancer Progression Moderator: Stephen Hursting, University of Texas at Austin

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87 APPENDIX B Overview of mechanisms - Nathan Berger, Case Western Reserve University School of Medicine Increased risk of cancer in obesity and type 2 diabetes - Derek LeRoith, Mount Sinai School of Medicine Growth factor and energy sensing pathways - John DiGiovanni, University of Texas at Austin Hormonal factors in obesity and breast cancer - Angela Brodie, University of Maryland Obesity and breast inflammation: Implications for carcinogenesis - Andrew Dannenberg, Weill Medical College of Cornell University Obesity, stem cells, and cancer - Madhuri Kakarala, University of Michigan Signaling pathway crosstalk/Systems biology - Nathan Berger, Case Western Reserve University School of Medicine Panel Discussion 2:30 pm Questions: • hat is the evidence to support a role for the various W potential mechanisms underpinning the obesity–cancer link? • hat are the most pressing unanswered questions about W mechanistic pathways? • hat mechanisms are the most viable targets for W pharmacologic or other interventions? • re multipronged approaches feasible? Should the focus A be on combination therapies and interventions? • ow easy is it to measure the intermediate biomarkers H that have been suggested? - For which of these biomarkers are there reliable assays? - For which are there limited means to assess specific levels? - What barriers exist in determining levels in humans? (e.g., is fresh frozen tissue necessary for assessment?)

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88 THE ROLE OF OBESITY IN CANCER Break 3:30 pm Session 3: Dissecting the Obesity–Cancer Link—Is It 3:45 pm Obesity? Energy Balance? Physical Activity? Moderator: Wendy Demark-Wahnefried, University of Alabama at Birmingham Overview - Wendy Demark-Wahnefried Mechanistic insights from animal models - Stephen Hursting, University of Texas at Austin Clinical evidence - Jennifer Ligibel, Dana-Farber Cancer Center Panel Discussion 4:45 pm Questions: • hat is the ultimate driver of the obesity–cancer link? W • re the relationships between physical activity and A energy restriction in cancer similar to those in other diseases such as cardiovascular disease, or does cancer represent a different model? • hat model systems and research methodologies W could help us sort out the various contributions to the obesity–cancer link? • hat is needed for effective clinical studies? W • f we are able to discern the factors most influential I in cancer promotion, would that necessarily change medical practice? • ow might we best break the obesity–cancer link? H Wrap-up, Day 1 5:15 pm Adjourn Day 1 5:30 pm

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89 APPENDIX B DAY 2 Session 4: Tying It All Together 8:30 am Moderator: Pamela Goodwin, University of Toronto Overview of weight loss interventions for obese adults - Thomas Wadden, University of Pennsylvania Physical activity interventions in cancer survivors: What works? - Kerry Courneya, University of Alberta Evidence from diet and weight loss studies for cancer survivors: What works? - Cheryl Rock, University of California, San Diego Interventions in cancer survivors; issues and challenges in this population - Anne McTiernan, University of Washington When do we have enough evidence to intervene in cancer patients? - Patricia Ganz, UCLA Panel Discussion 10:30 am Opening statements by: Kate Murphy, Fight Colorectal Cancer Diana Dyer, CancerRD.com Questions: • hen is there enough evidence to warrant intervention? W • hat interventions are effective? What is the evidence? W • hen is the teachable moment? W • hat are the mechanics of intervention: Who, when, W where, how, and what? • hich interventions are likely to be the most W cost-effective? • hat barriers stand in the way of broad dissemination W on interventions? Lunch Break 11:30 am

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90 THE ROLE OF OBESITY IN CANCER Session 5: Reactions and Panel Discussion—What Are 12:00 pm the Policy and Research Implications? Moderators: Martin Murphy, CEO Roundtable on Cancer and Patricia Ganz, UCLA Lori Minasian, Division of Cancer Prevention, NCI Linda Nebeling, Division of Cancer Control and Population Sciences, NCI Jo Anne Zujewski, Division of Cancer Treatment and Diagnosis, NCI Edward Partridge, American Cancer Society and University of Alabama at Birmingham Dean Brenner, American Society of Clinical Oncology and University of Michigan Questions: • hat are the research needs and goals to advance W understanding of this topic? • hat resources and infrastructures are needed to W accomplish the research goals? • hat is needed for effective interdisciplinary research in W this area? • hat policy changes do you suggest to reduce obesity- W related cancer incidence and mortality? • hat are the obstacles to implementing such policy W changes? How could those obstacles be overcome? • ow can we work with other medical fields to H accomplish common goals? Closing Remarks—Wendy Demark-Wahnefried 1:00 pm Adjourn 1:10 pm