PROJECT SUMMARY
Aging is the major risk factor for cancer incidence, with more than 60% of cancer diagnoses occurring in those
aged 65 and above. In addition, anecdotal observations indicate that age affects prognosis and outcome. Yet,
very little experimental data dissect the connection of aging, cancer progression and sensitivity to anti-cancer
therapies. In fact, the vast majority of preclinical research that guide the discovery of novel therapeutic targets
and clinical trials that lead to anti-cancer treatments approved by the FDA neglect to account for the age of the
average patient. This lack of understanding of how aging plays a role in cancer is especially troubling considering
that the number of new cancer cases is on the rise globally, a fact that is tied to the increase in the proportion of
the older population in the world. Biologically the aging process affects the function of every cell in an organism
suggesting that a cancer developing in an aged host is a different disease than a cancer developing in a young
one. Using human serum samples, I recently demonstrated that tumor progression and metastasis formation
occur, at least in part, as a manifestation of global metabolic deregulation of the aged host. This supports the
idea that the role of aging in cancer goes far beyond increased exposure time to mutagens and puts the aging
process at the center stage coordinating the different aspects required for the evolution of malignant phenotypes.
Therefore, in order to effectively treat cancer, we must look beyond the current framework which neglects the
role of the cancer patient’s age. Here, we propose that the aged host tumor microenvironment exerts distinct
Darwinian pressures that combined with the decline of the host anti-cancer defenses define how tumor cells
evolve within the primary tumor, progress into metastatic disease and respond to anti-cancer therapies.
Employing a combination of cutting-edge bulk and single cell technologies we expect to systematically delineate
how aging affects the phenotypes and genotypes of cancer cells as well as to characterize the effects of the
aging process on the composition and interactions of the different components of the tumor microenvironment.
Finally, we will directly evaluate if old age affects the response to FDA-approved chemotherapeutic regiments
and immunotherapies, and evaluate if strategies known to rejuvenate old tissues can affect the response to these
therapeutic interventions. Through these studies, we aim to build the knowledge infrastructure required to design
therapeutic strategies that account for the reprogramming that occurs with aging.