Titles and Affiliations
Director, Geriatric Oncology
Lineberger Comprehensive Cancer Center
Professor of Medicine
University of North Carolina
Chapel Hill, North Carolina
Areas of Focus
- Tumor Biology
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.
Progress Thus Far
Dr. Muss’ team has shown that different adjuvant chemotherapy regimens affect a marker of aging called p16 in both older and younger women with breast cancer and that chemotherapy rapidly and irreversibly age 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. Levels of p16 increase dramatically and rapidly with chemotherapy in a large percentage of patients and being able to identify those patients who are likely to have accelerated aging will enable development of personalized interventions.
Dr. Muss is now focusing on p16 and its relationship to other toxicities such as cardiovascular disease in long-term survivors. He and his team are conducting a trial in patients who received adjuvant (post-surgery) chemotherapy to compare changes in p16 levels with other molecular changes that occur with age, for example changes in DNA function, and to correlate p16 with long-term outcomes during survivorship. Dr. Muss hopes to uncover the long-term implications of chemotherapy-accelerated biologic aging (e.g., heart disease, diabetes, second cancers). Dr. Muss is now testing the efficacy of drugs called senolytics and strength training exercises in slowing the effects of chemotherapy-associated aging.
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.