Abstract A106: Associations between active cytomegalovirus infection and patient-reported quality of life, fatigue and cognitive functioning among ovarian cancer survivors
Authors: Vogel Rachel I. , Brown Katherine , Honeyfield Kate , Hunter-Schlichting Devon , Gruner Morgan , Teoh Deanna , Geller Melissa , Nelson Heather 
Published: March 2024

Over 50% of the US population has been infected with cytomegalovirus (CMV) by age 40 and once infected the virus can reactivate from latency later in life. Previous studies suggest that in some individuals with ovarian cancer, sub-clinical CMV infection is present at the time of diagnosis and may occur/reactivate during chemotherapy treatment. The goal of this study was to assess the associations between CMV infections among ovarian cancer survivors following completion of frontline chemotherapy and patient-reported outcomes. We conducted a cross-sectional study of individuals diagnosed with ovarian, primary peritoneal or fallopian tube cancer who had received at least 3 cycles of chemotherapy as part of their first line therapy, irrespective of current disease or treatment status. Eligible participants were recruited from academic and community cancer clinics in Minnesota. Participants were asked to complete a one-time blood draw and survey (paper or online, available in English only). Plasma CMV DNA levels were assessed using digital PCR; &gt;100 copies/mL of plasma was considered CMV (CMV+). Quality of life (Functional Assessment of Cancer Therapy – General), fatigue severity (Fatigue Symptom Inventory), and cognitive function (PROMIS Cognitive Function 8a) were assessed using validated self-reported measures. Cancer diagnosis and treatment related information were abstracted from medical records. Data were summarized using descriptive statistics (mean ± standard deviations and frequencies) and compared by CMV status (CMV+ vs. CMV-) using t-tests; p-values and Cohen’s D effect sizes (ES) are presented. Data from a total of 129 participants were available at the time of this analysis. Participants were on average 64.1±11.9 years old and median of 2.1 years from diagnosis. Most (73.6%) had advanced stage disease, received a median of 6 cycles of chemotherapy, and about half (45%) had experienced at least one recurrence prior to participating in this study. Approximately one-third (36.4%) were CMV+, indicating an active CMV infection. Participants who were CMV+, compared to those who were CMV-, reported poorer overall quality of life (range: 0-108: 78.9±18.7 vs. 84.4±14.3, p=0.07; ES=0.33), poorer cognitive functioning (range: 8-40: 28.8±9.3 vs. 32.1±7.6, p=0.03; ES=0.39) and greater fatigue (range: 0-10: 3.6±2.2 vs. 2.8±1.9, p=0.03, ES=0.39). All three outcomes are moderately correlated with each other (correlation coefficients ~0.5). Individuals with ovarian cancer typically experience multiple physical and emotional symptoms associated with the disease and its treatment, with fatigue and changes in cognitive function being some of the most reported. Our data suggest that active CMV infection is associated with significant differences in self-reported symptoms of fatigue and cognitive functioning in ovarian cancer survivors.

Citation Format: Rachel I. Vogel, Katherine Brown, Kate Honeyfield, Devon Hunter-Schlichting, Morgan Gruner, Deanna Teoh, Melissa Geller, Heather Nelson. Associations between active cytomegalovirus infection and patient-reported quality of life, fatigue and cognitive functioning among ovarian cancer survivors [abstract]. In: Proceedings of the AACR Special Conference on Ovarian Cancer; 2023 Oct 5-7; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_2):Abstract nr A106.