bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic polymorphisms of SCNA9 as predictive markers of oxaliplatin-induced neuropathy.
Authors: Sereno Maria , Gutierrez-Gutierrez Gerardo , Rodriguez-Antona Cristina , Sanchez Lara , gomez Lopez Cesar , Lopez Gomez Miriam , Zambrana Tevar Francisco , Merino Maria , Miralles Ambrosio , Casado Enrique 
Published: March 2020

9073 Background: Oxaliplatin (OXL) is an active drug in digestive tumors. Oxaliplatin induced peripheral neuropathy (OIN) is the main dose limiting toxicity. Around 60-80% of patients developed a mild cold-induced neurotoxicity that used to disappear few days after but in 15% became a persistent neuropathy. The pathophysiology of oxaliplatin-induced neuropathy (OIN) remains unclear, preclinical studies suggest involvement of voltage Na channels. SCN9A gene codifies to Na channels α subunit highly expressed in nociceptive neurons. Mutations in SCN9A are involved in alterations in neuropatic pain perception. This study tried to identify if variants in SCN9A could be associated to a higher risk to OIN. Methods: Serum were obtained from 100 patients with digestive cancer (colorectal, gastric, pancreatic and bile duct) treated with OXL (adjuvant or advanced setting) in Infanta Sofía University Hospital. No diabetes or hypotiroidism were detected. Patients were divided in two groups according to the development of OIN: Arm A 50 patients diagnosed of grade 2-3 OIN after 6 courses and Arm B 50 with no OIN. The evaluation of severity of the OIN by a neurologist included a classification according to NCI-CTC and OSNS scales and conduction studies. Genomic DNA was isolated from serum and variants of SCN9A were analyzed by PCR-RFLP. The relation between SCN9A genotype and the development of severe OIN was the primary aim Results: One hundred patients were enrolled between May 2010-November 2011. 56 (56%) females and 44 (44%) males; mean age was 62; mean ECOG was 1; primary tumor were colorectal 81 pts (81%), gastric 10 (10%); 8 (8%) pancreto-biliar and anus 1(1%). Stage were classified in localized 65 (65%) and advanced (35%). The chemotherapy regimen included: 94 (94%) XELOX, 1 (1%) XELOX-Herceptin and 5 (5%) EOX regimen. The mean of cycles were 7 (1-14). Mean OXL dose intensity was 100mg/m2.The mean PFS was 23 months. High expression of SCN9A variants were detected in patients 26/50, 52% arm A and in 5/50, 10% arm B patients, suggesting a possible relationship beetwen the development of OIN and SCN9A genotype (p=0.04). Conclusions: SCN9A polimorphysms may help to identify those patients with a higher risk to develop oxaliplatin induced neuropathy.
Pilot study of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy.
Authors: Pachman Deirdre R. , Linquist Breanna M. , Barton Debra L. , Fee-Schroeder Kelliann C. , Smith Thomas J. , Lachance Daniel Honore , Liu Heshan , Seisler Drew K. , Loprinzi Charles L. 
Published: March 2020

9075 Background: Chemotherapy-induced peripheral neuropathy (CIPN), a common dose-limiting side effect of chemotherapy, remains without known effective interventions. Preliminary data support that Scrambler therapy, a device which treats pain via non-invasive cutaneous electrostimulation, is beneficial for the treatment of CIPN. This pilot trial was performed to investigate the effect of Scrambler therapy for the treatment of CIPN. Methods: Eligible patients included those age ≥18 years, ECOG PS ≤2, life expectancy ≥3 months, with pain or CIPN symptoms of ≥1 month duration and tingling or pain ≥4/10 during the prior week. Patients were treated with Scrambler therapy to the affected area for up to 10 daily 30 minute sessions. Symptoms were monitored daily during therapy using a questionnaire to measure symptoms of neuropathy with a numerical analogue scale. Results: We report on the first 11 CIPN patients, enrolled between 7/18/2011 and 12/12/2011, 3 men and 8 women; mean age 57 years. Patients had history of exposure to various chemotherapeutic agents and the majority had symptoms >2 years. The table portrays data at baseline, at the end of the 10 planned days of therapy, and the percent changes from baseline to the end of treatment, regarding patient reported pain, tingling, and numbness over the preceding 24 hours. There were no adverse events. Persistent benefit out to 5 weeks was seen in some patients; maturing data will be available by May 2012. Descriptive summary statistics formed the basis of data analysis. Further patients are being entered on this trial. Conclusions: Scrambler therapy appears to be beneficial in the treatment of CIPN. A prospective placebo-controlled clinical trial should be performed to confirm these preliminary findings. [Table: see text]
Paucity of core palliative care elements available to children with cancer at end-of-life: Perspectives of bereaved parents and clinicians.
Authors: Kassam Alisha , Habib Sharifa , Skiadaresis Julia , Alexander Sarah , Wolfe Joanne 
Published: March 2020

9076 Background: Recognition of serious deficits in palliative care for children has prompted hospitals to develop specialized pediatric palliative care programs. However, only a minority of children who die from advanced cancer receive services from these dedicated programs. We aimed to determine which elements of palliative care are considered important according to bereaved parents and pediatric oncology clinicians and to determine availability of these elements. Methods: We administered questionnaires to 75 bereaved parents (response rate 53%) and 48 pediatric oncology clinicians (response rate 91%) at the Hospital for Sick Children in Toronto, Canada. The main outcome measures were importance ratings and availability of core elements of palliative care delivery based on the National Quality Forum clinical practice guidelines for quality palliative care. Results: Fifteen of the twenty-one core elements were highly valued by both parents and clinicians (defined as > 60% of parents and clinicians reporting the item as important). When compared to clinicians, parents gave higher importance ratings to receiving cancer-directed therapy during the last month of life (p = 0.007) and involvement of a religious or spiritual mentor (p = 0.03). Clinicians gave higher importance ratings to involvement of a social worker (p < 0.0001). Notably, of the valued elements, only three of them were available greater than 60% of the time according to clinicians and parents. Valued elements least likely to be available included a direct admission policy to hospital, involvement of a religious or spiritual mentor, sibling support and parent preparation for medical aspects surrounding death. Conclusions: Children with advanced cancer are not receiving key elements of palliative care despite both parents and clinicians recognizing them as important. Evaluation of barriers to provision of quality palliative care and strategies for overcoming them is critical.
Randomized trial of a physical activity intervention in patients with metastatic breast cancer.
Authors: Ligibel Jennifer A. , Giobbie-Hurder Anita , Shockro Laura , Campbell Nancy , Partridge Ann H. , Tolaney Sara M. , Lin Nancy U. , Winer Eric P. 
Published: March 2020

9084 Background: Physical activity (PA) interventions improve fitness, functional capacity, and quality of life in patients with early-stage breast cancer. There are almost no data regarding the feasibility or potential benefits of PA in women with metastatic breast cancer (MBC). Our study evaluated the impact of a moderate-intensity PA intervention upon functional measures in patients with MBC. Methods: Participants were randomized 1:1 to a 16-week PA intervention or usual care control group. Eligibility included diagnosis of MBC, ECOG 0-1, and no active brain metastases. The intervention consisted of 4 weekly meetings with an exercise physiologist, followed by monthly in-person and weekly telephone-based meetings. The PA goal was 150 minutes per week. Baseline and 16-week evaluation included: modified Bruce treadmill test, 7-Day Physical Activity Recall Interview, and EORTC QLQ C-30 questionnaire. Results: 101 women enrolled between 9/06 and 3/11. Median age was 49 years, median time since diagnosis of MBC was 1.1 years, 48% of participants were on hormonal therapy and 42% on chemotherapy/biologic therapy. 69% completed all study measures (an additional 9% all but the final treadmill test). Attrition was higher in the intervention arm (30% vs. 16%, p=0.15). Outcome measures are shown in table below. Both groups experienced improvements in treadmill times. Intervention participants also reported improvements in physical functioning and increased minutes of weekly PA, with a trend toward significant differences between groups. Conclusions: Women with MBC participating in a PA intervention experienced consistent, but non-significant, trends toward improvements in functional measures. Our sample size was small, limiting power to evaluate the potential benefits of PA in women with MBC. Additional work is warranted, particularly since PA interventions appear feasible in this patient population. [Table: see text]
Usefulness of medical oncologists’ estimates of survival time in people with advanced cancer.
Authors: Kiely Belinda E. , Martin Andrew J. , Tattersall Martin HN , Nowak Anna K. , Goldstein David , Wilcken Nicholas , Wyld David , Beale Philip James , Jefford Michael , Glasgow Amanda L. , Abdi Ehtesham A. , Glare Paul A. , Stockler Martin R. 
Published: March 2020

9087 Background: We sought to determine the calibration, precision, prognostic significance and suitability of estimated survival time (EST) as a basis for estimating and explaining prognosis in advanced cancer. Methods: Medical oncologists recorded their EST as the “median survival of a group of identical patients” in patients with advanced cancer and a life expectancy >3 months recruited to a randomized trial of sertraline (Lancet Oncol 2007; 8: 603). Calibration, precision and suitability were defined by the proportions of patients whose observed survival times (OST) were bounded by simple multiples of their EST (based on our previous studies), i.e. 50% expected to live longer (or shorter) than their EST; 30% expected to live from 0.75 to 1.33 times their EST (arbitrary criterion for precision); 50% expected to live from half to double their EST (range for typical scenario); 10% expected to live >3 times their EST (best case scenario), or <¼ of their EST (worst case scenario). Results: Characteristics of the 114 patients were: median age 63 years, Karnofsky performance status (KPS) ≤70 in 25%, and a median of 8.5 months since diagnosis of advanced cancer. Primary cancer sites included breast (18%), colorectal (16%), lung (15%), prostate (12%) and ovary (10%). Median survival was 10.6 months after a median follow-up of 14 months and 68 deaths. EST were well-calibrated: 54% of patients lived longer than their EST and 46% lived shorter than their EST. EST were imprecise (21% within 0.75 to 1.33 times OST) but equally likely to be over-optimistic (34% >1.33 x OST) or over-pessimistic (39% <0.75 x OST). 6% of patients lived <¼ of their EST; 62% lived from half to double their EST and 9% lived >3 times their EST. Independently significant predictors of OST in a multivariable Cox model included EST (HR=0.92, p=0.004), dry mouth (HR=5.07, p<0.0001), alkaline phosphatase >101U/L (HR=2.80, p=0.0002), KPS ≤70 (HR=2.30, p=0.007), prostate primary (HR=0.23, p=0.002), and steroid use (HR=2.35, p=0.02). Conclusions: Medicaloncologists’ EST were well-calibrated, imprecise, independently associated with OST, and useful for estimating and explaining best case, worse case, and typical scenarios for survival time in patients with advanced cancer.
Incidence, characteristics, and associations of oxaliplatin-induced peripheral neuropathy in colorectal cancer patients: Results of a prospective, multicenter, international study.
Authors: Argyriou Andreas , Alberti Paola , Briani Chiara , Velasco Roser , Bruna Jordi , Campagnolo Marta , Cazzaniga Marina Elena , Bergamo Francesca , Cortinovis Diego Luigi , Santos Cristina , Papadimitriou Konstantinos , Cavaletti Guido , Kalofonos Haralabos 
Published: March 2020

9090 Background: We sought to trace the incidence and severity of oxaliplatin-induced peripheral neuropathy (OXLIPN) and to determine its clinical pattern. Among other associations, we also specifically aimed at testing whether the degree of acute neuropathy is clinically related to the development and severity of chronic OXLIPN. Methods: 170 patients (mean age 64y), scheduled to be treated with either FOLFOX or XELOX for metastatic colorectal cancer were studied. Patients were prospectively monitored at baseline and followed-up during chemotherapy in four European sites. The motor/neurosensory NCI-CTCv3 criteria and the clinical version of the Total Neuropathy Score were applied to clinically grade the severity of OXLIPN. Nerve conduction studies were also longitudinally performed. Results: Evidence of acute OXLIPN was disclosed in 146/170 patients (85.9%). The vast majority of patients manifested cold-induced perioral (95.2%) or pharyngolaryngeal dysesthesias (91.8%). Other uncommon symptoms, such as jaw spasm were also present. Severe acute OXLIPN, requiring prolongation of OXL infusion from 2 to 4-6 hours was evident in 32/146 patients (21.9%). Overall, 123/170 patients (72.4%) experienced chronic OXLIPN. Severities were grade I: 39 (22.9%); grade II: 52 (30.6%); grade III: 33 patients (19.4%). Worst severities were related to cumulative oxaliplatin dose (r:0.269;p<0.001). Follow-up assessments revealed significant decrease in all sensory action potentials examined. The severity of the acute OXLIPN was significantly correlated with both the development (r:0.450;p<0.001) and degree of the chronic form (r:0.703;p<0.001). Conclusions: Most patients treated with oxaliplatin-based chemotherapy would manifest OXLIPN, mainly of moderate degree. The severity of the acute syndrome appears to clinically correlate with the degree of the chronic form of OXLIPN. Our data suggest that acute phenomena, related to axonal hyperexcitability, could contribute to the development of peripheral neuropathy; thus it could be advisable to test agents against acute OXLIPN in order to verify their effects on the chronic form.
Sexual functioning in young women with breast cancer.
Authors: Rosenberg Shoshana , Tamimi Rulla M. , Gelber Shari I. , Ruddy Kathryn Jean , Kereakoglow Sandra , Borges Virginia F. , Come Steven E. , Schapira Lidia , Winer Eric , Partridge Ann H. 
Published: March 2020

9100 Background: Sexual dysfunction is a known complication of adjuvant therapy for breast cancer and an important determinant of quality of life. Little is known about the frequency and magnitude of this problem among very young women with breast cancer during the year following diagnosis. Methods: 298 sexually-active women enrolled in an ongoing multi-center cohort study with Stage 0-III breast cancer at or before age 40 were included in this analysis. Treatment data was self-reported on a survey mailed to participants at enrollment. Sexual functioning was assessed using the sexual interest and dysfunction subscales from the Cancer Rehabilitation Evaluation System (CARES). Scores range from 0-4, with higher scores indicative of poorer function. The survey included a measure of anxiety and depression (Hospital Anxiety and Depression Scale), of body image (CARES) and of physical and menopausal symptoms (Breast Cancer Prevention Trial Symptom Checklist). Mean differences in CARES scores between treatment groups (chemotherapy vs. none; hormone therapy vs. none; lumpectomy vs. mastectomy vs. mastectomy + reconstruction vs. no surgery; radiation vs. none) were compared using T-tests and ANOVA. Multiple regression models were fit to assess symptoms thought to be mediators of the treatment-sexual functioning association. Results: Mean age at diagnosis was 36 (range: 22-40) years and mean time from diagnosis to survey completion was 5 months (range: 1-16). Mean CARES sexual interest and dysfunction scores were higher in women who received chemotherapy compared to those who did not (p<0.0001). In the multivariate analysis, chemotherapy was no longer associated with decreased sexual interest or function. Anxiety, depression, musculoskeletal pain, and poorer body image were predictive of both decreased sexual interest and function. Vaginal pain symptoms were associated with greater dysfunction, while unhappiness with appearance was associated with decreased interest. Conclusions: Young women who receive chemotherapy are at risk for problems related to sexual functioning early in the survivorship period. This effect appears to be mediated through several physiologic and psychologic mechanisms, underscoring the need for interventions that target both.
Anemia and functional disability in older adults with cancer.
Authors: Owusu Cynthia , Tew William P. , Hardt Molly , Mohile Supriya Gupta , Klepin Heidi D. , Gross Cary P. , Gajra Ajeet , Lichtman Stuart M. , Ramani Rupal , Katheria Vani , Zavala Laura , Hurria Arti 
Published: March 2020

9109 Background: While anemia is associated with functional disability in older adults in general, this relationship has not been well characterized in older adults with cancer. We sought to examine the association between anemia and functional disability and to identify other factors associated with functional disability in patients (pts) age ≥65 with cancer. Methods: We conducted a secondary analysis of a multi-center prospective study of 500 pts ≥ age 65 that identified predictors of chemotherapy (chemo) toxicity (Hurria et al, JCO, 2011). The primary outcome of this analysis was functional disability, defined as need for assistance with ≥1 instrumental activities of daily living. Data collected prior to initiation of a new chemo regimen included: age, tumor/treatment variables, labs [including hemoglobin (Hb)], and geriatric assessment (functional status, comorbidity, social support, psychological, cognitive, and nutritional status). Anemia (World Health Organization criteria) was defined as Hb <12g/dl (women) and Hb <13g/dl (men). Bivariate analysis and logistic regression were used to examine the association between functional disability, anemia, and other pre-treatment variables. Results: Among 500 pts [median age 72 years (range 65-91), 56% female, 61% stage IV], the prevalence of functional disability and anemia was 43% and 51%, respectively. The mean Hb was 11.7g/dl and 12.6g/dl among pts with and without functional disability. Pts with anemia were more likely to report functional disability (53% vs. 46%, p<0.01). On multivariate analysis, factors associated with functional disability included anemia [Odds Ratio (OR)= 2.06, 95% confidence interval (CI)= 1.39-3.05], increased age (OR= 1.04, 95% CI = 1.00-1.07), increased comorbidity (OR= 1.23, 95% CI = 1.09-1.39), advanced stage (OR= 1.85, 95% CI = 1.22-2.80), and unintentional weight loss (OR= 2.02, 95% CI = 1.37-3.00). Conclusions: Anemia was highly prevalent and was associated with functional disability. Prospective studies that further examine the relationship between anemia and functional disability and randomized-controlled trials that evaluate the correction of anemia as a modifiable strategy to improve functional status in older pts with cancer are warranted.
Pain, sleep disturbance, and fatigue symptom cluster in patients suffering from chronic chemotherapy-induced neuropathic pain (CINP).
Authors: Gewandter Jennifer S. , Heckler Charles E , Devine Katie , Mohile Supriya Gupta , Palesh Oxana , Roscoe Joseph , Morrow Gary R. , Bury Martin Joseph , Jacobs Andrew 
Published: March 2020

9113 Background: Various symptom cluster combinations of pain, fatigue, sleep disturbance (SD), and depression have been identified in cancer patients. The presence of symptom clusters has not been assessed in patients with persistent CINP. This exploratory analysis aimed to determine which symptoms statistically clustered with pain in cancer survivors with CINP. Methods: The University of Rochester Cancer Center Community Clinical Oncology Program recruited 461 patients with CINP > 4 (on a 0-10 scale) who had completed chemotherapy (median 7 months ago) for a pain intervention trial. At baseline, groups of highly associated symptoms that included pain were identified empirically using factor and cluster analyses of the 11 symptoms in the University of Rochester Symptom Inventory plus the Hospital Anxiety and Depression Scale (HADS) scores. To investigate if associated symptoms track together over time, multiple linear regression (MLR) analysis was performed using changes in symptom severity between baseline and week 6, controlling for gender, age, education, race, and marital status. Results: Subjects were 88% white and 71% female, and on average 61 years old. Mean (standard deviation) baseline pain, fatigue, and SD were 5.7 (2.8), 5.0 (2.7), and 4.2 (3.1), respectively; 26% of subjects had borderline or abnormal HADS scores. Factor analysis identified 3 factors that accounted for 88% of the variance. One factor included pain, fatigue, SD, but not HADS, and accounted for 37% of the variance. Variable clustering also identified pain, SD, and fatigue as 1 symptom cluster. Changes in severity of SD and fatigue (p < 0.0001), but not HADS, were associated with changes in pain (adjusted R2 = 0.168) in MLR analysis. Conclusions: Pain, fatigue, and SD were identified as a symptom cluster by factor and cluster analyses, and were found to track together over time by MLR. Since these data suggest that pain is associated with sleep quality and fatigue in patients with persistent CINP, targeting one of these symptoms may lead to reductions in the others. Future research should investigate interventions that target pain, fatigue, and SD concurrently in cancer survivors suffering from CINP.