bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk tolerance and attitudes toward chemotherapy: Who chooses palliative treatment when cure is possible?
Authors: LeBlanc Thomas William , Scherr Karen , Wang Annabel , Lemmon Monica , Ubel Peter A. 
Published: September 2018

10054 Background: Many patients with acute myeloid leukemia (AML) face a difficult choice about whether to receive palliative chemotherapy or high-dose, potentially-curative chemotherapy that poses a risk of early death. How people weigh these factors in decision-making is unknown. We hypothesized that the possibility of cure primarily drives decision-making, regardless of treatment risk. Methods: We designed an electronic survey describing two treatment paths: (1) high-dose chemotherapy with possibility of cure but a 10% risk of early death, and (2) palliative chemotherapy with no chance of cure but no risk of early death. We recruited respondents via Amazon MTurk and presented 7 scenarios in random order, varying only the likelihood of cure associated with high-dose chemotherapy. Subjects rated their preferred treatment on a 4-point Likert scale. We assessed numeracy and attitudes toward chemotherapy using validated scales, and employed attention checks for quality assurance. Results: 100 subjects completed the survey (median age 30.5; 52 female, 85 Caucasian). 46 (46%) had at least a bachelor’s degree and numeracy was generally high (median 4.75 out of 6). Respondents’ preferences for intensive chemotherapy varied with likelihood of cure, however some displayed a fixed preference for either curative or palliative treatment throughout, regardless of benefit level. For example, given a 50% likelihood of cure 20 respondents (20%) still preferred palliative therapy; similarly, with only a 1% likelihood of cure 28 respondents (28%) still preferred high-dose chemotherapy. In a multivariable model, preference for palliative chemotherapy was significantly predicted by subjects’ scores on the attitudes toward chemotherapy scale (p < 0.001), controlling for age, education, and numeracy. Conclusions: Contrary to our hypothesis, a significant proportion of subjects preferred palliative chemotherapy, even in scenarios where high-dose chemotherapy confers a high likelihood of cure. Pre-existing attitudes toward chemotherapy appear to drive patients’ decision-making, even when treatments are potentially curative. This finding may have significant implications for risk communication in oncology.
Multicenter, randomized phase II trial of physical activity (PA), metformin (Met), or the combination on metabolic biomarkers in stage I-III colorectal (CRC) and breast cancer (BC) survivors.
Authors: Meyerhardt Jeffrey A. , Irwin Melinda L , Jones Lee , Zhang Sui , Campbell Nancy , Brown Justin C. , Pollak Michael N. , Sorrentino Alexandra , Cartmel Brenda , Harrigan Maura , West Miranda , Tolaney Sara M. , Yung Rachel Lynn , Winer Eric P. , Ng Kimmie , Abrams Thomas Adam , Fuchs Charles S. , Sanft Tara Beth , Douglas Pamela , Ligibel Jennifer A. 
Published: September 2018

10059 Background: Observational data demonstrate an inverse relationship between PA and Met to disease outcomes in CRC & BC pts. A mechanism that these could impact cancer recurrence and mortality is hypothesized to involve insulin and related growth factors. We investigated the effects of PA, Met or the combination on metabolic biomarkers in CRC & BC pts. Methods: In a phase 2 RCT, stage I-III CRC & BC survivors at least 2 months from completing standard therapy (excluding hormone rx or trastuzumab) were randomized to PA, Met, PA + Met or control. Major eligibility included absence of recurrence or diabetes (glucose < 160 (random) or < 126 (fasting) mg/dl) and exercising < 120 min/wk. The PA intervention consisted of supervised aerobic training at least 2 x /wk. Metformin dosing was 850 mg 1x/day titrated to 850 mg 2x/day after 2 wks if tolerated. Interventions were 12 weeks in duration. Fasting bloods at baseline & 12 wks were analyzed for insulin (1oendpoint), leptin, IGF1, IGFBP1 & IGFBP3. Results: 139 pts were enrolled: 62% BC/38% CRC; 83% female; median BMI 28.3; median 2 yrs from dx; median age 56 (range 34-79). 107 pts completed assigned therapy. Pts in PA and PA + Met arms increased PA by 166 and 140 min/wk vs 30 min/wk in controls (both P<0.0001). Pts in the Met and PA + Met arms lost weight vs controls (-1.41 and -0.91 kg vs + 1.97 kg, both P <0.0001). Both interventions had impact on metabolic biomarkers (Table). Conclusions: PA and Met both led to significant changes in insulin and other biomarkers in CRC & BC survivors with potential synergistic effect on leptin with dual intervention. Clinical trial information: NCT01340300. [Table: see text]
Chemotherapy-induced ovarian failure (CIOF) in young women with early breast cancer (EBC).
Authors: Furlanetto Jenny , Thode Christian , Bassy Martina , Denkert Carsten , Hanusch Claus , Huober Jens Bodo , Jackisch Christian , Kummel Sherko , Schneeweiss Andreas , Untch Michael , Fasching Peter A. , Karn Thomas , Marme Frederic , van Mackelenbergh Marion , Müller Volkmar , Schem Christian , Von Minckwitz Gunter , Strik Dominika , Nekljudova Valentina , Loibl Sibylle 
Published: September 2018

10068 Background: Women ≤45 years (yrs) treated with chemotherapy (CT) for EBC have a high risk of developing CIOF. Awareness of CIOF is essential for young women. Methods: 740 patients (pts) aged ≤45yrs treated with anthracycline or taxane-based CT for EBC from 4 German neoadjuvant/adjuvant trials were included. Blood samples were collected at baseline (N=740), end of treatment (EOT n=740), 6 (n=177), 12 (n=113), 18 (n=69), 24 (n=47) months (m) after EOT. Only samples collected in a time sequence were included. Estradiol (E2), Follicle-Stimulating Hormone (FSH) and Anti-Müllerian Hormone (AMH) were centrally assessed. CIOF was defined as FSH >12.4IU/l and E2 <52.2ng/ml and was analysed per timepoint and according to clinical and treatment-related variables. Results: Median age was 40yrs (range 21-45); 57.2% had BMI 18.5-<25, 41.1% ≥25; 32% had luminal, 35.9% HER2+, 32.0% triple-negative BC. Median hormone levels at baseline for pts <30yrs vs 30-40yrs vs ≥40yrs were: FSH 5.2IU/I vs 5.6IU/I vs 6.4IU/I; E2 101ng/l vs 86ng/l vs 88ng/l; AMH 2.14ng/ml vs 1.58ng/ml vs 0.53ng/ml. 85.7% of pts had CIOF at EOT, 62.2% at 6m, 54.0% at 12m, 43.5% at 18m, 38.3% at 24m. Similar results were observed in 47 pts with all timepoint samples available. Older vs younger pts had more frequently CIOF at EOT (≥40yrs 94.6%, 30-40yrs 82.0%, <30yrs 50.0%, p<0.001). CIOF at EOT was not influenced by BMI. CT agents impacted the rate of CIOF (p<0.001; Table 1). Higher rate of CIOF was associated with longer CT duration (12w 58.3%, 16-18w 94.5%, 24w 82.1%; p<0.001) and with dose-dense (ddEC-ddD, weekly PM(Cb), intense-dd (idd) EnPC) vs conventional dosed CT (P/nP-EC q3w, P, Cz) (94.5% vs 78.6%; p<0.001). Conclusions: The majority of young women experienced CIOF after CT for EBC. After 2 yrs 62% of the pts returned to premenopausal hormone levels. Age, CT regimen, duration and density influenced the rate of CIOF and should be taken into account when counseling young women who desire to maintain ovarian function. [Table: see text]
Fatigue and health behaviors in cancer survivors: A cross-sectional population based study.
Authors: Matias Margarida , Baciarello Giulia , Neji Mohamed , Michiels Stefan , Partridge Ann H. , Bendiane Marc Karim , Fizazi Karim , Ducreux Michel , Andre Fabrice , Luis Ines Maria Vaz Duarte 
Published: September 2018

10069 Background: A substantial proportion of breast, colo-rectal and prostate cancer patients (pts) can expect long term disease free survival after their primary treatment. Among those, fatigue commonly persists after diagnosis (dx) and can be debilitating. In this study, we evaluated the incidence of fatigue 2 years (y) after cancer dx and its association with health behaviors. Methods: We used a French population based cross-sectional study, which included a representative sample of pts from 12 cancer types (VICAN2). VICAN2 surveyed 4347 pts 2 y after dx. There is a 99% completion rate of fatigue related questions. For this study, we included 2017 pts with breast (1237), colo-rectal (348) and prostate (432) cancer without evidence of metastases at dx or relapse 2y after dx and with fatigue information. Severe fatigue was defined as average score of EORTC QLQC30 fatigue subscale ≥40 at 2y after dx. There were <1% of missing values in the evaluated covariates. Multivariate logistic regression models looked at associations of fatigue with heatlh behaviors (Δ in exercise since dx, exercise at diagnosis, body mass index (BMI), Δ since dx, smoking), age, gender, comorbidities, education, employment, cancer type, radiation, chemotherapy, hormonal therapy. Results: 52% of pts reported severe fatigue at 2 y after dx (median fatique score: 44, range: 0-100). 2 y after dx, 47% of pts either stopped or decrease exercise and 16% had a ≥ 10% change in BMI. Factors associated with fatigue included health behaviors (Table), but also age (adjusted odds ratio [ aOR] for severe fatigue, 95% confidence interval [95% CI]: 0.97, 0.96-0.98), gender ( aOR, 95 CI male vs. female: 0.5, 0.3-0.8), comorbidities ( aOR, 95 CI yes vs. no: 2.0, 1.6-2.4) and treatment type ( aOR, 95 CI radiation vs. no: 1.5, 1.1-2.0). Conclusions: Fatigue continues to be a substantial problem for cancer survivors 2 y after dx. Some factors that may contribute to persistent fatigue (health behaviors) may be amenable to interventions. [Table: see text]
Genitourinary disease risks among 5-year ovarian cancer survivors in a population-based cohort study.
Authors: Hashibe Mia , Chen Yuji , Blackburn Brenna , Wan Yuan , Rowe Kerry G. , Snyder John , Deshmukh Vikrant , Newman Michael , Fraser Alison M , Werner Theresa Louise , Smith Ken R , Gaffney David K. , Doherty Jennifer , Ganz Patricia A. 
Published: September 2018

10073 Background: In the US, there are approximately 235,200 ovarian cancer survivors today. Five-year survival for ovarian cancer has increased from 36% for women who were diagnosed in 1975-1977 to 46% for women diagnosed between 2005-2011. Long term follow-up studies among ovarian cancer survivors are uncommon and late effects have not been well characterized in a population-based cohort. Although genitourinary complications during treatment are well known, long term impacts need to be investigated. Methods: A total of 602 first primary invasive ovarian cancer cases diagnosed between 1996-2012 who survived for > 5 years were identified in the Utah Population Database and compared to a general population cohort of women. Genitourinary disease diagnoses were identified through ICD codes from hospital electronic medical records and statewide ambulatory surgery and inpatient data. Cox regression models were used to estimate hazard ratios for disease risks by time since cancer diagnosis with adjustments on matching factors, baseline BMI, baseline Charlson Comorbidity Index (CCI), and race. Results: The overall risk of genitourinary diseases for ovarian cancer patients in comparison to the general population cohort was 1.51 (95%CI = 1.30-1.74) 5-10 years after cancer diagnosis. Approximately 54.6% of ovarian cancer survivors were diagnosed with a genitourinary disease 5-10 years after cancer diagnosis. The most common genitourinary diseases among the ovarian cancer survivors were urinary tract infections (10.1%), acute renal failure (5.5%), and chronic kidney disease (4.4%). The greatest risks were observed for hydronephrosis (HR = 10.65, 95%CI = 3.68-30.80), pelvic peritoneal adhesions (HR = 5.81, 95%CI = 1.11-30.39), cystitis and urethritis (HR = 2.67, 95%CI = 1.21-6.38), and acute renal failure (HR = 2.30, 95%CI = 1.36-3.88). Conclusions: Ovarian cancer survivors experience increased risks of various genitourinary diseases in the 5-10 year period following cancer diagnosis. Understanding the multimorbidity trajectory among ovarian cancer survivors is of vital importance to improve their clinical care after cancer diagnosis and allow for increased attention to these potential late effects.
Immediate-term chemotherapy-related cognitive impairment (CRCI) following administration of intravenous (IV) chemotherapy.
Authors: Khan Omar Farooq , Cusano Ellen R. , Raissouni Soundouss , Pabia Mica , Haeseker Johanna , Bosma Nicholas Adam , Ko Jenny J. , Kumar Aalok , Yip Steven , Vickers Michael M. , Tang Patricia A. 
Published: September 2018

10084 Background: The acute impact of chemotherapy on cognition is unknown. This study utilized performance on the psychomotor vigilance task (PVT) and trail-making test B (TMT) to assess CRCI immediately following chemotherapy administration. Methods: Patients aged 18-80 years receiving first-line IV chemotherapy for any stage of breast or colorectal cancer were eligible. Patients with brain metastases, neurologic disorders or allergic reactions to chemotherapy were excluded. Patient symptoms, peripheral neuropathy and Stanford Sleepiness Scale were assessed. A five-minute PVT and TMT were completed on a tablet computer pre-chemotherapy and immediately post-chemotherapy. Paired Wilcoxon Rank Sum tests were used to assess change in median PVT reaction time, TMT completion time, TMT errors and PVT lapses. A priori, an increase in median PVT reaction times by over 20 ms (approximating reaction time changes with blood alcohol concentrations of 0.04 to 0.05 g%) was considered a clinically relevant change. Results: 144 patients (74 breast, 70 colorectal, median age 55.5 years) were tested. Post-chemotherapy, median PVT reaction time slowed by an average of 12.4 ms ( p = 0.01). Post-chemotherapy median PVT times slowed by over 20 ms in 59 patients (40.9%). TMT completion post-chemotherapy was faster by an average of 6.1 seconds ( p < 0.001). No differences were seen in TMT errors ( p = 0.417) or PVT lapses ( p = 0.845). Change in median PVT reaction time was not associated with age, gender, number of prior chemotherapy cycles, peripheral neuropathy grade, self-reported symptoms (anxiety, fatigue or depression). Change in median PVT reaction time was also not significantly associated with use of any specific chemotherapeutic drug or class, including paclitaxel (which includes ethanol as an excipient). Conclusions: Median PVT reaction time was significantly slower immediately after chemotherapy compared to a pre-chemotherapy baseline, and impairment correlating to effects of alcohol was seen in 41% of patients. This effect appears independent of age, self-reported symptoms or prior chemotherapy cycles. Further studies assessing functional impact of immediate-term CRCI are warranted.
Impact of skeletal muscle index (SMI) loss during palliative systemic treatment (Tx) on time to progression and overall survival (OS) in metastatic colorectal cancer (mCRC) patients.
Authors: Kurk Sophie , Peeters Petra H.M. , Stellato Rebecca K. , Dorresteijn Bram , Jourdan Marion , Creemers Geert-Jan , Erdkamp Frans , de Jongh Felix E. , Kint Petrus Alouisius Maria , Poppema Boelo Jan , Radema Sandra Anita , Simkens Lieke H , Tanis Bea , Tjin-A-Ton Manuel Lucien Roy , Van Der Velden Ankie , Punt Cornelis J. A. , Koopman Miriam , May Anne Maria 
Published: September 2018

10087 Background: Evidence for a strong link between skeletal muscle depletion and poor outcomes in mCRC is growing. However, the impact of SMI changes over time on progression and OS during palliative systemic Tx is not known. The CAIRO3 study (Simkens et al. Lancet 2015) randomized 556 mCRC patients after 6 cycles capecitabine+oxaliplatin+bevacizumab (CAPOX-B) to maintenance CAP-B Tx (Main) vs. observation (Obs). Upon 1st disease progression (PD1), CAPOX-B or other treatment was reintroduced until 2nddisease progression (PD2). This is the first analysis using scan data of multiple time-points to investigate SMI changes during palliative systemic treatment Tx and its association with survival. Methods: 1227 CT-scans of a random selection of 416 CAIRO3 patients (mean age 64±9 years, Main n = 206; Obs n = 210) were analyzed for SMI (skeletal muscle area at the L3 level in cm2/m2). Using mixed model analysis, SMI changes were analyzed for two intervals; interval 1: from randomization to PD1, and interval 2: from PD1 to PD2. Three Cox regression models were used to study the association between SMI loss and time to PD2 and death for interval 1, and time to death for interval 2. Main and Obs groups were combined in the analyses since the p-value for interaction was not significant. Hazard ratios (HR) were reported per 2 units change in SMI. Results: Median times from randomization to PD1, PD2 and death were 7.7, 13.5 and 24 months resp. During interval 1 (less intensive or no Tx) patients gained SMI on average (1.2 units; 95%CI 0.6-1.8), but 23% of patients still lost SMI. SMI loss was associated with shorter time to PD2 (HR 0.88; 0.81-0.98, p= .01), but not with shorter OS (HR 0.94; 0.86-1.02, p= .17). During interval 2 (more intensive Tx) average SMI loss was -2.2 units ( 1.5-2.8) and 63% of patients lost SMI. SMI loss was associated with shorter OS (HR 0.73; 0.62-0.86, p< .00). Conclusions: Loss of SMI was related to shorter time to progression during first line less intensive main Tx or obs and shorter overall survival during more intensive reinduction Tx. This large longitudinal study suggests that SMI preservation may be a therapeutic goal. Clinical trial information: NCT00442637.
Comprehensive study of risk factors for chemotherapy-induced nausea and vomiting in cancer patients receiving cisplatin-based chemotherapy: A TRIPLE pharmacogenomics study.
Authors: Ayuhara Hideaki , Tsuji Daiki , Yokoi Mari , Suzuki Kenichi , Kawasaki Yohei , Nakao Masahiko , Kogure Yuki , Shibata Kazuhiko , Hayashi Toshinobu , Hirai Keita , Inoue Kazuyuki , Hama Toshihiro , Takeda Koji , Nishio Makoto , Itoh Kunihiko 
Published: September 2018

10091 Background: Chemotherapy-induced nausea and vomiting (CINV) is one of the most unpleasant adverse effects of chemotherapy. Resistance to prophylactic antiemetic treatment is problematic, with 30%–50% of patients experiencing unsatisfactory control. Younger age and female sex are well-known risk factors for CINV. Genetic polymorphisms are suggested to influence antiemetic treatment response. Methods: This study included a subset of patients previously enrolled in a randomised controlled trial. This study aimed to evaluate the role of pharmacogenomic polymorphisms relevant to antiemetic response in patients with cancer receiving cisplatin-based chemotherapy. The study’s efficacy endpoint was the proportion of patients with complete response (CR). The study endpoint was evaluated separately in the acute (CR0-24) and delayed (CR24-120) phases. Thirteen polymorphisms were genotyped, and the association of these genotypes with the efficacy of prophylactic antiemetics was then investigated. Confounding variables for CR were identified using stepwise multivariate logistic regression analysis. Age and sex were included as independent variables by the forced-entry method, and the stepwise method was used to select the pharmacogenomic factors for inclusion as independent variables. Results: In this genetic polymorphism association study, 156 patients with solid cancer were evaluated. Multivariate logistic regression analysis revealed that ERCC1 8092AA (odd ratio [OR]: 11.251; 95% confidence interval [CI]: 1.741–72.712, P = 0.011) and female sex (OR = 3.630; 95% CI = 1.138–11.578, P = 0.029) were significant predictors of CR0-24. No significant association of CR24-120 with pharmacogenomic polymorphisms was found via multivariate logistic regression analysis. Conclusions: ERCC1 polymorphism might be influenced the extent of CINV control in patients receiving cisplatin-based chemotherapy. Clinical trial information: 000009335.
Nutritional counseling with or without systematic use of oral nutritional supplements in head and neck cancer patients undergoing radiotherapy.
Authors: Pedrazzoli Paolo , Cereda Emanuele , Cappello Silvia , Colombo Sara , Klersy Catherine , Imarisio Ilaria , Turri Annalisa , Caraccia Marilisa , Verlicchi Alberto , Benazzo Marco , Corbella Franco , Caccialanza Riccardo 
Published: September 2018

10098 Background: The benefit of systematic use of oral nutritional supplements (ONS) in addition to nutritional counseling in head and neck cancer (HNC) patients undergoing radiotherapy (RT) has not still been properly assessed. Methods: In a single-center, randomized, pragmatic, parallel-group controlled trial (ClinicalTrials.gov: NCT02055833; February 2014 - August 2016), 159 newly diagnosed HNC patients suitable for to RT regardless of previous surgery and induction chemotherapy were randomly assigned to nutritional counseling in combination with omega-3 enriched ONS (N = 78) or without ONS (N = 81) from the start of RT and continuing for up to 3 months after its end. The primary endpoint was the change in body weight at the end of RT. Secondary endpoints included changes in protein-calorie intake, muscle strength, body composition and quality of life (EORTC-QLQ-C30) over the study time points and anti-cancer treatment tolerance. Results: In patients in whom all the variables could be assessed, counseling plus ONS (N = 67) resulted in smaller loss of body weight than nutritional counseling alone (N = 69; mean difference, 1.6 kg [95%CI, 0.5 to 2.7]; P = 0.006). Imputation of missing outcomes provided consistent findings. In the ONS-supplemented group, higher protein-calorie intake and improvement in quality of life over time were also observed (P < 0.001 for all). The use of ONS reduced the need for changes in scheduled anti-cancer treatments (i.e. for RT and/or systemic treatment dose reduction or complete suspension, HR = 0.40 [95%CI, 0.18 to 0.91], P = 0.029). Nine patients reported gastrointestinal intolerance to ONS. Conclusions: In HNC patients undergoing RT or RT plus systemic treatment, and receiving nutritional counseling, weight loss could not be completely prevented, but the use of ONS resulted in better weight maintenance, increased protein-calorie intake, improved quality of life and better anti-cancer treatment tolerance. Clinical trial information: NCT02055833.