bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sedentary lifestyle as a predictor of early death in older adults with cancer: A prospective cohort study with 2692 patients.
Authors: Telles O Lima Jurema , Mello Maria Julia Gonçalves , Sales Letícia telles , Miranda DOS Santos Luis Filipe , Silva Fernanda R de Melo , Rayol Rafael M M C , sILVA José Roberto , Costa José Iran , Rebello Mirella , Cavalcanti Zilda , Thuler Luiz Claudio Santos ,   BLOGG - BRAZILIAN ONCOLOGY GERIATRIC GROUP
Published: June 2023

12058 Background: Physical activity is an important aspect of the global health of older adults with cancer (OAC). The aim of this study was to determine sedentary lifestyle as a predictor of early death in OAC. Methods: Prospective cohort involving elderly (60+) with cancer, cared for in a public hospital in Pernambuco, from January 2015 to December 2021. Sociodemographic, clinical, and lifestyle variables were considered. The level of physical activity was assessed before cancer treatment by the International Physical Activity Questionnaire (IPAQ), short version, with classification into active (active/very active) and inactive (sedentary/inadequately active) and comprehensive geriatric assessment (CGA). The outcome was death within 180 days. Kaplan-Meier survival curves and Cox multivariate analysis were performed. Results: 2692 patients were included, most were men, with family income less than 01 minimum wage in almost 30%. The presence of two or more comorbidities was observed in 70.1% of patients. The main primary sites were prostate (30.8%), breast (17%) and digestive system (25.8%), gynecological system (10.6%), lung (5.9%), and the majority (67.6%) had no metastatic disease. There were 461 deaths (25.7% sedentary and 9.7% non-sedentary). Sedentary lifestyle was an independent risk factor for early death (HR=1.28,95% CI=1.07-1.64 p< 0.036), controlled by tumor topography and presence or absence of metastasis, presence of polypharmacy and Karnofsky performance scale, recent hospitalization and nutritional status. At 180 days, survival among patients with some level of physical activity was higher (90% (0.88 - 0.92)) than among sedentary patients (74% (0.72 - 0.77, p < 0.01). Conclusions: Sedentary lifestyle at the time of cancer diagnosis was an independent risk factor for early death among Older adults with cancer. Encouraging physical activity is an important public health action to face aging-related health problems, such as cancer.
Older patients with early-stage triple-negative breast cancer: The Memorial Sloan Kettering Cancer Center experience.
Authors: Zhi Iris , Lake Diana E , Ehrich Fiona , Chen Yuan , Korc-Grodzicki Beatriz , Norton Larry , Robson Mark E. , Singh Jasmeet Chadha 
Published: June 2023

12063 Background: Approximately 15% of cases of early-stage triple-negative breast cancer (TNBC) are diagnosed in individuals over the age of 70. Despite studies indicating that older patients derive similar benefits from polychemotherapy as younger patients, breast cancer specific mortality among older patients remains disproportionately high. Use of the comprehensive geriatric assessment (CGA) and individualized risk tools can help tailor treatment and minimize negative side effects while preserving quality of life. We performed a retrospective analysis of patients ≥ 70 years of age diagnosed with stage I-III TNBC at Memorial Sloan Kettering Cancer Center between 2015 and 2019 to describe clinical practices for managing this population. Methods: Demographics, CGA, systemic therapy data were collected from electronic medical records. A multivariable logistic regression model was used to identify factors that were independently associated with the probability of receiving chemotherapy. Results: We included 159 women, with a median age of 74.5 years (range 70-96). 67 (42%) had stage I disease, 71 (45%) had stage II, and 21 (13%) had stage III. 29 (18%) reported difficulty in Activities of Daily Living (ADL), 34 (21%) reported difficulties in Instrumental Activities of Daily Living (iADL), and 40 (26%) were identified as having a high risk for falls. 25 (17%) patients underwent CGA per physician’s choice. The prevalence of cardiac risk factors was as follows: hypertension in 80 patients (50%), diabetes in 25 (16%), obesity in 7 (4.4%), heart failure in 1 (0.6%). 147 underwent breast surgery, with 106 (67%) receiving lumpectomy and 41 (26%) mastectomy. 97 (61%) patients received chemotherapy: 35 (22%) neoadjuvant and 62 (40%) adjuvant. Anthracycline, Cyclophosphamide, Paclitaxel (AC-T) and Cyclophosphamide, Methotrexate, Fluorouracil (CMF) were the most common regimens. In multivariable logistic regression analysis, use of chemotherapy was associated with younger age (odds ratio [OR] 0.84 for one year increase in age, 95% confidence interval [CI] 0.75-0.93, p = 0.001) and higher disease stage (stage II vs. I OR 4.97, 95% CI 1.66-16.4, p = 0.006; stage III vs. I OR 22.0, 95% CI 3.3-312, p = 0.006). No significant difference was found in geriatric referrals, cardiovascular risk factors, or difficulties with ADL or iADL between those receiving or not receiving chemotherapy. Conclusions: In our single center experience, 61% of older patients with early-stage TNBC received chemotherapy, with AC-T and CMF being the most common regimens. The referral rate for CGA was low. Age < 75 years and higher disease stage were significantly associated with receiving chemotherapy. Overcoming barriers to incorporating CGA and toxicity prediction into routine clinical practice is crucial for personalized treatment in this population.
Frailty and pre-frailty associated with physical functional performance and quality of life in breast cancer and bone marrow transplant survivors.
Authors: Wang Shuo , Te Hok Sreng , Cao Qing , Yousefzadeh Matthew J. , Napurski Char , Arora Mukta , Barcelo Helene , Niedernhofer Laura , Thyagarajan Bharat , Prizment Anna , El Jurdi Najla H. , Blaes Anne Hudson 
Published: June 2023

12064 Background: Frailty in cancer survivors poses a great challenge to health care providers. Frailty is associated with premature mortality, functional decline, and poor quality of life (QOL). We aimed to examine the associations of frailty and pre-frailty with physical functional performance and QOL in breast cancer survivors and bone marrow transplant (BMT) survivors. Methods: 43 breast cancer survivors and 55 BMT survivors who had received chemotherapy and did not have active cancer were recruited to the study. Based on Fried frailty phenotype, survivors were classified as frail if 3 or more criteria were present: unintentional weight loss, exhaustion, slow walking speed, low physical activity, and weakness. Pre-frail was classified if 1 or 2 criteria were present. Physical functional performance was assessed by Karnofsky performance scale (KPS) and continuous summary performance score (CSPS, comprises walking speed, standing balance, and repeated chair stands tests). p16INK4a, a marker for cellular senescence, was measured from survivors’ blood samples. QOL was measured using the 36-Item Short Form Survey. Groups were compared using chi-square test for categorical variables and rank-sum test for continuous variables. Results: Median age of survivors was 59 yrs (39% male). 13% of survivors (N = 13) were frail and 26% (N = 25) were pre-frail. Frail/pre-frail survivors tended to be older, male, and BMT survivors and had worse results for KPS, walking speed, repeated chair stands, and CSPS (p-values<0.03). Frail/pre-frail versus non-frail survivors had a higher p16INK4a expression (p-value<0.01). For QOL, frail/pre-frail survivors had lower median scores of physical functioning, role limitations due to physical health, role limitations due to emotional problems, energy/fatigue, social functioning, bodily pain, and general health (p-values<0.04), but the median scores of emotional well-being for frail/pre-frail and non-frail survivors were similar (p-value=0.06). Conclusions: Frailty and pre-frailty in a study of breast cancer and BMT survivors were associated with worse physical functional performance, higher p16INK4a expression, and lower quality of life. [Table: see text]
Geriatric-assessment-guided interventions for older adults with multiple myeloma: A feasibility study.
Authors: Jensen Christopher Edward , Nyrop Kirsten A. , Logan Maya , Strayhorn Martha Dell , Deal Allison Mary , Miller Jordan , Muss Hyman B. , Lichtman Eben I. , Rubinstein Sam , Tuchman Sascha Alexander 
Published: June 2023

12065 Background: Multiple myeloma (MM) is disproportionately a disease of older adults, and aging-related impairments are common in this population. Geriatric assessment (GA) guided supportive care programs have been linked to improved treatment outcomes among older adults with solid-organ cancers. We sought to evaluate the feasibility of a GA-guided supportive care program among older adults treated for MM. Methods: We leveraged an existing registry of adults with plasma cell disorders at the University of North Carolina. Registry participants meeting inclusion criteria were offered referrals to supportive care resources by their MM provider during routine visits in 2021-2022. Inclusion criteria were diagnosis of MM, age ≥60, and presence of ≥1 selected problem areas (physical function, polypharmacy, mental health) on the GA. Function deficits were defined as self-report of requiring assistance with ≥1 instrumental activities of daily living or recent fall(s), polypharmacy as ≥10 daily medications, and anxiety/depression on the Mental Health Index 13. Individuals with physical function deficits were offered referral to physical therapy (PT). Those with polypharmacy were offered referral to an oncology Clinical Pharmacist Practitioner (CPP) for comprehensive medication reconciliation and evaluation for de-prescribing. Patients with mental health symptoms were offered referral to our center’s Comprehensive Cancer Support Program (CCSP). Results: 59 individuals were identified as having at least one deficit on the GA (Table). Of these, 14 were already utilizing all relevant resources, leaving 45 individuals eligible for a new resource. Among these, 16 accepted a referral to at least one resource. An additional 16 were approached and declined all offered referrals. For the remaining 13 screened individuals, providers were prompted regarding a referral recommendation prior to the patient’s visit, but a referral was not offered during the visit. Physical therapy was the most commonly identified relevant resource (n = 46), followed by CPP visits (n = 33). Referral acceptance rates were highest among those recommended for a pharmacy visit (55% of those approached) and lowest for CCSP (0%). Conclusions: Given the prevalence of polypharmacy or physical function deficits and acceptance rates for related interventions, future interventions focusing on collaboration with CPPs or physical therapists appear feasible in this setting. Methods to direct patients to supportive care resources that do not rely on provider recommendations during the limited window of clinic visits may also be beneficial. Clinical trial information: NCT04999085 . [Table: see text]
A pilot study of intraneural facilitation versus standard physical therapy for prevention of chemotherapy-induced peripheral neuropathy.
Authors: Castillo Dan Ran , Jeon Won Jin , Lucero Carvy Floyd , Bussell Mark , Coleman Ron , Pieters Karla , Hankins Jamie , Boggs Annette , Dehom Salem , Garcia Lorena , D'Errico Ellen , Nagaraj Gayathri 
Published: June 2023

12068 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect necessitating chemotherapy (CT) dose adjustments or early termination. Intraneural Facilitation (INF) is a novel form of manual physical therapy (PT) developed to mitigate CIPN-related symptoms and improve patients’ functional outcome. We conducted a randomized pilot study evaluating the efficacy of INF vs. standard PT in the prevention of CIPN (NCT 03272919). Methods: Eligible participants were patients with newly diagnosed breast cancer (stages I-III) and gynecologic cancer without preexisting peripheral neuropathy planning to receive platinum-based and/or taxane-based CT. Participants were randomly assigned to either INF or PT arm and received two 45-minute treatments twice a week for six weeks during their CT course. Outcomes reported here are a) assessment of pain between the 2 arms using the Pain Quality Assessment Scale (PQAS), and b) measurement of vascular patterns using ultrasound (US), evaluating pulsatility index, volume flow and peak systolic velocity between the 2 arms. Participants were evaluated at baseline, week 3 (W3), week 6 (W6), and month 3 (M3). PQAS scores ranged from 0 to 10 with subscale evaluations of paroxysmal, surface, and deep pain. Pain scores on a scale from 0 to 10 were grouped into none (0), mild (1-3), moderate (4-6) and severe (7-10). The use of neuropathy medications, CT dose reductions, premature CT discontinuation and participant satisfaction surveys between the two groups were previously reported at SABCS 2022. Results: Of 104 screened participants, 44 met the eligibility criteria, with 38 eligible for analysis (n=20 INF arm and n=18 PT arm). Participants reporting moderate or severe pain in either arm were combined (Table). Pain symptoms peaked at W6 coinciding with cumulative CT effects. At M3, none in the INF arm reported moderate or severe paroxysmal pain compared to two participants in the PT arm. One participant in each arm reported moderate or severe surface or deep pain at M3. The US results showed physiologic impact in both arms at W3 and W6, suggesting their role in preserving neural tissue blood flow and reducing vascular damage. Conclusions: Our study shows fewer number of participants on both intervention arms reporting pain, with numerically lower scores on PQAS in INF arm compared to PT arm, especially during ongoing CT. The US results suggest that INF has a unique pathophysiological impact on the microvasculature compared to standard PT; further studies are needed to validate these findings and potentially address their clinical significance as a combined modality. Clinical trial information: NCT03272919 . [Table: see text]
The effect of exercise on physical function and medication adherence in women receiving endocrine therapy for breast cancer: The breast cancer endocrine therapy fitness (BE-FIT) randomized controlled trial.
Authors: Myers Samantha , LeVasseur Nathalie , Mackenzie Kelly , Fujita Rafael A. , Faulkner Guy , Berkowitz Jonathan , Olson Robert Anton , Trinh Linda , Campbell Kristin L. 
Published: June 2023

12069 Background: Approximately 20% of women receiving endocrine therapy (ET) for early-stage breast cancer (BrCa) discontinue their regimen due to side effects, including vasomotor symptoms and arthralgias, subjecting them to higher rates of disease recurrence. Exercise is one approach to mitigate ET-related toxicity and potentially improve medication adherence by mitigating ET-related symptoms. However, only 11% of women with BrCa adhere to recommended exercise guidelines. Purpose: To examine the effect of a virtual supervised exercise program for women receiving ET for early-stage BrCa on physical function (PF) (primary outcome) and adherence to ET (secondary outcome). Methods: Participants were recruited through referral by oncology care providers from multiple BC Cancer sites and self-referral. Eligible participants were: females with stage I-III BrCa being treated with curative intent, 19-75 years, taking ET for at least 3 months up to 3 years. Using a partial cross-over design (NCT04824339), participants were randomized to the immediate exercise group (INT) or the delayed exercise group (CON), which crossed over at 8 weeks. The 8-week intervention was comprised of a 50-minute resistance exercise circuit, delivered virtually by an exercise physiologist twice per week via Zoom, and self-directed aerobic exercise (progressing to 90 minutes or more per week of at least moderate intensity). PF was assessed using the 30-second chair stand test. ET adherence was measured by the Voils self-reported medication non-adherence questionnaire. Values reported as means and standard deviations. The difference at 8 weeks by intervention arm was examined using two sample t-test (continuous) or kappa measure of agreement (categorical). Results: A total of 132 women were randomized. On average, women were 54 years, White (European) (47%), married (64%), had at least a bachelor’s degree or higher (51%), and had a body mass index of 27.7 kg/m2. The most common type of ET women received was Letrozole (43%), followed by Tamoxifen (36%). At 8 weeks, there was a significant improvement in PF for INT versus CON (mean change +2.5±2.9 vs. +0.7±2.2 stands, p< 0.001). There was no difference between groups in change in medication adherence status (k = 0.35). Conclusions: An 8-week virtual supervised exercise program for women receiving ET for early-stage BrCa significantly improved PF but did not change medication adherence at 8 weeks. The potential impact of the intervention on long-term medication adherence will be explored up to one year and with covariates. Based on improvement in PF, future trials to establish effectiveness and inform implementation are warranted. Clinical trial information: NCT04824339 .
Preliminary outcomes of a financial navigation program among lower socioeconomic patients with cancer.
Authors: Tan Chiu Yi Joey , Jacoby Jessica , Garber Greg D. , Leader Amy , Cammy Rebecca , Incudine Andrea , O’Brien Morgan , Cunningham Rosie , Stivers Thomas , Doherty Meredith 
Published: June 2023

12071 Background: Cancer patients receiving treatment are at risk of experiencing financial hardship, especially among those from lower socioeconomic status (SES) households. Patients experiencing financial toxicity are more likely to report poorer physical-wellbeing, higher anxiety, housing or food insecurity, and treatment non-adherence. While financial navigation programs are present, there is a lack of standardized practice to mitigate financial hardship among cancer patients. The purpose of this study is to evaluate the preliminary efficacy of Family Reach’s oncology financial treatment program (FTP) on financial toxicity, quality of life, and anxiety in low SES patients. FTP consists of individualized resource navigation, financial education services, and a $1000 patient assistance grant that was used towards non-treatment related expenses. Methods: 152 cancer patients undergoing active treatment, with household incomes under the 400% poverty line were recruited from two NCI-designated cancer centers. 99 participants completed the baseline and 2-month follow-up survey, consisting of these measures: COST: A FACIT Measure of Financial Toxicity (COST), Hospital Anxiety and Depression Scale (HADS), 36-Item Short Form Health Survey (SF-36), poverty exposers and treatment adherence items (secondary outcomes). Results: Participants were 69% female; roughly half (51%) were African American/Black, 34% were white, 4% were mixed, 3% were Asian and 8% reported ‘other’ or preferred not to answer. COST score at baseline (M=10.5, SD=6.4) significantly increased after 2 months (M=12.9, SD=7.9), t(176.2)= -2.3, p<.05. HADS-Anxiety score at baseline (M=11.1, SD=4.7) significantly decreased after 2 months (M=9.2, SD=4.4), t(186.0)= 2.88, p<.01. SF-36 Physical functioning score at baseline (M=34.0, SD=27.2) significantly increased after 2 months (M=43.9, SD=31.0), t(170.3)= -2.26, p<.05. See Table for secondary outcomes. Conclusions: Early evidence of FTP indicates promising results to increase financial and physical well-being, and in reducing anxiety among lower SES cancer patients. FTP showed improvements in COST scores and reduced non-medical cost concerns. However, COST scores reported in this study are still lower compared to other studies. A planned future study involving monthly guaranteed income payments will be carried out to examine if financial well-being and treatment adherence can be achieved. Supported by: One Family Foundation/Social Impact Fund Secondary outcomes. [Table: see text]
Survivorship care and breast and cervical cancer screening.
Authors: Santos Teles Marco , Modugu Ganesh , Silva Isabel C. , Mattes Malcolm David , Eskander Mariam F. 
Published: June 2023

12075 Background: Studies suggest that despite their history, cancer survivors may be equally or less likely to be screened for various cancers. The impact of the components of survivorship care on post-treatment screening is unknown. We aim to gauge the association of receipt of treatment summaries, follow-up care instructions (including where to obtain “routine cancer check-ups”), and type of doctor providing survivorship care on breast cancer screening (BCS) and cervical cancer screening (CCS) in female cancer survivors. Methods: A cross-sectional, retrospective analysis using Behavioral Risk Factor Surveillance System (BRFSS) survey data from 2016 and 2018 was conducted. BCS-eligible women were aged 40-74; CCS-eligible women were 30-64. BCS completion was defined as a mammogram within 2 years and CCS completion as a pap smear within 3 years or an HPV test within 5 years. Univariate analysis was conducted using chi-square. Multivariate logistic regression was used to determine which survivorship care factors were associated with BCS and CCS. Results: 4,533 BCS and 2,566 CCS-eligible survivors were identified. In the BCS-eligible group, 85.9% were aged ≥50, 89.7% were white, 62.5% had a degree beyond high school, 48.7% earned ≤$50,000, and 96.1% were insured. In the CCS-eligible group, 68.1% were aged ≥50, 87.9% were white, 63.7% had a degree beyond high school, 45.0% earned ≤$50,000, and 93.3% were insured. 82.0% were up-to-date (UTD) with BCS; 92.6% were UTD with CCS. BCS and CCS were higher for insured survivors (82.2% vs. 66.2%, p = 0.009; 93.8% vs. 83.3%, p = 0.013, respectively). 48.7% of BCS-eligible and 50.5% of CCS-eligible survivors received a treatment summary. 75% of BCS-eligible and 77% of CCS-eligible survivors received follow-up instructions. Among BCS-eligible survivors, recipients of treatment summaries and follow-up instructions were significantly more UTD with BCS than non-recipients (84.9% vs. 78.5% and 84.5% vs. 74.3%, respectively, p < 0.001). Among CCS-eligible survivors, recipients of follow-up instructions were significantly more UTD with CCS (94.5% vs. 88.9%, p = .021); there was no significant difference for recipients of treatment summaries (p = .201). In both groups, there was no significant difference in BCS or CCS based on the type of physician providing survivorship care (p = .732 and p = .098, respectively). On multivariate analysis, receipt of follow-up instructions was the only factor significantly associated with BCS (OR 1.46; 95% CI: 1.05–2.03) and CCS (OR 2.57; 95% CI: 1.19–5.55). Conclusions: Follow-up instructions, which are part of the survivorship plan, have the greatest association with BCS and CCS among cancer survivors. Despite this, about 25% of BCS and CCS-eligible cancer survivors did not receive them. Additional research should focus on improving the practice of survivorship care, particularly follow-up instructions, as a method to increase uptake of BCS and CCS among cancer survivors.