bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attribution of symptoms to adjuvant endocrine therapy and association with adherence among older women with breast cancer: A qualitative study.
Authors: Lee Amy Yoonjin , Lyons Anna , Kamaraju Sailaja , Stolley Melinda , Neuner Joan Marie , Flynn Kathryn E. 
Published: June 2022

e24086 Background: Oral adjuvant endocrine therapy (AET) is an effective treatment for hormone receptor positive breast cancer to decrease recurrence and mortality. However, adherence to AET is poor, with 1/3 of patients not completing the recommended 5-year treatment course. Studies have shown that symptoms of the medication, such as joint pain, hot flashes, and fatigue, are associated with AET discontinuation. While previous studies have focused on symptoms post-AET initiation, preliminary evidence suggests that pre-AET symptoms may be an important predictor of early AET discontinuation. We used qualitative interviews to explore adherence to AET and patients’ attribution of symptoms to AET to provide context for a larger quantitative study on the role of patient-reported distress pre-AET as a predictor of AET discontinuation. Methods: Participants were recruited from the Froedtert/MCW Cancer Center registry, stratified by high (≥4) and low pre-AET Distress Thermometer scores and adherence to/discontinuation of AET. Semi-structured phone interviews followed an interview guide focused on constructs previously identified in the literature as having strong associations with AET adherence. Interviews were recorded and transcribed. A multidisciplinary team developed a codebook based on the conceptual framework describing AET discontinuation by AlOmeir et al. as well as other themes that emerged from the data. Results: Interviews were conducted with 31 participants; ages ranged from 57-86 years. Participants were diverse with respect to race/ethnicity (55% white, 26% Black, 13% Latina, and 6% other racial/ethnic groups). Participants who reported symptoms described hot flashes, joint pain, low appetite, memory loss, depression, and fatigue. We saw support for previous findings by AlOmeir et al in which ability to deal with symptoms affected the decision to continue AET. We uncovered additional nuance related to attribution of symptoms, in that some participants attributed their symptoms to a side effect of AET, while others attributed symptoms to other factors including older age, recent completion of other cancer treatments, and psychological burden associated with a cancer diagnosis and treatment. Those who did not attribute symptoms to AET focused on AET as necessary treatment to increase survival, while those who attributed symptoms to AET reported a more negative AET experience in general, with AET described as an additional burden after cancer. Conclusions: Symptom attribution rather than experience of specific symptoms may be a key factor leading to discontinuation of AET. Patient-reported symptoms and associated distress pre-AET may be a viable way to identify patients at high-risk for AET nonadherence, allowing for timely intervention. This will be quantitatively tested in a large sample.
Cisplatin-induced tinnitus (CIS-TINN) and patient-reported outcomes in adult-onset cancer survivors.
Authors: Shuey Megan , Sanchez Victoria , Dinh Paul C. , Monahan Patrick O. , Sesso Howard D. , Dolan Mary Eileen , Fossa Sophie D. , Einhorn Lawrence H. , Vaughn David J. , Martin Neil E. , Fung Chunkit , Frisina Robert D. , Travis Lois B. 
Published: June 2022

e24089 Background: Cisplatin is one of the most used cytotoxic drugs worldwide, but few studies have comprehensively evaluated CIS-TINN in adult-onset cancer survivors. It is critical to identify survivors with high degrees of handicap and related risk factors, as tinnitus (TINN) is strongly related to adverse health outcomes (AHO) including reduced quality of life, and poorer physical and mental health. Methods: Eligible cisplatin-treated testicular cancer survivors (TCS) (aged < 60 y at diagnosis) completed comprehensive, validated health surveys, including the 20-item Tinnitus Primary Function Questionnaire (TPFQ). TPFQ assesses the 4 main TINN-impaired domains (see Table), each with a response metric of 0% (no interference) to 100% interference by TINN, with final impairment groupings of 0-16% (none/minimal), 17-42% (mild/moderate), and 43-100% (significant). TPFQ measures were compared by 2-sided signed-rank tests. Multinomial logistic regression models (adjusted for age, income, education, yrs since therapy, cisplatin dose, BMI, smoking, hypertension, and hearing loss (HL)) tested for associations with TINN severity. Results are shown as OR [95% CI], p-value. Results: Among 213 TCS [median age 46 y (IQR: 38-52 y); median time since therapy: 10.6 y (IQR: 6.8-16.6 y)], the most common AHOs were CIS-TINN (60%), and HL (60%). For TCS with CIS-TINN, the mean degree of reported interference across all TPFQ domains was 21% (median: 15, IQR: 3-33). TCS with CIS-TINN reported significantly greater interference with emotion (median: 22, range 5-40) than with concentration (median 13, IQR: 1.0-37, p = .004), hearing (median: 10, IQR: 0-30, p < .001), and sleep (median: 2.4, IQR: 0-21, p < .001). Conclusions: Following cisplatin chemotherapy, CIS-TINN is a leading AHO and often reported with HL and reduced quality of life. Severe CIS-TINN was associated with greater handicap on the TPFQ as well as with depression, cognitive dysfunction, and hearing aid use. Overall, however, TCS with CIS-TINN and HL reported underutilization of hearing aids.[Table: see text]
Diagnosis of malnutrition according to glim criteria predicts complications and six-month survival in cancer outpatients.
Authors: Marti Pi Maria , Gascon Ruiz Marta , Casas-Deza Diego , Torres Ramon Irene , Zapata-Garcia Maria , Sesma Andrea , Lambea- Sorrosal Julio Jose , Alvarez Maria , Quilez Elisa , Zurera Berjaga Maria , Moratiel Pellitero Alba , Ruiz Moreno Ines , Goas Gomez Ana , Isla Dolores , Arbonés-Mainar José Miguel 
Published: June 2022

e24093 Background: Malnutrition is a condition with great impact in oncology patients. Poor nutritional status is often associated with increased morbidity and mortality, increased toxicity and reduced tolerance to chemotherapy, among other complications. The recent GLIM criteria for malnutrition aim to homogenize its diagnosis, considering the baseline disease status. Due to the few studies that assess the predictive capacity of these new criteria, we aimed to evaluate their performance for the prediction of complications and mortality in patients with cancer. Methods: Prospective, single-centre study. All outpatients under active treatment for head and neck, upper gastrointestinal and colorectal tumors between February and October 2020 were recruited. These patients were followed up for 6 months, assessing the occurrence of complications and survival, based on GLIM diagnosis of malnutrition. Results: We enrolled 165 outpatients 46.66% malnutrition. During 6-month follow-up, patients with malnutrition (46.7%, according to GLIM criteria) had an ̃3-fold increased risk of hospital admission (p < 0.001) and the occurrence of severe infections (considered as such those requiring hospitalization, intravenous antibiotics and/or drainage by interventional procedure) during follow-up (p = 0.002). Similarly, malnourished patients had a 3.5-fold increased risk of poor pain control and a 4.4-fold increased need for a higher dose of opioids (both p < 0.001). They also had a 2.6-fold increased risk of toxicity (p = 0.044) and a 2.5-fold increased likelihood of needing a dose decrease or discontinuation of cancer treatment (p = 0.011). 6-month survival of malnourished patients was significantly lower (p = 0.023) than non-malnourished patients. Conclusions: Diagnosis of malnutrition according to GLIM criteria in oncology patients on active treatment predicts increased complications and worse survival at 6-month follow-up, making them a useful tool to assess the nutritional status of oncology patients.[Table: see text]
Cancer cachexia impact on chemotherapy dose reduction, treatment discontinuation, and survival: A qualitative systematic review.
Authors: Bonomi Philip D. , Walsh Declan , Currow David C. , Ballinari Gianluca , Skipworth Richard J. E. 
Published: June 2022

e24103 Background: Cachexia is a syndrome of muscle wasting, weight loss, and anorexia, that frequently affects patients with advanced cancer across all major areas of oncology (surgical, medical, radiation, and chemotherapy), contributing to poorer treatment outcomes, including survival. In this qualitative systematic literature review, we reviewed the recent literature to assess the impact of cancer cachexia on chemotherapy dose reduction, treatment discontinuation, and survival. Methods: A systematic search was conducted on PubMed and Embase on November 26th, 2021, using the following search terms, among others: “cancer”, “cachexia”, “sarcopenia”, “muscle loss”, “body weight loss”, “chemotherapy”, “drug dose reduction”, “survival”, “treatment withdrawal”, and “treatment interruption”. 1,559 entries published between 2018 and 2021 were identified, of which 175 were duplicates. Publications were screened for eligibility and only original research in peer-reviewed journals were considered eligible. Inclusion criteria included: chemotherapy-specific studies; studies reporting on cachexia, body weight, or body composition changes; and studies reporting data on survival, chemotherapy dose reduction or treatment discontinuation, or occurrence of toxicities which may lead to chemotherapy dose reduction or treatment discontinuation in these patients. All studies that did not analyze the impact of cachexia on these outcomes were excluded. Results: A total of 63 studies, comprising a total of 15,832 patients, were considered eligible and selected for further analysis. The majority of analyzed studies, comprising 14,493 patients, reported associations between cancer cachexia (or its characteristics, such as weight loss or muscle wasting) and chemotherapy dose reductions in 7% of the studies, treatment discontinuation in 20% of the studies, and increased toxicity in 25% of the reports. Cachexia parameters were associated with inferior survival in 90% of the studies. The types of cancer most commonly associated with this effect were pancreatic (31% of studies), foregut (gastric, esophageal, and others, 17%), and lung cancer (14%). Conclusions: More than 70% of studies identified in the literature were retrospective assessments of patient records, while the remaining were prospective observational and interventional studies. In this review, cancer cachexia parameters were associated with reduced treatment delivery and inferior survival in multiple types of advanced cancer. These observations could have important implications for clinical practice, as early detection and successful treatment of cachexia might provide better outcomes for cancer patients undergoing chemotherapy. Disclosure: This study was funded by Helsinn Healthcare SA. Contact: Gianluca.Ballinari@helsinn.com .
Prospective, multicenter study on non-pharmacological, patient related predictive factors of chemotherapy induced nausea and vomiting (CINV): A NOGGO-EMRISK trial.
Authors: Sehouli Jalid , Oskay-Özcelik Gülten , Zocholl Dario , Klemt Anna-Sophia , Bangemann Nikola , Albrecht Oliver , Strittmatter Hans-Joachim , Wimberger Pauline , Kaczerowsky Anna , Lorenz Ralf , Ruhwedel Wencke , Fehm Tanja N. , Zahn Andreas , Tome Oliver , Markert Miriam , Hager Dietrich , Zorr Andreas , Keller Maren , Rittmeister Hannah , Grabowski Jacek P. 
Published: June 2022

e24107 Background: Despite many years of clinical research and development, nausea and vomiting remain challenging toxicities related to chemotherapy. The aim of our study was assessment of non-pharmacological, patient-related risk factors for chemotherapy-induced nausea and vomiting and development of unique predictive score in patients with gynaecological malignancies planned for chemotherapy. Methods: A research-based questionnaire of 27 risk factors was generated and provided to patients diagnosed with gynaecological malignancies prior to indicated chemotherapy. The data on nausea and vomiting from at least 3 cycles therapy was collected. Variable selection via stepwise and LASSO regression combined with patients history was used to identify a small set of questions with high predictive power. As risk prediction model, a Bayesian logistic regression was implemented with a cut-off chosen to yield a sensitivity of 80%. Area under the curve analysis (AUC) was conducted, and accuracy of prediction was calculated. Results: In total 191 patients were enrolled. The most frequent diagnosis and chemotherapy was ovarian cancer (69%) and carboplatinum/paclitaxel combination (57.7%), respectively. Six factors (emetogenic potential of the therapy, educational status, nausea and vomiting due to other medication, motion sickness, anxiety from therapy in general and anxiety from nausea due to therapy) were identified as most important predictive factors. All questions were answered by 132 (69.1%) patients. Among those 97 (68%) reported nausea or vomiting. The AUC of the predictive score consisting mentioned factors was 0.741, with a sensitivity of 80.4%, specificity of 51.4% and an overall accuracy of 72.7%. Conclusions: Patients related risk factors are missing in selection of the antiemetic prophylaxis in patients under chemotherapy. Presented predictive score showed very promising predictive power and is going to be validated in further phase of the trial. Clinical trial information: DRKS-ID: DRKS00015151.
Real-world treatment outcomes and healthcare resource use associated with antiemetics among cancer patients on highly emetogenic platinum-based chemotherapy.
Authors: Navari Rudolph M. , Nelson Winnie , Utt James K , Shoaib-Agwan Sofia , Singh Risho , Zhang Weiping , Bailey William L. 
Published: June 2022

e24109 Background: Chemotherapy-induced nausea and vomiting (CINV) is a recognized adverse outcome among cancer patients, and guidelines recommend appropriate prophylactic antiemetics. Highly emetogenic chemotherapy (HEC) is associated with high risk of CINV that potentially lead to additional healthcare resource use. This retrospective study aimed to quantify the treatment outcomes and resource utilization associated with antiemetic use to prevent CINV in a broad US population. Methods: Cancer patients who received platinum–based HEC were identified in the All Payers Claims Database (APCD). The APCD is a database representing the US population with commercial, Medicare, or Medicaid insurance. Insurance claims denote medical care associated with payment, providing an optimal data source to study healthcare resource use. Study patients were age ≥18 years and administered IV 1) fosnetupitant/palonosetron (IV NEPA), 2) aprepitant/fosaprepitant + palonosetron (IV APPA) or 3) aprepitant/fosaprepitant + ondansetron (IV APON) along with HEC. Patients were identified from 1/2016 - 12/2019. The index date was the first treatment date of a study antiemetic. Demographic and clinical characteristics were evaluated in the baseline period, which was 12 months prior to the index date. The post-HEC follow-up period was 14 days, starting the day after each HEC administration. Outcomes were reported descriptively as weighted means, with the cycles of treatment as the unit of analysis, including nausea & vomiting, dehydration, fluid-electrolyte imbalances, and hydration therapy. Results: Study included 1,216 IV NEPA, 43,537 IV APPA, and 16,140 IV APON patients who received HEC. During the post-HEC follow-up period, IV NEPA patients reported fewer occurrences of nausea & vomiting and fluid-electrolyte imbalances per cycle of treatment when compared to IV APPA and IV APON patients. Despite having similar or more dehydration claims for IV NEPA, the occurrence of hydration therapy was lower or similar to the other study groups. (Table). Conclusions: The choice of antiemetics to prevent CINV among cancer patients receiving HEC may impact real-world outcomes and healthcare resource use.[Table: see text]
The outcome and prognostic factors of advanced non-small cell lung cancer patients with do-not-intubation order in intensive care unit.
Authors: Shen Chia-I , Yang Shan-Yao , Chiu Hwa-Yen , Chen Wei-Chih , Yu Wen-Kuang , Yang Kuang-Yao 
Published: June 2022

e24113 Background: The survival of lung cancer patients in critical care has been improved. Increasing number of lung cancer patients have signed predefined do-not-intubation (DNI) order before admission to ICU. These patients may still be transferred to ICU and even receive non-invasive ventilation (NIV) supports. However, there is still lack of prognostic prediction in this cohort. Whether patients will be benefit of ICU care remain unclear. Methods: We retrospectively collected data of patients with advanced lung cancer, having signed DNI order before ICU admission in a tertiary medical center. The clinical characteristics and survival outcomes were discussed. The enrollment duration is between 2014 to 2016. Results: Total 140 patients were included. All patients were diagnosed with stage III or IV non-small cell lung cancer (AJCC 7th edition) and signed DNI. The median age was 73 years old and about two-thirds were male. Most patients had received NIV during ICU course. The median APACHE II score was 14 (SE, 0.66) and the mean P/F ratio was 174.2(+/-104) mmHg. The APACHE II score was significantly lower in 28-day survivors (survivor 12 (+/-0.98) vs non-survivor 15 (+/-0.83), p = 0.019). The P/F ratio of the survivors was higher than non-survivors (survivor 209.6+/-111.4 vs non-survivor 157.9+/-96.7, p = 0.006). Patients with P/F ratio ≥150 had better 28-day survival (p = 0.005). By combining P/F ratio≥150 and APACHE II score < 16, those with high P/F ratio and low APACHE II score during ICU admission had a notable 28-day survival compared with the rest (p < 0.001). These prognostic factors could also be applied for 90-day survival (p = 0.003). The prediction model was significant in those with driver mutations in 90-day survival (p = 0.021) but not in those without driver mutations (p = 0.061). Conclusions: The P/F ratio≥150 and APACHE II score < 16 were the prognostic significance of critically ill lung cancer patients with DNI. The prediction could be applied for 90-day survival in patients with driver mutation. The finding was informative for clinical practice and decision-making.
The impact of anthracycline-based chemotherapy on fatigue: Results from WF-97415.
Authors: Avis Nancy E , Levine Beverly J , Mihalko Shannon L. , Klepin Heidi D. , Brubaker Peter H. , Calhoun Tonya , Dent Susan Faye , Hackney Mary Helen , Ky Bonnie , Ladd Amy , Ntim William Ofori , Wagner Lynne I. , Weaver Kathryn E. , Hundley W. Gregory 
Published: June 2022

e24115 Background: Chemotherapy (CT) is one of the most common factors associated with fatigue among breast cancer (BC) patients. However, there is a paucity of research on the impact of different types of CT on fatigue, specifically, whether women who receive anthracycline-based (Anth) CT experience greater fatigue than those who receive non-anthracycline-based (noAnth) CT. Methods: Analyses are from the longitudinal Understanding and Predicting fatigue, cardiovascular decline, and events after BrEast cAncer sTudy (UPBEAT: WF 97415)), conducted through the NCI Community Oncology Research Program (NCORP). We compared fatigue 3-months after initiating cancer treatment, controlling for fatigue measured just prior to beginning CT (baseline), in 3 groups of women: BC patients receiving Anth CT (N = 103 at baseline), BC patients receiving NoAnth CT (N = 155), and women without cancer (N = 145). Fatigue was measured by the Functional Assessment of Chronic Illness Therapy Fatigue scale where lower scores indicate greater fatigue. Scores < 30 indicate severe fatigue. We used ANOVA and ANCOVA models (PROC GLM; SAS v. 9.4) to generate unadjusted and adjusted mean fatigue scores in the 3 groups at the relevant time point. Given that selection to CT type was not random, we further adjusted for patient characteristics that influence treatment type (stage and comorbidities) in a model with the two CT groups only. Results: Mean age of participants (75.7% White and 18.1% Black) was 53.9 years. Among BC patients, the Anth group had higher tumor stage compared to the NoAnth group. Both cancer treatment groups reported significantly greater (unadjusted) fatigue pre-chemotherapy and at 3 months than healthy controls, but did not differ from each other. Adjusting for age and baseline fatigue, 3-month fatigue scores were significantly worse for the two CT groups (32.3 for Anth group, 34.3 for the NoAnth group) compared to the controls (44.6) (p < .0001). In a model of cancer patients only, the difference between Anth and NoAnth groups remained non-significant (p = 0.10), after adjusting additionally for number of comorbidities and cancer stage. The unadjusted percentage of women with severe fatigue at 3 months was significantly greater for the BC patients (39% in the Anth group; 38% in the NoAnth group) compared to the healthy controls (1%), but again the two chemotherapy groups were not significantly different from each other. Adjustment for covariates listed above did not change this finding. Conclusions: Analyses support previous studies showing significant fatigue among BC patients treated with CT compared to women without cancer. Our data suggest that fatigue significantly impacts patients receiving CT irrespective of the regimen selected.[Table: see text]