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Nannini DR, Cortese R, VonTungeln C, Hildebrandt GC. Chemotherapy-induced acceleration of DNA methylation-based biological age in breast cancer. Epigenetics 2024; 19:2360160. [PMID: 38820227 DOI: 10.1080/15592294.2024.2360160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/21/2024] [Indexed: 06/02/2024] Open
Abstract
Breast cancer is the most common cancer diagnosed in women and is often treated with chemotherapy. Although previous studies have demonstrated increasing biological age in patients who receive chemotherapy, evaluation of this association with DNA methylation-based markers of biological ageing may provide novel insight into the role of chemotherapy on the ageing process. We therefore sought to investigate the association between chemotherapy and markers of biological ageing as estimated from DNA methylation in women with breast cancer. DNA methylation profiling was performed on peripheral blood collected from 18 patients before and after the first cycle of chemotherapy using the Infinium HumanMethylation450 BeadChip. Six markers of biological age acceleration were estimated from DNA methylation levels. Multiple linear regression analyses were performed to evaluate the association between each metric of biological age acceleration and chemotherapy. After adjusting for chronological age and race, intrinsic epigenetic age acceleration (p = 0.041), extrinsic epigenetic age acceleration (p = 0.050), PhenoAge acceleration (p = 0.001), GrimAge acceleration (p < 0.001), and DunedinPACE (p = 0.006) were significantly higher and telomere length (p = 0.027) was significantly lower following the first cycle of chemotherapy compared to before treatment initiation. These results demonstrate greater biological ageing as estimated from DNA methylation following chemotherapy in women with breast cancer. Our findings illustrate that cytotoxic therapies may modulate the ageing process among breast cancer patients and may also have implications for age-related health conditions in cancer survivors.
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Affiliation(s)
- Drew R Nannini
- Department of Internal Medicine, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
| | - Rene Cortese
- Department of Child Health and Department of Obstetrics, Gynecology, and Women's Health, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, USA
| | - Christopher VonTungeln
- Department of Internal Medicine, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
| | - Gerhard C Hildebrandt
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, USA
- Division of Hematology and Medical Oncology, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
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Koevoets EW, Petr J, Monninkhof EM, Geerlings MI, Witlox L, van der Wall E, Stuiver MM, Sonke GS, Velthuis MJ, Jobsen JJ, van der Palen J, Mutsaerts HJMM, de Ruiter MB, May AM, Schagen SB. Effect of Physical Exercise on MRI-Assessed Brain Perfusion in Chemotherapy-Treated Breast Cancer Patients: A Randomized Controlled Trial. J Magn Reson Imaging 2024; 59:1667-1680. [PMID: 37801027 DOI: 10.1002/jmri.28967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Exercise is a promising intervention to alleviate cognitive problems in breast cancer patients, but studies on mechanisms underlying these effects are lacking. PURPOSE Investigating whether an exercise intervention can affect cerebral blood flow (CBF) in cognitively impaired breast cancer patients and to determine if CBF changes relate to memory function. STUDY TYPE Prospective. POPULATION A total of 181 chemotherapy-treated stage I-III breast cancer patients with cognitive problems and relatively low physical activity levels (≤150 minutes moderate to vigorous physical activity per week), divided into an exercise (N = 91) or control group (N = 90). FIELD STRENGTH/SEQUENCE Two-dimensional echo planar pseudo-continuous arterial spin labeling CBF sequence at 3 T. ASSESSMENT The 6-month long intervention consisted of (supervised) aerobic and strength training, 4 × 1 hour/week. Measurements at baseline (2-4 years post-diagnosis) and after 6 months included gray matter CBF in the whole brain, hippocampus, anterior cingulate cortex, and posterior cingulate cortex. Physical fitness and memory function were also assessed. Subgroup analyses were performed in patients with high fatigue levels at baseline. STATISTICAL TESTS Multiple regression analyses with a two-sided alpha of 0.05 for all analyses. RESULTS There was a significant improvement in physical fitness (VO2peak in mL/minute/kg) in the intervention group (N = 53) compared to controls (N = 51, β = 1.47 mL/minute/kg, 95% CI: 0.44-2.50). However, no intervention effects on CBF were found (eg, whole brain: P = 0.565). Highly fatigued patients showed larger but insignificant treatment effects on CBF (eg, whole brain: P = 0.098). Additionally, irrespective of group, a change in physical fitness was positively associated with changes in CBF (eg, whole brain: β = 0.75, 95% CI: 0.07-1.43). There was no significant relation between CBF changes and changes in memory performance. DATA CONCLUSION The exercise intervention did not affect CBF of cognitively affected breast cancer patients. A change in physical fitness was associated with changes in CBF, but changes in CBF were not associated with memory functioning. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 5.
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Affiliation(s)
- Emmie W Koevoets
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Department of General Practice, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life and Personalized Medicine, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, The Netherlands
| | - Lenja Witlox
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gabe S Sonke
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Jan J Jobsen
- Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Job van der Palen
- Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands
- Section Cognition, Data and Education, Universiteit Twente, Enschede, The Netherlands
| | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
| | - Michiel B de Ruiter
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Brain and Cognition Group, University of Amsterdam, Amsterdam, The Netherlands
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McNeish BL, Dittus K, Mossburg J, Krant N, Steinharter JA, Feb K, Cote H, Hehir MK, Reynolds R, Redfern MS, Rosano C, Richardson JK, Kolb N. The association of chemotherapy-induced peripheral neuropathy with reduced executive function in chemotherapy-treated cancer survivors: A cross-sectional study. J Geriatr Oncol 2024; 15:101765. [PMID: 38581957 PMCID: PMC11088516 DOI: 10.1016/j.jgo.2024.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/14/2024] [Accepted: 04/01/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy (CIPN) is common and disabling among cancer survivors. Little is known about the association of CIPN with other measures of the nervous system's integrity, such as executive dysfunction. We compared measures of executive function in older chemotherapy-treated cancer survivors with and without CIPN. MATERIALS AND METHODS This cross-sectional study enrolled 50 chemotherapy-treated cancer survivors (65.6 ± 11.5 years, 88% female) post-chemotherapy treatment who were previously referred for outpatient rehabilitation at the request of the cancer survivor or a medical provider. Twenty-two participants (44%) had CIPN defined by patient-reported distal paresthesia or numbness, which began with chemotherapy and continued to the time of cognitive testing. Measures of executive function included Trails-B, Stroop, and rapid reaction accuracy (RRA) and were evaluated between cancer survivors with and without CIPN using t-tests. Multivariable models were then used to determine whether CIPN was an independent determinant of the measures of executive function (Trails-B, Stroop Incongruent, and RRA). Models were adjusted for age, sex, history of anxiety, and benzodiazepine use due to their known associations with CIPN and executive function. RESULTS Cancer survivors with CIPN (CIPN+) had reduced executive function compared to survivors without CIPN (CIPN-) on Trails-B (CIPN+: 84.9 s ± 44.1 s, CIPN-: 59.1 s ± 22.5 s, p = 0.01), Stroop (CIPN+: 100.6 s ± 38.2 s, CIPN-: 82.1 s ± 17.3 s, p = 0.03), and RRA (CIPN+: 60.3% ± 12.9%, CIPN-: 70.6% ± 15.7%, p = 0.01). There were no differences in cancer stage severity or functional status by patient report or sit-to-stand function. The association between CIPN and reduced executive function was found in multivariable models after adjusting for age, sex, anxiety, and benzodiazepine use for Trails-B (ß:17.9, p = 0.046), Stroop (ß:16.9, p = 0.02), and RRA (ß:-0.072, p = 0.03). DISCUSSION In this population, CIPN is associated with reduced executive function in older cancer survivors treated with chemotherapy. Future research is required to further understand this preliminary association, the causality, and the potential risk factors.
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Affiliation(s)
- Brendan L McNeish
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
| | - Kim Dittus
- University of Vermont Cancer Center, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA.
| | - Jurdan Mossburg
- Department of Physical Therapy, University of Vermont, Burlington, VT, USA
| | - Nicholas Krant
- Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
| | - John A Steinharter
- Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
| | - Kendall Feb
- Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Hunter Cote
- Department of Physical Therapy, University of Vermont, Burlington, VT, USA.
| | - Michael K Hehir
- Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
| | | | - Mark S Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Caterina Rosano
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - James K Richardson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
| | - Noah Kolb
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
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Yan M, Wu S, Wang Y, Liang M, Wang M, Hu W, Yu G, Mao Z, Huang F, Zhou J. Recent Progress of Supramolecular Chemotherapy Based on Host-Guest Interactions. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2304249. [PMID: 37478832 DOI: 10.1002/adma.202304249] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/10/2023] [Indexed: 07/23/2023]
Abstract
Chemotherapy is widely recognized as an effective approach for treating cancer due to its ability to eliminate cancer cells using chemotherapeutic drugs. However, traditional chemotherapy suffers from various drawbacks, including limited solubility and stability of drugs, severe side effects, low bioavailability, drug resistance, and challenges in tracking treatment efficacy. These limitations greatly hinder its widespread clinical application. In contrast, supramolecular chemotherapy, which relies on host-guest interactions, presents a promising alternative by offering highly efficient and minimally toxic anticancer drug delivery. In this review, an overview of recent advancements in supramolecular chemotherapy based on host-guest interactions is provided. The significant role it plays in guiding cancer therapy is emphasized. Drawing on a wealth of cutting-edge research, herein, a timely and valuable resource for individuals interested in the field of supramolecular chemotherapy or cancer therapy, is presented. Furthermore, this review contributes to the progression of the field of supramolecular chemotherapy toward clinical application.
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Affiliation(s)
- Miaomiao Yan
- Department of Chemistry, College of Sciences, Northeastern University, Shenyang, 110819, P. R. China
| | - Sha Wu
- Department of Chemistry, College of Sciences, Northeastern University, Shenyang, 110819, P. R. China
| | - Yuhao Wang
- Department of Chemistry, College of Sciences, Northeastern University, Shenyang, 110819, P. R. China
| | - Minghao Liang
- Department of Chemistry, College of Sciences, Northeastern University, Shenyang, 110819, P. R. China
| | - Mengbin Wang
- Stoddart Institute of Molecular Science, Department of Chemistry, Zhejiang University, Hangzhou, 310058, P. R. China
- Zhejiang-Israel Joint Laboratory of Self-Assembling Functional Materials, ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 311215, P. R. China
| | - Wenting Hu
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, P. R. China
| | - Guocan Yu
- Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology, Department of Chemistry, Tsinghua University, Beijing, 100084, P. R. China
| | - Zhengwei Mao
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, P. R. China
| | - Feihe Huang
- Stoddart Institute of Molecular Science, Department of Chemistry, Zhejiang University, Hangzhou, 310058, P. R. China
- Zhejiang-Israel Joint Laboratory of Self-Assembling Functional Materials, ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 311215, P. R. China
| | - Jiong Zhou
- Department of Chemistry, College of Sciences, Northeastern University, Shenyang, 110819, P. R. China
- Guangdong Provincial Key Laboratory of Functional Supramolecular Coordination Materials and Applications, Jinan University, Guangzhou, 510632, P. R. China
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Naaktgeboren WR, Koevoets EW, Stuiver MM, van Harten WH, Aaronson NK, van der Wall E, Velthuis M, Sonke G, Schagen SB, Groen WG, May AM. Effects of physical exercise during adjuvant chemotherapy for breast cancer on long-term tested and perceived cognition: results of a pragmatic follow-up study. Breast Cancer Res Treat 2024; 205:75-86. [PMID: 38285111 PMCID: PMC11062992 DOI: 10.1007/s10549-023-07220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) following chemotherapy is commonly reported in breast cancer survivors, even years after treatment. Data from preclinical studies suggest that exercise during chemotherapy may prevent or diminish cognitive problems; however, clinical data are scarce. METHODS This is a pragmatic follow-up study of two original randomized trials, which compares breast cancer patients randomized to exercise during chemotherapy to non-exercise controls 8.5 years post-treatment. Cognitive outcomes include an online neuropsychological test battery and self-reported cognitive complaints. Cognitive performance was compared to normative data and expressed as age-adjusted z-scores. RESULTS A total of 143 patients participated in the online cognitive testing. Overall, cognitive performance was mildly impaired on some, but not all, cognitive domains, with no significant differences between groups. Clinically relevant cognitive impairment was present in 25% to 40% of all participants, regardless of study group. We observed no statistically significant effect of exercise, or being physically active during chemotherapy, on long-term cognitive performance or self-reported cognition, except for the task reaction time, which favored the control group (β = -2.04, 95% confidence interval: -38.48; -2.38). We observed no significant association between self-reported higher physical activity levels during chemotherapy or at follow-up and better cognitive outcomes. CONCLUSION In this pragmatic follow-up study, exercising and being overall more physically active during or after adjuvant chemotherapy for breast cancer was not associated with better tested or self-reported cognitive functioning, on average, 8.5 years after treatment. Future prospective studies are needed to document the complex relationship between exercise and CRCI in cancer survivors.
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Affiliation(s)
- Willeke R Naaktgeboren
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Emmie W Koevoets
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Center for Quality of Life, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
- Rijnstate Hospital, Arnhem, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Miranda Velthuis
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Gabe Sonke
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Brain and Cognition Group, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim G Groen
- Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Aging & Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
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Lomeli N, Pearre DC, Cruz M, Di K, Ricks-Oddie JL, Bota DA. Cisplatin induces BDNF downregulation in middle-aged female rat model while BDNF enhancement attenuates cisplatin neurotoxicity. Exp Neurol 2024; 375:114717. [PMID: 38336286 PMCID: PMC11087041 DOI: 10.1016/j.expneurol.2024.114717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/04/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
Cancer-related cognitive impairments (CRCI) are neurological complications associated with cancer treatment, and greatly affect cancer survivors' quality of life. Brain-derived neurotrophic factor (BDNF) plays an essential role in neurogenesis, learning and memory. The reduction of BDNF is associated with the decrease in cognitive function in various neurological disorders. Few pre-clinical studies have reported on the effects of chemotherapy and medical stress on BDNF levels and cognition. The present study aimed to compare the effects of medical stress and cisplatin on serum BDNF levels and cognitive function in 9-month-old female Sprague Dawley rats to age-matched controls. Serum BDNF levels were collected longitudinally during cisplatin treatment, and cognitive function was assessed by novel object recognition (NOR) 14 weeks post-cisplatin initiation. Terminal BDNF levels were collected 24 weeks after cisplatin initiation. In cultured hippocampal neurons, we screened three neuroprotective agents, riluzole (an approved treatment for amyotrophic lateral sclerosis), as well as the ampakines CX546 and CX1739. We assessed dendritic arborization by Sholl analysis and dendritic spine density by quantifying postsynaptic density-95 (PSD-95) puncta. Cisplatin and exposure to medical stress reduced serum BDNF levels and impaired object discrimination in NOR compared to age-matched controls. Pharmacological BDNF augmentation protected neurons against cisplatin-induced reductions in dendritic branching and PSD-95. Ampakines (CX546 and CX1739) and riluzole did not affect the antitumor efficacy of cisplatin in vitro. In conclusion, we established the first middle-aged rat model of cisplatin-induced CRCI, assessing the contribution of medical stress and longitudinal changes in BDNF levels on cognitive function, although future studies are warranted to assess the efficacy of BDNF enhancement in vivo on synaptic plasticity. Collectively, our results indicate that cancer treatment exerts long-lasting changes in BDNF levels, and support BDNF enhancement as a potential preventative approach to target CRCI with therapeutics that are FDA approved and/or in clinical study for other indications.
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Affiliation(s)
- Naomi Lomeli
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Diana C Pearre
- Gynecologic Oncology, Providence Specialty Medical Group, Burbank, CA, USA
| | - Maureen Cruz
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Kaijun Di
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Joni L Ricks-Oddie
- Center for Statistical Consulting, Department of Statistics, University of California Irvine, Irvine, CA, USA; Biostatistics, Epidemiology and Research Design Unit, Institute for Clinical and Translational Sciences, University of California Irvine, Irvine, CA, USA
| | - Daniela A Bota
- Department of Neurology, University of California Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA.
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Ma H, Lu C, Jin Z, Liu R, Miao Z, Zha Z, Tao Z. Rhodium-Rhenium Alloy Nanozymes for Non-inflammatory Photothermal Therapy. ACS APPLIED MATERIALS & INTERFACES 2024; 16:21653-21664. [PMID: 38644787 DOI: 10.1021/acsami.4c02550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Analogous to thermal ablation techniques in clinical settings, cell necrosis induced during tumor photothermal therapy (PTT) can provoke an inflammatory response that is detrimental to the treatment of tumors. In this study, we employed a straightforward one-step liquid-phase reduction process to synthesize uniform RhRe nanozymes with an average hydrodynamic size of 41.7 nm for non-inflammatory photothermal therapy. The obtained RhRe nanozymes showed efficient near-infrared (NIR) light absorption for effective PTT, coupled with a remarkable capability to scavenge reactive oxygen species (ROS) for anti-inflammatory treatment. After laser irradiation, the 4T1 tumors were effectively ablated without obvious tumor recurrence within 14 days, along with no obvious increase in pro-inflammatory cytokine levels. Notably, these RhRe nanozymes demonstrated high biocompatibility with normal cells and tissues, both in vitro and in vivo, as evidenced by the lack of significant toxicity in female BALB/c mice treated with 10 mg/kg of RhRe nanozymes over a 14 day period. This research highlights RhRe alloy nanoparticles as bioactive nanozymes for non-inflammatory PTT in tumor therapy.
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Affiliation(s)
- Hongna Ma
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui 230009, People's Republic of China
| | - Chenxin Lu
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui 230009, People's Republic of China
| | - Zhaoying Jin
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui 230009, People's Republic of China
| | - Rui Liu
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui 230009, People's Republic of China
| | - Zhaohua Miao
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui 230009, People's Republic of China
- Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei, Anhui 230026, People's Republic of China
| | - Zhengbao Zha
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui 230009, People's Republic of China
| | - Zhenchao Tao
- Department of Radiation Oncology, The First Affiliated Hospital of USTC West District, Anhui Provincial Cancer Hospital, Hefei, Anhui 230031, People's Republic of China
- Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, Anhui 230032, People's Republic of China
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Westrick AC, Zhu P, Friese CR, Langa KM, Kobayashi LC. The association of pre-cancer diagnosis cardiovascular risk factors with memory aging after a cancer diagnosis, overall and by race/ethnicity. J Cancer Surviv 2024:10.1007/s11764-024-01593-4. [PMID: 38647590 DOI: 10.1007/s11764-024-01593-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Cardiovascular risk factors (CVRFs) are associated with increased risk for cognitive impairment and decline in the general population, but less is known about how CVRFs might influence cognitive aging among older cancer survivors. We aimed to determine how CVRFs prior to a cancer diagnosis affect post-cancer diagnosis memory aging, compared to cancer-free adults, and by race/ethnicity. METHODS Incident cancer diagnoses and memory (immediate and delayed recall) were assessed biennially in the US Health and Retirement Study (N = 5,736, 1998-2018). CVRFs measured at the wave prior to a cancer diagnosis included self-reported cigarette smoking, obesity, diabetes, heart disease, hypertension, and stroke. Multivariable-adjusted linear mixed-effects models evaluated the rate of change in standardized memory score (SD/decade) post-cancer diagnosis for those with no, medium, and high CVRFs, compared to matched cancer-free adults, overall and stratified by sex and race/ethnicity. RESULTS Higher number of CVRFs was associated with worse baseline memory for both men and women, regardless of cancer status. Cancer survivors with medium CVRFs had slightly slower rates of memory decline over time relative to cancer-free participants (0.04 SD units/decade [95% CI: 0.001, 0.08]). Non-Hispanic Black (NHB) and Hispanic cancer-free participants and cancer survivors had worse baseline memory than their Non-Hispanic White (NHW) counterparts. CONCLUSIONS CVRFs were associated with worse baseline memory function, but not decline, for cancer-free adults and cancer survivors. Racial disparities were largely similar between cancer survivors and cancer-free adults. IMPLICATIONS FOR CANCER SURVIVORS These findings may inform hypotheses about pre-diagnosis multimorbidity and cognitive aging of cancer survivors from diverse groups.
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Affiliation(s)
- Ashly C Westrick
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Peiyao Zhu
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Christopher R Friese
- Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Kenneth M Langa
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
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Zhang Z, Wang P, Chen S, Xiang D, Chen J, Huang W, Liu X, Yi T, Wang D, Pu Y, He L, Zhang H. NXPH4 can be used as a biomarker for pan-cancer and promotes colon cancer progression. Aging (Albany NY) 2024; 16:5866-5886. [PMID: 38613793 PMCID: PMC11042927 DOI: 10.18632/aging.205648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/17/2024] [Indexed: 04/15/2024]
Abstract
NXPH4 promotes cancer proliferation and invasion. However, its specific role and mechanism in cancer remain unclear. Transcriptome and clinical data for pan-cancer were derived from the TCGA database. K-M survival curve and univariate Cox were used for prognostic analysis. CIBERSORT and TIMER algorithms were employed to calculate immune cell infiltration. Gene set enrichment analysis (GSEA) was employed for investigating the function of NXPH4. Western blot verified differential expression of NXPH4 in colon cancer. Functional assays (CCK-8, plate clonogenicity assay, wound healing assay, and Transwell assay) confirmed the impact of NXPH4 on proliferation, invasion, and migration of colon cancer cells. Dysregulation of NXPH4 in pan-cancer suggests its potential as a diagnostic and prognostic marker for certain cancers, including colon and liver cancer. High expression of NXPH4 in pan-cancer might be associated with the increase in copy number and hypomethylation. NXPH4 expression in pan-cancer is substantially linked to immune cell infiltration in the immune microenvironment. NXPH4 expression is associated with the susceptibility to immunotherapy and chemotherapy. Western blot further confirmed the higher expression of NXPH4 in colon cancer. Knockdown of NXPH4 significantly suppresses proliferation, invasion, and migration of colon cancer cell lines HT-29 and HCT116, as validated by functional assays.
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Affiliation(s)
- Zhipeng Zhang
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Pengfei Wang
- Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Siwen Chen
- The Sixth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dezhi Xiang
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Jinzhen Chen
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Wanchang Huang
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Xiao Liu
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Tongwen Yi
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Dawei Wang
- Key Laboratory of Hepatosplenic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yunfei Pu
- Key Laboratory of Hepatosplenic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Longfu He
- Department of Anorectal Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Hao Zhang
- Department of Physiology, Zhuhai Campus of Zunyi Medical University, Zhuhai, China
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Gaynor AM, Ahsan A, Jung D, Schofield E, Li Y, Ryan E, Ahles TA, Root JC. Novel computerized neurocognitive test battery is sensitive to cancer-related cognitive deficits in survivors. J Cancer Surviv 2024; 18:466-478. [PMID: 35939254 DOI: 10.1007/s11764-022-01232-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE There is increasing interest in developing new methods to improve sensitivity in detecting subtle cognitive deficits associated with cancer and its treatments. The current study aimed to evaluate the ability of a novel computerized battery of cognitive neuroscience-based tests to discriminate between cognitive performance in breast cancer survivors and controls. METHODS Breast cancer survivors (N = 174) and age-matched non-cancer controls (N = 183) completed the Enformia Cogsuite Battery of cognitive assessments, comprised of 7 computerized tests of multiple cognitive domains. Primary outcome measures included accuracy, reaction times (RT), and coefficients of variation (CV) for each task, as well as global scores of accuracy, RT, and CV aggregated across tests. RESULTS Linear regressions adjusting for age, education, and remote vs. in-office administration showed that compared to non-cancer controls, survivors had significantly lower performance on measures of attention, executive function, working memory, verbal ability, visuospatial ability, and motor function. Survivors had significantly greater CV on measures of attention, working memory, and processing speed, and significantly slower RT on measures of verbal fluency. CONCLUSIONS The Cogsuite battery demonstrates sensitivity to cancer-related cognitive dysfunction across multiple domains, and is capable of identifying specific cognitive processes that may be affected in survivors. IMPLICATIONS FOR CANCER SURVIVORS The sensitivity of these tasks to subtle cognitive deficits has advantages for initial diagnosis of cancer-related cognitive dysfunction, as well as detecting changes in survivors' cognitive function over time. The remote delivery of the battery may help overcome barriers associated with in-office administration and increase access to neurocognitive evaluation.
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Affiliation(s)
- Alexandra M Gaynor
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA.
- Taub Institute for Research On Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA.
| | - Anam Ahsan
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | | | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Neurocognitive Research Laboratory, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7thFloor, New York, NY, 10022, USA
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11
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Klaver KM, Duijts SFA, Geusgens CAV, Aarts MJB, Ponds RWHM, van der Beek AJ, Schagen SB. Neuropsychological test performance and self-reported cognitive functioning associated with work-related outcomes in occupationally active cancer survivors with cognitive complaints. J Cancer Surviv 2024; 18:412-424. [PMID: 35776235 DOI: 10.1007/s11764-022-01223-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To assess cognitive functioning in occupationally active non-central nervous system cancer survivors with cognitive complaints using neuropsychological tests, and to investigate the association between (1) formally assessed cognitive functioning and self-reported work-related outcomes and (2) self-reported cognitive functioning at work and self-reported work-related outcomes. METHODS Baseline data of a multicenter, randomized controlled trial (n = 279) were used. Associations between neuropsychological test performance (Amsterdam Cognition Scan) and self-reported cognitive functioning (Cognitive Symptom Checklist-work) with work ability (Work Ability Index) and work functioning (Work Role Functioning Questionnaire) were examined using multivariate linear regression. RESULTS Thirty percent of cancer survivors had lower than expected performance on neuropsychological tests. Higher overall neuropsychological test performance was associated with better work ability (Cohen's f2 = 0.014) and physical functioning at work (Cohen's f2 = 0.13). Furthermore, higher motor performance was associated with better work ability (Cohen's f2 = 0.018). In addition, self-reported work-related cognitive complaints were associated with self-reported work-related outcomes (Cohen's f2 = 0.13-0.35). CONCLUSIONS The percentage of cancer survivors with lower than expected performance on neuropsychological tests exceeded the percentage expected in a normal population. This neuropsychological test performance was weakly associated with various aspects of work ability and work functioning. Stronger associations were found between self-reported cognitive functioning at work with self-reported work-related outcomes. IMPLICATIONS FOR CANCER SURVIVORS A cognitive rehabilitation approach that specifically aims at reducing cognitive symptoms at work could be a valuable part of interventions that aim to improve work-related outcomes. Trial registration The study is registered at ClinicalTrials.gov (NCT03900806) at 03 April 2019 (current status: ongoing), https://clinicaltrials.gov/ct2/show/NCT03900806?term=NCT03900806&draw=2&rank=1.
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Affiliation(s)
- Kete M Klaver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Chantal A V Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Maureen J B Aarts
- Department of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University, MC, Maastricht, The Netherlands
| | - Rudolf W H M Ponds
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Brain and Cognition Group, University of Amsterdam, Amsterdam, The Netherlands.
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12
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Ahles TA, Orlow I, Schofield E, Li Y, Ryan E, Root JC, Patel SK, McNeal K, Gaynor A, Tan H, Katheria V, Vazquez J, Corrales-Guerrero S, Sadeghi K, Traina T, Hurria A. The impact of APOE and smoking history on cognitive function in older, long-term breast cancer survivors. J Cancer Surviv 2024; 18:575-585. [PMID: 36279076 PMCID: PMC10123173 DOI: 10.1007/s11764-022-01267-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/28/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE This study aims to determine whether older breast cancer survivors score lower on neuropsychological tests compared to matched non-cancer controls and to test the hypotheses that survivors who were APOE ε4 carriers would have the lowest cognitive performance but that smoking history would decrease the negative effect of ε4 on cognition. METHODS Female breast cancer survivors who had been diagnosed and treated at age 60 or older and were 5-15-year survivors (N = 328) and age and education matched non-cancer controls (N = 162) were assessed at enrollment and at 8-, 16-, and 24-month follow-ups with standard neuropsychological and psychological assessments. Blood for APOE genotyping was collected, and smoking history was assessed at enrollment. Participants were purposely recruited so that approximately 50% had a history of treatment with chemotherapy or no chemotherapy and approximately 50% had a smoking history. RESULTS After adjusting for age, cognitive reserve, depression, and fatigue, breast cancer survivors scored significantly lower on all domains of cognitive function. A significant two-way interaction demonstrated that the negative effect of ε4 on cognitive performance was stronger among survivors. A significant three-way interaction supported the hypothesis that smoking history had a protective effect on cognitive function in ε4 carriers that was more pronounced in the controls than the survivors. CONCLUSIONS The results support the long-term cognitive impact of breast cancer diagnosis and treatments on older, disease-free survivors, particularly for ε4 carriers. The results also emphasize the importance of assessing smoking history when examining APOE and cognition and are an example of the complex interactions of age, genetics, health behaviors, and disease history in determining cognitive function. IMPLICATIONS FOR CANCER SURVIVORS These results help explain why only a subset of breast cancer survivors appear to be vulnerable to cognitive problems.
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Affiliation(s)
- Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Irene Orlow
- Molecular Epidemiology Laboratory, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sunita K Patel
- Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Katrazyna McNeal
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexandra Gaynor
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Heidi Tan
- Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Vani Katheria
- Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jessica Vazquez
- Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sergio Corrales-Guerrero
- Molecular Epidemiology Laboratory, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Keimya Sadeghi
- Molecular Epidemiology Laboratory, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tiffany Traina
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Arti Hurria
- Center for Cancer and Ageing, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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13
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Liu Y, Li RL, Chen L, Zhao FY, Su YL, Jin S, Liu JE. Construction and validation of a risk-prediction model for chemotherapy-related cognitive impairment in patients with breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01566-7. [PMID: 38512563 DOI: 10.1007/s11764-024-01566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. METHODS A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy-cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. RESULTS A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. CONCLUSION Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. IMPLICATIONS FOR CANCER SURVIVORS Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Lu Chen
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Fu-Yun Zhao
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, 100050, Beijing, China
| | - Shuai Jin
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China.
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Rick O, Gerhardt A, Schilling G. Cancer-Related Cognitive Dysfunction: A Narrative Review for Clinical Practice. Oncol Res Treat 2024; 47:218-223. [PMID: 38471462 DOI: 10.1159/000538277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Cancer-related cognitive dysfunction (CRCD) is a major functional disorder in patients with cancer. This central nervous dysfunction is found in up to 60% of patients after tumour therapy, often significantly limits the quality of life, and significantly impedes participation in working life. For this reason, diagnosis and treatment of CRCD are of central importance. This narrative review is intended to provide an overview and support for practical clinical care with regard to diagnostics and therapeutic options. SUMMARY In Germany, CRCD has received insufficient attention in clinical practice due to the lack of guidelines for diagnosis and therapy. The pathophysiology is complex and cannot be explained by chemotherapeutic treatment alone. In addition to the tumour disease as such and the tumour therapy, psychological factors such as anxiety and depression as well as sleep disorders also play a significant role. Today, it is known that in addition to age, molecular genetic changes also have an effect on cognitive function. Morphologically, CRCD can be located in the frontal cortex and hippocampus. In addition to easy-to-use screening instruments such as the visual analogue scale, validated questionnaires such as the Questionnaire of Subjectively Experienced Deficits in Attention (FEDA) developed in Germany are also available. These allow the suspected diagnosis to be substantiated and the patient to be referred to further neurological, neuropsychological, or psycho-oncological diagnostics. Within the framework of further neuropsychological diagnostics, the International Cognition and Cancer Task Force (ICCTF) recommends testing learning, memory, processing speed, and executive functions. From the authors' point of view, a step-by-step diagnosis is recommended in order to avoid overdiagnosis. In clinical practice, graduation according to the "Common Terminology Criteria for Adversity Events" (CTCAE Version 5.0) is suitable for assessing the degree of severity. Cognitive training should be behaviourally oriented and include regular practice of cognitive skills to restore attention, psychomotor speed, memory, and executive functions. The best evidence is currently found for web-based training programmes that can be used by the patient at home. There is also evidence for mindfulness training and physical exercises. In particular, the combination of these three therapeutic elements currently seems to be the optimal treatment strategy for CRCD. KEY MESSAGES Cognitive dysfunction should be given much more attention in the clinical care of cancer patients. Diagnostic tools for this purpose and evidence-based therapeutic interventions are available. In the future, networks should be created that allow for better care of patients with CRCD.
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Affiliation(s)
- Oliver Rick
- Klinik Reinhardshöhe, Bad Wildungen, Germany
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15
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Liu C, Cao Y, Zuo Y, Zhang C, Ren S, Zhang X, Wang C, Zeng Y, Ling J, Liu Y, Chen Z, Cao X, Wu Z, Zhang C, Lu J. Hybridization-based discovery of novel quinazoline-2-indolinone derivatives as potent and selective PI3Kα inhibitors. J Adv Res 2024:S2090-1232(24)00089-4. [PMID: 38471647 DOI: 10.1016/j.jare.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION Phosphatidylinositol 3-kinases (PI3Ks) overexpression can elicit cellular homeostatic dysregulation, which further contributes to tumorigenesis, with PI3Kα emerging as the most prevalent mutant isoform kinase among PI3Ks. Therefore, selective inhibitors targeting PI3Kα have attracted considerable interest in recent years. Molecular hybridization, with the advantage of simplified pharmacokinetics and drug-drug interactions, emerged as one of the important avenues for discovering potential drugs. OBJECTIVES This study aimed to construct PI3Kα inhibitors by hybridization and investigate their antitumor activity and mechanism. METHODS 26 quinazoline-2-indolinone derivatives were obtained by molecular hybridization, and their structure-activity relationship was analyzed by MTT, in vitro kinase activity and molecular docking. The biological evaluation of compound 8 was performed by transwell, flow cytometry, laser scanning confocal microscopy, Western blot, CTESA and immunohistochemistry. RESULTS Here, we employed molecular hybridization methods to construct a series of quinazoline-2-indolinone derivatives as PI3Kα selective inhibitors. Encouragingly, representative compound 8 exhibited a PI3Kα enzymatic IC50 value of 9.11 nM and 10.41/16.99/37.53-fold relative to the biochemical selectivity for PI3Kβ/γ/δ, respectively. Moreover, compound 8 effectively suppressed the viability of B16, HCT116, MCF-7, H22, PC-3, and A549 cells (IC50 values: 0.2 μM ∼ 0.98 μM), and dramatically inhibited the proliferation and migration of NSCLC cells, as well as induced mitochondrial apoptosis through the PI3K/Akt/mTOR pathway. Importantly, compound 8 demonstrated potent in vivo anti-tumor activity in non-small cell lung cancer mouse models without visible toxicity. CONCLUSIONS This study presented a new avenue for the development of PI3Kα inhibitors and provided a solid foundation for novel QHIDs as potential future therapies for the treatment of NSCLC.
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Affiliation(s)
- Changqun Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yuening Cao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yi Zuo
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Chaozheng Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Senmiao Ren
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xin Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Chuanqi Wang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yingjie Zeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Jie Ling
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yilan Liu
- Hematology Department, The General Hospital of the Western Theater Command PLA, Chengdu 610081, China
| | - Zixian Chen
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xiujun Cao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Zhengzhi Wu
- The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China.
| | - Chuantao Zhang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Jun Lu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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16
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Falahatpishe Z, Moradi A, Parhoon H, Parhoon K, Jobson L. Investigating executive functioning and episodic future thinking in Iranian women with breast cancer. J Psychosoc Oncol 2024:1-17. [PMID: 38459900 DOI: 10.1080/07347332.2024.2312970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
BACKGROUND This study examined executive functioning and episodic future thinking among Iranian women with breast cancer. METHOD We recruited 40 healthy female community volunteers and 80 females with breast cancer (either currently undergoing chemotherapy n = 40 or not undergoing chemotherapy n = 40). Participants were assessed using cognitive tasks that assessed executive functioning and episodic future thinking and a measure of cancer-related fatigue. RESULTS Both cancer groups had poorer performance than controls on all measures of executive functioning and episodic future thinking. Those undergoing chemotherapy had poorer performance on all measures of executive functioning than those not undergoing chemotherapy. Cross-sectional mediation analyses revealed cancer-related fatigue had a significant mediator role between cancer group and executive functioning and episodic future thinking. CONCLUSION Those with breast cancer, particularly those undergoing chemotherapy, may be experiencing cognitive difficulties. These cognitive concerns should be considered by health teams as addressing these impairments may assist in improving quality of life and treatment adherence.
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Affiliation(s)
| | - Alireza Moradi
- Kharazmi University and Institute for Cognitive Science Studies, Tehran, Iran
| | - Hadi Parhoon
- Department of Psychology, Razi University, Kermanshah, Iran
| | - Kamal Parhoon
- Postdoc Researcher in Cognitive Psychology, Kharazmi University, Tehran, Iran
| | - Laura Jobson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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17
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Estelle MCP, Voelbel GT. The effect of processing speed on verbal and visual memory of adults with a chronic acquired brain injury. Brain Inj 2024; 38:170-176. [PMID: 38287215 DOI: 10.1080/02699052.2024.2309250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE Memory problems are among the most frequently reported cognitive complaints by individuals with an acquired brain injury (ABI). Processing speed and working memory deficits are often the result of ABI. These cognitive deficits significantly impact the acquisition and retention of information necessary for memory formation. This study investigated the influence of processing speed and working memory on immediate and delayed recall for verbal and visual memory, as well as overall memory recall in adults living with a chronic ABI. METHODS Sixty-three participants living with a chronic ABI, who were at least one-year post-injury, were cognitively assessed with the CNS-Vital Signs (CNS-VS) computerized cognitive battery and Wechsler Test of Adult Reading. RESULTS The CNS-VS Processing Speed significantly predicted delayed recall for verbal memory and overall memory performance. The CNS-VS Working Memory was not a significant predictor of memory recall. CONCLUSIONS Processing speed deficits negatively impact memory in individuals with a chronic ABI. These findings suggest the memory recall of adults with a chronic ABI is associated with poor processing speed and poor acquisition of information. Therefore, cognitive rehabilitation that improves processing speed should be the focus for individuals with ABI to improve memory performance as well as impaired processing speed.
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Affiliation(s)
| | - Gerald T Voelbel
- Department of Occupational Therapy, New York University, New York, New York, USA
- Center of Health and Rehabilitation Research, New York University, New York, New York, USA
- Department of Rehabilitation Medicine, New York University Langone Health, New York, New York, USA
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18
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Gong Z, Lu B, Wang H, Ren X, Liu X, Ma H, Wu D, Fan D, Wei Q. Double-Amplified Electrochemiluminescence Immunoassay Sensor for Highly Sensitive Detection of CA19-9 Using a Ternary Semiconductor CdSSe. Anal Chem 2024; 96:1678-1685. [PMID: 38215346 DOI: 10.1021/acs.analchem.3c04690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
In this paper, an electrochemiluminescence (ECL) immunosensor for ultrasensitive detection of CA19-9 was constructed using ternary compound CdSSe nanoparticles as ECL emitter. The immunosensor employs Cu2S and gold-doped diindium trioxide (Au-In2O3) nanocubes as coreaction accelerators to achieve a double-amplification strategy. In general, a hexagonal maple leaf-shaped Cu2S with a large surface area was selected as the template, and the in situ growth of CdSSe on its surface was achieved using a hydrothermal method. The presence of Cu2S not only inhibited the aggregation of CdSSe nanoparticles to reduce their surface energy but also acted as an ECL cathode coreaction promoter, facilitating the generation of SO4•-. Consequently, the ECL intensity of CdSSe was significantly enhanced, and the reduction potential was significantly lower. In addition, the template method was employed to synthesize Au-In2O3 nanocubes, which offers the advantage of directly connecting materials with antibodies, resulting in a more stable construction of the immunosensor. Furthermore, In2O3 serves as a coreaction promoter, enabling the amplification strategy for ECL intensity of CdSSe, thus contributing to the enhanced sensitivity and performance of the immunosensor. The constructed immunosensor exhibited a wide linear range (100 μU mL-1 to 100 U mL-1) and a low detection limit of 80 μU mL-1, demonstrating its high potential and practical value for sensitive detection of CA19-9.
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Affiliation(s)
- Zhengxing Gong
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Baoyu Lu
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Huan Wang
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Xiang Ren
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Xuejing Liu
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Hongmin Ma
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Dan Wu
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Dawei Fan
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
| | - Qin Wei
- Collaborative Innovation Center for Green Chemical Manufacturing and Accurate Detection, Key Laboratory of Interfacial Reaction & Sensing Analysis in Universities of Shandong, School of Chemistry and Chemical Engineering, University of Jinan, Jinan 250022, People's Republic of China
- Department of Chemistry, Sungkyunkwan University, Suwon 16419, Republic of Korea
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19
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Duranti E, Cordani N, Villa C. Edaravone: A Novel Possible Drug for Cancer Treatment? Int J Mol Sci 2024; 25:1633. [PMID: 38338912 PMCID: PMC10855093 DOI: 10.3390/ijms25031633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Despite significant advancements in understanding the causes and progression of tumors, cancer remains one of the leading causes of death worldwide. In light of advances in cancer therapy, there has been a growing interest in drug repurposing, which involves exploring new uses for medications that are already approved for clinical use. One such medication is edaravone, which is currently used to manage patients with cerebral infarction and amyotrophic lateral sclerosis. Due to its antioxidant and anti-inflammatory properties, edaravone has also been investigated for its potential activities in treating cancer, notably as an anti-proliferative and cytoprotective drug against side effects induced by traditional cancer therapies. This comprehensive review aims to provide updates on the various applications of edaravone in cancer therapy. It explores its potential as a standalone antitumor drug, either used alone or in combination with other medications, as well as its role as an adjuvant to mitigate the side effects of conventional anticancer treatments.
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Affiliation(s)
| | | | - Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (E.D.); (N.C.)
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20
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Klaver KM, Duijts SFA, Geusgens CAV, Kieffer JM, Agelink van Rentergem J, Hendriks MP, Nuver J, Marsman HA, Poppema BJ, Oostergo T, Doeksen A, Aarts MJB, Ponds RWHM, van der Beek AJ, Schagen SB. Internet-based cognitive rehabilitation for working cancer survivors: results of a multicenter randomized controlled trial. JNCI Cancer Spectr 2024; 8:pkad110. [PMID: 38273712 PMCID: PMC10868395 DOI: 10.1093/jncics/pkad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Cognitive problems contribute to decline in work performance. We evaluated (1) the effectiveness of basic self-management and extensive therapist-guided online cognitive rehabilitation on attainment of individually predetermined work-related goals among occupationally active cancer survivors, and (2) whether effectiveness of the programs differed for survivors with and without formal cognitive impairment. METHODS In a 3-arm randomized controlled trial (NCT03900806), 279 non-central nervous system cancer survivors with cognitive complaints were assigned to the basic program (n = 93), the extensive program (n = 93), or a waiting-list control group (n = 93). Participants completed measurements pre-randomization (T0), 12 weeks post-randomization upon program completion (T1), and 26 weeks post-randomization (T2). Mixed-effects modeling was used to compare intervention groups with the control group on goal attainment, and on self-perceived cognitive problems, work ability, and health-related quality of life. RESULTS Participants in the extensive program achieved their predetermined goals better than those in the control group, at short- and long-term follow-up (effect size [ES] = .49; P < .001; ES = .34; P = .014). They also had fewer recovery needs after work (ES = -.21; P = .011), more vitality (ES = .20; P = .018), and better physical role functioning (ES = .0.43 P = .015) than controls. At long-term follow-up, this finding persisted for physical role functioning (ES = .42; P = .034). The basic program elicited a small positive nonsignificant short-term (not long-term) effect on goal attainment for those with adequate adherence (ES = .28, P = .053). Effectiveness of the programs did not differ for patients with or without cognitive impairment. CONCLUSIONS Internet-based therapist-guided extensive cognitive rehabilitation improves work-related goal attainment. Considering the prevalence of cognitive problems in survivors, it is desirable to implement this program.
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Affiliation(s)
- Kete M Klaver
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, Amsterdam, the Netherlands
| | - Chantal A V Geusgens
- Department of Medical Psychology, Zuyderland Medical Center, Sittard, the Netherlands
| | - Jacobien M Kieffer
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Joost Agelink van Rentergem
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, the Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Boelo J Poppema
- Department of Medical Oncology, Ommelander Hospital Group, Groningen, the Netherlands
| | - Tanja Oostergo
- Department of Medical Oncology, Diakonessenhuis Utrecht, Utrecht, the Netherlands
| | - Annemiek Doeksen
- Department of Surgery, St Antonius Hospital, Utrecht, the Netherlands
| | - Maureen J B Aarts
- Department of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rudolf W H M Ponds
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, Amsterdam, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Sanne B Schagen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Zhao Y, Zheng Z, Yu CY, Wei H. Engineered cyclodextrin-based supramolecular hydrogels for biomedical applications. J Mater Chem B 2023; 12:39-63. [PMID: 38078497 DOI: 10.1039/d3tb02101g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Cyclodextrin (CD)-based supramolecular hydrogels are polymer network systems with the ability to rapidly form reversible three-dimensional porous structures through multiple cross-linking methods, offering potential applications in drug delivery. Although CD-based supramolecular hydrogels have been increasingly used in a wide range of applications in recent years, a comprehensive description of their structure, mechanical property modulation, drug loading, delivery, and applications in biomedical fields from a cross-linking perspective is lacking. To provide a comprehensive overview of CD-based supramolecular hydrogels, this review systematically describes their design, regulation of mechanical properties, modes of drug loading and release, and their roles in various biomedical fields, particularly oncology, wound dressing, bone repair, and myocardial tissue engineering. Additionally, this review provides a rational discussion on the current challenges and prospects of CD-based supramolecular hydrogels, which can provide ideas for the rapid development of CD-based hydrogels and foster their translation from the laboratory to clinical medicine.
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Affiliation(s)
- Yuqi Zhao
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study & School of Pharmaceutical Science, Hengyang Medical School, University of South China, 28 W Changsheng Road, Hengyang 421001, Hunan, China.
| | - Zhi Zheng
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study & School of Pharmaceutical Science, Hengyang Medical School, University of South China, 28 W Changsheng Road, Hengyang 421001, Hunan, China.
| | - Cui-Yun Yu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study & School of Pharmaceutical Science, Hengyang Medical School, University of South China, 28 W Changsheng Road, Hengyang 421001, Hunan, China.
| | - Hua Wei
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study & School of Pharmaceutical Science, Hengyang Medical School, University of South China, 28 W Changsheng Road, Hengyang 421001, Hunan, China.
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22
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Yang C, Wang K, Liang G, Tian S, Peng J, Mo L, Lin W. A versatile MOF-derived theranostic for dual-miRNA controlled accurate cancer cell recognition and photodynamic therapy. Talanta 2023; 265:124805. [PMID: 37331042 DOI: 10.1016/j.talanta.2023.124805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023]
Abstract
Precise detection and monitoring of microRNAs (miRNAs) in living tumor cells is significant for the prompt diagnosis of cancer and provides important information for treatment of cancer. A significant challenge is developing methods for imaging different miRNAs simultaneously to further enhance diagnostic and treatment accuracy. In this work, a versatile MOF-derived theranostic system (DAPM) was constructed using photosensitive metal-organic frameworks (PMOF, PM) and a DNA AND logic gate (DA). The DAPM exhibited excellent biostability and enabled sensitive detection of miR-21 and miR-155, achieving a low limit of detection (LOD) for miR-21 (89.10 pM) and miR-155 (54.02 pM). The DAPM probe generated a fluorescence signal in tumor cells where miR-21 and miR-155 co-existed, demonstrating the enhanced ability of tumor cell recognition. Additionally, the DAPM achieved efficient ROS generation and concentration-dependent cytotoxicity under light irradiation, providing effective photodynamic therapy for anti-tumors. The proposed DAPM theranostic system enables accurate cancer diagnosis, and provides spatial and temporal information for PDT.
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Affiliation(s)
- Chan Yang
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China
| | - Kun Wang
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China
| | - Guohan Liang
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China
| | - Shuo Tian
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China
| | - Juanjuan Peng
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China
| | - Liuting Mo
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China
| | - Weiying Lin
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, People's Republic of China.
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23
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Huang LW, Shi Y, Andreadis C, Logan AC, Mannis GN, Smith CC, Gaensler KML, Martin TG, Damon LE, Boscardin WJ, Steinman MA, Olin RL. Association of geriatric measures and global frailty with cognitive decline after allogeneic hematopoietic cell transplantation in older adults. J Geriatr Oncol 2023; 14:101623. [PMID: 37678052 PMCID: PMC11101048 DOI: 10.1016/j.jgo.2023.101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/18/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Allogeneic hematopoietic cell transplantation (alloHCT) is increasingly offered to older adults, and its potential impact on cognition in this population is understudied. This work aims to evaluate the ability of cancer-specific geriatric assessments (cGA) and a global frailty index based on accumulation of deficits identified in the cGA to predict the risk of cognitive decline after alloHCT in older adults. MATERIALS AND METHODS AlloHCT recipients aged 50 years or older completed a cGA, including a cognitive evaluation by the Blessed Orientation Memory Concentration (BOMC) test, at baseline prior to alloHCT and then at 3, 6, and 12 months after transplant. Baseline frailty was assessed using a deficit accumulation frailty index (DAFI) calculated from the cGA. A multinomial logit model was used to examine the association between predictors (individual cGA measures, DAFI) and the following three outcomes: alive with stable or improved cognition, alive with cognitive decline, and deceased. In post-hoc analyses, analysis of variance was used to compare BOMC scores at baseline, 3, 6, and 12 months across frailty categories. RESULTS In total, 148 participants were included, with a median age of 62 (range 50-76). At baseline, 12% had cognitive impairment; at one year, 29% of survivors had improved BOMC scores, 33% had stable BOMC, and 37% had worse BOMC. Prior to transplant, 25% were pre-frail and 11% were frail. Individual baseline cGA measures were not associated with cognitive change at one year as assessed by BOMC. Adjusting for age, sex, and education, those who were frail at baseline were 7.4 times as likely to develop cognitive decline at one year than those who were non-frail, although this finding did not reach statistical significance (95% confidence interval [CI] 0.74-73.8, p = 0.09). The probability of being alive with stable/improved cognition at 12 months for the non-frail, pre-frail, and frail groups was 43%, 34%, and 8%, respectively. DISCUSSION Baseline geriatric measures and frailty were not significantly associated with cognitive change as assessed by BOMC in adults aged 50 or older after alloHCT. However, the study was underpowered to detect clinically meaningful differences, and future work to elucidate potential associations between frailty and cognitive outcomes is warranted.
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Affiliation(s)
- Li-Wen Huang
- San Francisco VA Health Care System, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
| | - Ying Shi
- San Francisco VA Health Care System, San Francisco, CA, USA; Division of Geriatrics, University of California San Francisco, San Francisco, CA, USA
| | - Charalambos Andreadis
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Aaron C Logan
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Gabriel N Mannis
- Division of Hematology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Catherine C Smith
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Karin M L Gaensler
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Thomas G Martin
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Lloyd E Damon
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - W John Boscardin
- San Francisco VA Health Care System, San Francisco, CA, USA; Division of Geriatrics, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael A Steinman
- San Francisco VA Health Care System, San Francisco, CA, USA; Division of Geriatrics, University of California San Francisco, San Francisco, CA, USA
| | - Rebecca L Olin
- San Francisco VA Health Care System, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
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Schroyen G, Sleurs C, Ottenbourgs T, Leenaerts N, Nevelsteen I, Melis M, Smeets A, Deprez S, Sunaert S. Changes in leukoencephalopathy and serum neurofilament after (neo)adjuvant chemotherapy for breast cancer. Transl Oncol 2023; 37:101769. [PMID: 37651891 PMCID: PMC10480307 DOI: 10.1016/j.tranon.2023.101769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Previous case studies have provided evidence for chemotherapy-induced leukoencephalopathy in patients with breast cancer. However, prospective research is lacking. Hence, we investigated leukoencephalopathy before and after chemotherapy and its association with a serum neuroaxonal damage marker. METHODS This prospective cohort study included 40 patients receiving chemotherapy for breast cancer, and two age- and education-matched control groups, recruited between 2018 and 2021 (31-64 years of age). The latter control groups consisted of 39 chemotherapy-naïve patients and 40 healthy women. Fluid-attenuated inversion-recovery magnetic resonance imaging was used for lesion volumetry (total, juxtacortical, periventricular, infratentorial, and deep white matter) and blood serum to measure neurofilament light chain (NfL) levels. Acquisition took place pre-chemotherapy and three months and one-year post-chemotherapy, or at corresponding intervals. Within/between group differences were compared using robust mixed-effects modeling, and associations between total lesion volume and serum-NfL with linear regression. RESULTS Stronger increases in deep white matter lesion volumes were observed shortly post-chemotherapy, compared with healthy women (ßstandardized=0.09, pFDR<0.001). Increases in total lesion volume could mainly be attributed to enlargement of existing lesions (mean±SD, 0.12±0.16 mL), rather than development of new lesions (0.02±0.02 mL). A stronger increase in serum-NfL concentration was observed shortly post-chemotherapy compared with both control groups (ß>0.70, p<0.004), neither of which showed any changes over time, whereas a decrease was observed compared with healthy women one-year post-chemotherapy (ß=-0.54, p = 0.002). Serum-NfL concentrations were associated with lesion volume one-year post-chemotherapy (or at matched timepoint; ß=0.36, p = 0.010), whereas baseline or short-term post-therapy levels or changes were not. CONCLUSION These results underscore the possibility of chemotherapy-induced leukoencephalopathy months post-treatment, as well as the added value of serum-NfL as a prognostic marker for peripheral/central neurotoxicity. TRANSLATIONAL RELEVANCE Previous case studies have provided evidence of chemotherapy-induced leukoencephalopathy in patients with breast cancer. However, prospective studies to estimate longitudinal changes are currently missing. In this study, we used longitudinal fluid-attenuated inversion-recovery magnetic resonance imaging to assess white matter lesion volumes in patients treated for non-metastatic breast cancer and healthy women. Our findings demonstrate that chemotherapy-treated patients exhibit stronger increases in lesion volumes compared with healthy women, specifically in deep white matter, at three months post-chemotherapy. Increases could mainly be attributed to enlargement of existing lesions, rather than development of new lesions. Last, serum concentrations of neurofilament light chain, a neuroaxonal damage marker, increased shortly after chemotherapy and long-term post-chemotherapy levels were associated with lesion volumes. These findings highlight the potential of this non-invasive serum marker as a prognostic marker for peripheral and/or central neurotoxicity. Implementation in clinical practice could aid in therapeutic decisions, assessing disease activity, or monitoring treatment response.
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Affiliation(s)
- Gwen Schroyen
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Charlotte Sleurs
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; Tilburg University, Department of Cognitive Neuropsychology, Tilburg, the Netherlands; KU Leuven, Department of Oncology, Leuven, Belgium
| | - Tine Ottenbourgs
- KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Nicolas Leenaerts
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; KU Leuven, Department of Neurosciences, Mind-Body Research, Leuven, Belgium; KU Leuven, University Psychiatric Center, Leuven, Belgium; University Hospitals Leuven, Department of Psychiatry, Leuven, Belgium
| | - Ines Nevelsteen
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Oncology, Leuven, Belgium; University Hospitals Leuven, Department of Oncology, Surgical Oncology, Leuven, Belgium
| | - Michelle Melis
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium
| | - Ann Smeets
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Oncology, Leuven, Belgium; University Hospitals Leuven, Department of Oncology, Surgical Oncology, Leuven, Belgium
| | - Sabine Deprez
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium.
| | - Stefan Sunaert
- KU Leuven, Leuven Brain Institute, Leuven, Belgium; KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium; University Hospitals Leuven, Department of Radiology, Leuven, Belgium
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Trinh L, Tabaczynski A, Bastas D, Neville AR, Voss ML, Whitehorn A. Changes in physical activity, sedentary behavior, and self-reported cognitive function in cancer survivors before and during the COVID-19 pandemic: A cross-sectional study. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:653-663. [PMID: 37279854 PMCID: PMC10658308 DOI: 10.1016/j.jshs.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/23/2023] [Accepted: 04/10/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Physical activity (PA) and reductions in sedentary behavior (SED) may mitigate cancer-related cognitive impairment. The purpose of this study was to examine (a) the associations between changes in PA, SED, and cognitive function in cancer survivors before and during the coronavirus disease 2019 (COVID-19) pandemic; and (b) clinical subgroups that moderate this association. METHODS A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020. This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic. Self-reported Questionnaires assessed moderate-to-vigorous PA (MVPA) using the modified Godin Leisure Time Exercise Questionnaire, cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale, and SED using the Domain-specific Sitting Time questionnaire. Cancer survivors were classified into no change in behavior, desirable change (i.e., increase MVPA to meet PA guidelines or decrease SED by ≥60 min/day), and undesirable change (i.e., decrease MVPA to <150 min/week or increase SED by ≥60 min/day). Analysis of covariance examined differences in FACT-Cog scores across the activity change categories. Planned contrasts compared differences in FACT-Cog scores between cancer survivors with (a) no meaningful change vs. any change, and (b) a desirable change vs. an undesirable change. RESULTS There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors (n = 371; age = 48.6 ± 15.3 years (mean ± SD)). However, cancer survivors who were diagnosed ≥5 years ago (t(160) = -2.15, p = 0.03) or who received treatment ≥5 years ago (t(102) = -2.23, p = 0.03) and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change. CONCLUSION PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.
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Affiliation(s)
- Linda Trinh
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, OT M5S 2W6, Canada.
| | - Allyson Tabaczynski
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, OT M5S 2W6, Canada
| | - Denise Bastas
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, OT M5S 2W6, Canada
| | - Alyssa R Neville
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, OT M5S 2W6, Canada
| | - M Lauren Voss
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, OT M5S 2W6, Canada
| | - Alexis Whitehorn
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, OT M5S 2W6, Canada
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Utne I, Stokke K, Ritchie C, Løyland B, Grov EK, Rasmussen HL, Lindemann K, Paul SM, Torstveit AH, Miaskowski C. Changes in Subjective Measures of Cognitive Function in Older Adults From the Initiation Through 12 Months After the Receipt of Chemotherapy. Cancer Nurs 2023; 46:E365-E374. [PMID: 35781267 DOI: 10.1097/ncc.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment has a negative impact on older patients with cancer. OBJECTIVES The aim of this study was to evaluate for interindividual differences in 2 subjective measures of cognitive function in older patients (n = 112), as well as determine which demographic, clinical, and symptom characteristics, and levels of physical function, were associated with initial levels and with the trajectory of each of these 2 measures. METHODS Cognitive function was assessed using the cognitive function scale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Attentional Function Index at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess for interindividual differences in and characteristics associated with initial levels and changes in cognitive function. RESULTS Characteristics associated with decreases in Quality of Life Questionnaire Core 30 scores at the initiation of chemotherapy were longer time since the cancer diagnosis and higher depression scores. Characteristics associated with poorer Attentional Function Index scores at enrollment were lower levels of education and higher depression scores. No characteristics were associated with worse trajectories of either cognitive function measure. CONCLUSION Some older patients undergoing chemotherapy experience decrements in cognitive function. IMPLICATIONS FOR PRACTICE Our findings suggest that clinicians need to assess for depressive symptoms in older patients before the initiation of chemotherapy. Evidence-based interventions (eg, cognitive stimulation, increased physical activity) can be recommended to maintain and increase cognitive function in older oncology patients.
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Affiliation(s)
- Inger Utne
- Author Affiliations: Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University (Drs Utne, Løyland, and Grov, and Mss Rasmussen and Torstveit), Norway; Division of Cancer Medicine, Oslo University Hospital (Ms Stokke), Norway; Division of Palliative Care and Geriatric Medicine, Mongan Institute, Center for Aging and Serious Illness, Massachusetts General Hospital (Dr Ritchie), Boston; Department of Gynecological Oncology, Oslo University Hospital (Dr Lindemann), Norway; and School of Nursing, University of California, San Francisco (Drs Paul and Miaskowski)
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Pereira L, Bono MH, Braniecki S, Giblin T, Lawton B. Are Young Adult Survivors of Pediatric Cancer Being Overlooked? Cognitive Testing Results and Referrals in Child, Adolescent, and Young Adult Survivors. J Adolesc Young Adult Oncol 2023; 12:782-786. [PMID: 36856489 DOI: 10.1089/jayao.2022.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Treatment gaps in meeting the neuropsychological needs of young adult (YA) cancer survivors can be attributed to several clinical and systemic reasons. Access to neurocognitive care can be increased through the effective integration of neuropsychological monitoring and intervention in survivorship care. In this brief report, we aim to compare the efficacy of a brief neuropsychological screener (DIVERGT) in meeting the assessment and referral needs of pediatric and YA cancer survivors (n = 40) as part of a wellness and survivorship clinic. Participants (n = 40) were patients who presented to a pediatric oncology survivorship clinic over the span of 15 months.
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Affiliation(s)
- Lila Pereira
- Department of Pediatrics, New York Medical College, Valhalla, New York, USA
- The Pediatric Hematology, Oncology, and Stem Cell Transplantation, Maria Fareri Children's Hospital, Valhalla, New York, USA
- The Pediatric Hematology, Oncology, and Stem Cell Transplantation, Boston Children's Health Physicians, Hawthorne, New York, USA
| | - Madeline H Bono
- Department of Pediatrics, New York Medical College, Valhalla, New York, USA
- Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, New Jersey
| | - Suzanne Braniecki
- Department of Pediatrics, New York Medical College, Valhalla, New York, USA
- The Pediatric Hematology, Oncology, and Stem Cell Transplantation, Maria Fareri Children's Hospital, Valhalla, New York, USA
- The Pediatric Hematology, Oncology, and Stem Cell Transplantation, Boston Children's Health Physicians, Hawthorne, New York, USA
| | - Tara Giblin
- The Pediatric Hematology, Oncology, and Stem Cell Transplantation, Maria Fareri Children's Hospital, Valhalla, New York, USA
| | - Brittany Lawton
- Department of Pediatric Kidney Transplant, Lucille Packard Stanford Children's Hospital, Palo Alto, California, USA
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Westrick AC, Langa KM, Eastman M, Ospina-Romero M, Mullins MA, Kobayashi LC. Functional aging trajectories of older cancer survivors: a latent growth analysis of the US Health and Retirement Study. J Cancer Surviv 2023; 17:1499-1509. [PMID: 35218520 PMCID: PMC9411262 DOI: 10.1007/s11764-022-01185-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to identify prototypical functional aging trajectories of US cancer survivors aged 50 and older, overall and stratified by sociodemographic and health-related characteristics. METHODS Data were from 2986 survivors of a first incident cancer diagnosis (except non-melanoma skin cancer) after age 50 in the population representative U.S. Health and Retirement Study from 1998-2016. Cancer diagnoses, episodic memory function, and activity of daily living (ADL) limitations were assessed at biennial study interviews. Using time of cancer diagnosis as the baseline, we used group-based trajectory modeling to identify trajectories of memory function and ADL limitations following diagnosis. RESULTS We identified five memory loss trajectories (high: 8.4%; medium-high: 18.3%; medium-low: 21.5%; low: 25.5%; and, very low: 26.2%), and four ADL limitation trajectories (high/increasing limitations: 18.7%; medium limitations: 18.7%; low limitations: 8.14%; no limitations: 60.0). The high memory loss and high/increasing ADL limitation trajectories were both characterized by older age, being female (52% for memory, 58.9% for ADL), having lower pre-cancer memory scores, and a higher prevalence of pre-cancer comorbidities including stroke (30.9% for memory and 29.7% for ADL), hypertension (64.7% for memory and 69.8 for ADL), and depressive symptoms. In joint analyses, we found that generally those with higher memory were more likely to have fewer ADL limitations and vice versa. CONCLUSION Older cancer survivors experience heterogeneous trajectories of functional aging that are largely characterized by comorbidities prior to diagnosis. IMPLICATION FOR CANCER SURVIVORS Results can help identify older cancer survivors at increased risk for accelerated functional decline.
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Affiliation(s)
- Ashly C Westrick
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Kenneth M Langa
- Institute for Healthcare Policy and Innovations, University of Michigan, Ann Arbor, Michigan, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA
| | - Marisa Eastman
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Monica Ospina-Romero
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Ann Arbor, USA
| | - Megan A Mullins
- Center for Improving Patient and Population Health, University of Michigan, Ann Arbor, MI, USA
- Cancer Control and Population Sciences Program, Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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de Ruiter MB, Deardorff RL, Blommaert J, Chen BT, Dumas JA, Schagen SB, Sunaert S, Wang L, Cimprich B, Peltier S, Dittus K, Newhouse PA, Silverman DH, Schroyen G, Deprez S, Saykin AJ, McDonald BC. Brain gray matter reduction and premature brain aging after breast cancer chemotherapy: a longitudinal multicenter data pooling analysis. Brain Imaging Behav 2023; 17:507-518. [PMID: 37256494 PMCID: PMC10652222 DOI: 10.1007/s11682-023-00781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 06/01/2023]
Abstract
Brain gray matter (GM) reductions have been reported after breast cancer chemotherapy, typically in small and/or cross-sectional cohorts, most commonly using voxel-based morphometry (VBM). There has been little examination of approaches such as deformation-based morphometry (DBM), machine-learning-based brain aging metrics, or the relationship of clinical and demographic risk factors to GM reduction. This international data pooling study begins to address these questions. Participants included breast cancer patients treated with (CT+, n = 183) and without (CT-, n = 155) chemotherapy and noncancer controls (NC, n = 145), scanned pre- and post-chemotherapy or comparable intervals. VBM and DBM examined GM volume. Estimated brain aging was compared to chronological aging. Correlation analyses examined associations between VBM, DBM, and brain age, and between neuroimaging outcomes, baseline age, and time since chemotherapy completion. CT+ showed longitudinal GM volume reductions, primarily in frontal regions, with a broader spatial extent on DBM than VBM. CT- showed smaller clusters of GM reduction using both methods. Predicted brain aging was significantly greater in CT+ than NC, and older baseline age correlated with greater brain aging. Time since chemotherapy negatively correlated with brain aging and annual GM loss. This large-scale data pooling analysis confirmed findings of frontal lobe GM reduction after breast cancer chemotherapy. Milder changes were evident in patients not receiving chemotherapy. CT+ also demonstrated premature brain aging relative to NC, particularly at older age, but showed evidence for at least partial GM recovery over time. When validated in future studies, such knowledge could assist in weighing the risks and benefits of treatment strategies.
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Affiliation(s)
- Michiel B de Ruiter
- Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Rachael L Deardorff
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jeroen Blommaert
- Department of Oncology, KU Leuven, Leuven, Belgium and Research Foundation Flanders (FWO), Brussels, Belgium
| | - Bihong T Chen
- City of Hope National Medical Center, Duarte, CA, USA
| | | | - Sanne B Schagen
- Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Stefan Sunaert
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Lei Wang
- Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | | | | | - Kim Dittus
- University of Vermont Cancer Center, University of Vermont, Burlington, VT, USA
| | - Paul A Newhouse
- Center for Cognitive Medicine, Vanderbilt University Medical Center and Geriatric Research Educational and Clinical Center, Tennessee Valley VA Health System, Nashville, TN, USA
| | | | - Gwen Schroyen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brenna C McDonald
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA.
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Kesler SR, Henneghan AM, Prinsloo S, Palesh O, Wintermark M. Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment. Front Med (Lausanne) 2023; 10:1199605. [PMID: 37720513 PMCID: PMC10499624 DOI: 10.3389/fmed.2023.1199605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Cancer related cognitive impairment (CRCI) is commonly associated with cancer and its treatments, yet the present binary diagnostic approach fails to capture the full spectrum of this syndrome. Cognitive function is highly complex and exists on a continuum that is poorly characterized by dichotomous categories. Advanced statistical methodologies applied to symptom assessments have demonstrated that there are multiple subclasses of CRCI. However, studies suggest that relying on symptom assessments alone may fail to account for significant differences in the neural mechanisms that underlie a specific cognitive phenotype. Treatment plans that address the specific physiologic mechanisms involved in an individual patient's condition is the heart of precision medicine. In this narrative review, we discuss how biotyping, a precision medicine framework being utilized in other mental disorders, could be applied to CRCI. Specifically, we discuss how neuroimaging can be used to determine biotypes of CRCI, which allow for increased precision in prediction and diagnosis of CRCI via biologic mechanistic data. Biotypes may also provide more precise clinical endpoints for intervention trials. Biotyping could be made more feasible with proxy imaging technologies or liquid biomarkers. Large cross-sectional phenotyping studies are needed in addition to evaluation of longitudinal trajectories, and data sharing/pooling is highly feasible with currently available digital infrastructures.
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Affiliation(s)
- Shelli R. Kesler
- Division of Adult Health, School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Diagnostic Medicine, Dell School of Medicine, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell School of Medicine, The University of Texas at Austin, Austin, TX, United States
| | - Ashley M. Henneghan
- Division of Adult Health, School of Nursing, The University of Texas at Austin, Austin, TX, United States
- Department of Oncology, Dell School of Medicine, The University of Texas at Austin, Austin, TX, United States
| | - Sarah Prinsloo
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Oxana Palesh
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Max Wintermark
- Department of Neuroradiology, The University of Texas MD Anderson Cancer, Houston, TX, United States
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Ye M, Li B, Shi W, Liu H, Wang Y, Chen W, Wang J, Wang G. Preparation and tumor-targeting evaluation of BS-CyP albumin nanoparticles modified with hyaluronic acid based on boron neutron capture therapy. J Biomed Mater Res A 2023; 111:1176-1184. [PMID: 36740897 DOI: 10.1002/jbm.a.37506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/03/2023] [Accepted: 01/13/2023] [Indexed: 02/07/2023]
Abstract
Radiation therapy has been widely used in the clinical treatment of tumors. Due to the low radiation absorption of tumors, a high dose of ionizing radiation is often required during radiotherapy, which causes serious damage to normal tissues near tumors. Boron neutron capture therapy (BNCT) is more targeted than conventional radiotherapy. To improve the therapeutic effect of cancer, albumin was selected as the drug carrier to wrap the fluorescent tracer boron drug BS-CyP and prepare the nanoparticles. Then, we developed a novel tumor-targeting nano-boron drug by using hyaluronic acid to modify the nanoparticles. We found that BS-CyP albumin nanoparticles modified with hyaluronic acid effectively delayed drug release and enhanced the aggregation, in tumors, showing good safety with no obvious toxicity to cells and mice. This study confirmed the advantages of boron drugs modified with hyaluronic acid targeting tumors and may provide a reference for BNCT.
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Affiliation(s)
- Minjun Ye
- Key Laboratory of Biorheological and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Modern Life Science Experiment Teaching Center at Bioengineering College of Chongqing University, Chongqing, China
| | - Bingyi Li
- Key Laboratory of Biorheological and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Modern Life Science Experiment Teaching Center at Bioengineering College of Chongqing University, Chongqing, China
| | - Wanyu Shi
- International Department, Nankai Middle School, Chongqing, China
| | - Huaize Liu
- International Department, Nankai Middle School, Chongqing, China
| | - Yi Wang
- Key Laboratory of Biorheological and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Modern Life Science Experiment Teaching Center at Bioengineering College of Chongqing University, Chongqing, China
| | - Weiqing Chen
- Gastroenterology Oncology Department, Affiliated Cancer Hospital of Chongqing University, Chongqing, China
| | - Jian Wang
- Executive Management, Chongqing Gaojin Biological Company, Chongqing, China
| | - Guixue Wang
- Key Laboratory of Biorheological and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Modern Life Science Experiment Teaching Center at Bioengineering College of Chongqing University, Chongqing, China
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Melis M, Schroyen G, Blommaert J, Leenaerts N, Smeets A, Van Der Gucht K, Sunaert S, Deprez S. The Impact of Mindfulness on Functional Brain Connectivity and Peripheral Inflammation in Breast Cancer Survivors with Cognitive Complaints. Cancers (Basel) 2023; 15:3632. [PMID: 37509292 PMCID: PMC10377401 DOI: 10.3390/cancers15143632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) has been linked to functional brain changes and inflammatory processes. Hence, interventions targeting these underlying mechanisms are needed. In this study, we investigated the effects of a mindfulness-based intervention on brain function and inflammatory profiles in breast cancer survivors with CRCI. METHODS Female breast cancer survivors reporting cognitive complaints (n = 117) were randomly assigned to a mindfulness-based intervention (n = 43), physical training (n = 36), or waitlist control condition (n = 38). Region-of-interest (ROI) and graph theory analyses of resting state functional MRI data were performed to study longitudinal group differences in functional connectivity and organization in the default mode, dorsal attention, salience, and frontoparietal network. Additionally, bead-based immunoassays were used to investigate the differences in inflammatory profiles on serum samples. Measures were collected before, immediately after and three months post-intervention. RESULTS No ROI-to-ROI functional connectivity changes were identified. Compared to no intervention, graph analysis showed a larger decrease in clustering coefficient after mindfulness and physical training. Additionally, a larger increase in global efficiency after physical training was identified. Furthermore, the physical training group showed a larger decrease in an inflammatory profile compared to no intervention (IL-12p70, IFN-γ, IL-1β, and IL-8). CONCLUSION Both mindfulness and physical training induced changes in the functional organization of networks related to attention, emotion processing, and executive functioning. While both interventions reduced functional segregation, only physical training increased functional integration of the neural network. In conclusion, physical training had the most pronounced effects on functional network organization and biomarkers of inflammation, two mechanisms that might be involved in CRCI.
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Affiliation(s)
- Michelle Melis
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
| | - Gwen Schroyen
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
| | - Jeroen Blommaert
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Oncology, Gynecological Oncology, Catholic University Leuven, 3000 Leuven, Belgium
| | - Nicolas Leenaerts
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Neurosciences, Mind-Body Research, Catholic University Leuven, 3000 Leuven, Belgium
| | - Ann Smeets
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Oncology, Surgical Oncology, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Surgical Oncology, Multidisciplinary Breast Center, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Katleen Van Der Gucht
- Tilburg School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, Catholic University Leuven, 3000 Leuven, Belgium
- Neuromodulation Laboratory, Biomedical Sciences Group, Department of Rehabilitation Sciences, Catholic University Leuven, 3000 Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, Translational MRI, Catholic University Leuven, 1000 Brussels, Belgium
- Leuven Brain Institute, Catholic University Leuven, 3000 Leuven, Belgium
- Leuven Cancer Institute, Catholic University Leuven, 3000 Leuven, Belgium
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Ospina-Romero M, Brenowitz WD, Glymour MM, Westrick A, Graff RE, Hayes-Larson E, Mayeda ER, Ackley SF, Kobayashi LC. Education, incident cancer, and rate of memory decline in a national sample of US adults in mid-to-later-life. J Geriatr Oncol 2023; 14:101530. [PMID: 37210786 PMCID: PMC10332197 DOI: 10.1016/j.jgo.2023.101530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/30/2023] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Middle-aged and older adults who develop cancer experience memory loss following diagnosis, but memory decline in the years before and after cancer diagnosis is slower compared to their cancer-free counterparts. Educational attainment strongly predicts memory function during aging, but it is unclear whether education protects against memory loss related to cancer incidence or modifies long-term memory trajectories in middle-aged and older cancer survivors. MATERIALS AND METHODS Data were from 14,449 adults (3,248 with incident cancer, excluding non-melanoma skin cancer) aged 50+ in the population-based US Health and Retirement Study from 1998 to 2016. Memory was assessed every two years as a composite of immediate and delayed word recall tests and proxy assessments for impaired individuals. Memory scores all time points were standardized at to the baseline distribution. Using multivariate-adjusted linear mixed-effects models, we estimated rates of memory decline in the years before cancer diagnosis, shortly after diagnosis, and in the years after diagnosis. We compared rates of memory decline between incident cancer cases and age-matched cancer-free adults, overall and according to level of education (<12 years, "low"; 12 to <16 years, "intermediate"; ≥16 years, "high"). RESULTS Incident cancer diagnoses were followed by short-term declines in memory averaging 0.06 standard deviation (SD) units (95% confidence interval [CI]: -0.084, -0.036). Those with low education experienced the strongest magnitude of short-term decline in memory after diagnosis (-0.10 SD units, 95% CI: -0.15, -0.05), but this estimate was not statistically significantly different from the short-term decline in memory experienced by those with high education (-0.04 SD units, 95% CI: -0.08, 0.01; p-value for education as an effect modifier = 0.15). In the years prior to and following an incident cancer diagnosis, higher educational attainment was associated with better memory, but it did not modify the difference in rate of long-term memory decline between cancer survivors and those who remained cancer-free. DISCUSSION Education was associated with better memory function over time among both cancer survivors and cancer-free adults aged 50 and over. Low education may be associated with a stronger short-term decline in memory after a cancer diagnosis.
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Affiliation(s)
- Monica Ospina-Romero
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America; Department of Pathology and Laboratory Medicine, University of Wisconsin, United States of America.
| | - Willa D Brenowitz
- Department of Psychiatry, University of California San Francisco, United States of America; Kaiser Permanente Center for Health Research, Portland, United States of America
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Ashly Westrick
- Department of Epidemiology, School of Public Health, University of Michigan, United States of America
| | - Rebecca E Graff
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, United States of America
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, United States of America
| | - Sarah F Ackley
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Lindsay C Kobayashi
- Department of Epidemiology, School of Public Health, University of Michigan, United States of America
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Nordhjem BJT, Tjørnlund M, Thomsen BL, Hjerming M, Kjær TW, Pappot H, Hjalgrim LL. Protocol for a prospective, longitudinal study of cognitive impairment in young patients with cancer: a multidisciplinary neuroscience approach (MyBrain). BMJ Open 2023; 13:e070534. [PMID: 37202143 DOI: 10.1136/bmjopen-2022-070534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION The aim of this research is to investigate young cancer patients' cognitive functioning and the underlying neurobiological mechanisms when cognitive functions are impaired. The MyBrain protocol is a multidisciplinary study that investigates cancer-related cognitive impairment in children, adolescents and young adults, combining neuropsychology, cognitive neuroscience and cellular neuroscience. The study is exploratory with a wide focus on trajectories of cognitive functions from diagnosis to the end of treatment and into survivorship. METHODS AND ANALYSIS Prospective longitudinal study including patients diagnosed with non-brain cancers at age 7-29 years. Each patient is paired with a control matched on age and social circle. PRIMARY OBJECTIVE Evaluation of neurocognitive function over time. SECONDARY OBJECTIVES Evaluation of self-perceived quality of life and fatigue, P300 in an electroencephalography (EEG) oddball paradigm, power spectrum in resting state EEG, serum and cerebrospinal fluid levels of biomarkers of neuronal damage, neuroplasticity, proinflammatory and anti-inflammatory markers and their association with cognitive function. ETHICS AND DISSEMINATION The study is approved by the Regional Ethics Committee for the Capital Region of Denmark (no. H-21028495), and the Danish Data Protection Agency (no. P-2021-473). Results are expected to guide future interventions to prevent brain damage and support patients with cognitive difficulties. TRIAL REGISTRATION NUMBER The article is registered at clinicaltrials.gov NCT05840575 (https://clinicaltrials.gov/ct2/show/NCT05840575).
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Affiliation(s)
| | - Morten Tjørnlund
- Center for Rehabilitation of Brain Injury, University of Copenhagen, Copenhagen, Denmark
| | - Birthe Lykke Thomsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Haematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Helle Pappot
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Hiensch AE, Beckhaus J, Witlox L, Monninkhof EM, Schagen SB, van Vulpen JK, Sweegers MG, Newton RU, Aaronson NK, Galvão DA, Steindorf K, Stuiver MM, Mesters I, Knoop H, Goedendorp MM, Bohus M, Thorsen L, Schulz KH, Schmidt ME, Ulrich CM, Sonke GS, van Harten WH, Winters-Stone KM, Velthuis MJ, Taaffe DR, van Mechelen W, Kersten MJ, Nollet F, Wiskemann J, Buffart LM, May AM. Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis. J Cancer Surviv 2023:10.1007/s11764-023-01392-3. [PMID: 37160571 DOI: 10.1007/s11764-023-01392-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This individual participant data meta-analysis (IPD-MA) assesses exercise effects on self-reported cognitive functioning (CF) and investigates whether effects differ by patient-, intervention-, and exercise-related characteristics. METHODS IPD from 16 exercise RCTs, including 1987 patients across multiple types of non-metastatic cancer, was pooled. A one-stage IPD-MA using linear mixed-effect models was performed to assess exercise effects on self-reported CF (z-score) and to identify whether the effect was moderated by sociodemographic, clinical, intervention- and exercise-related characteristics, or fatigue, depression, anxiety, and self-reported CF levels at start of the intervention (i.e., baseline). Models were adjusted for baseline CF and included a random intercept at study level to account for clustering of patients within studies. A sensitivity analysis was performed in patients who reported cognitive problems at baseline. RESULTS Minimal significant beneficial exercise effects on self-reported CF (β=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, β=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, β=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (β=-0.14 [-0.25; -0.04]) or 24 weeks or longer (β=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (β=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (β=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (β=-0.19 [-0.31; -0.06]). No other significant moderators were identified. CONCLUSIONS This cross-cancer IPD meta-analysis observed small beneficial exercise effects on self-reported CF when the intervention was delivered post-treatment, especially in patients who reported cognitive problems at baseline. IMPLICATIONS FOR CANCER SURVIVORS This study provides some evidence to support the prescription of exercise to improve cognitive functioning. Sufficiently powered trials are warranted to make more definitive recommendations and include these in the exercise guidelines for cancer survivors.
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Affiliation(s)
- Anouk E Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Julia Beckhaus
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lenja Witlox
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jonna K van Vulpen
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Maike G Sweegers
- Division of Psychosocial Research and Epidemiology & Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology & Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Martine M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany
- Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer, Department of Oncology, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Karl-Heinz Schulz
- Athleticum - Competence Center for Sports- and Exercise Medicine and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - Gabe S Sonke
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Kerri M Winters-Stone
- Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Miranda J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, location: Vrije Universiteit, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
- Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Marie José Kersten
- Department of Hematology, Amsterdam University Medical Centers, Location University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Division of Medical Oncology, University Clinic Heidelberg and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Laurien M Buffart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.
- Department of Physiology, Radboudumc, Nijmegen, The Netherlands.
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Li JJ, Rong RX, Yang Y, Hu ZY, Hu B, Zhao YY, Li HB, Hu XY, Wang KR, Guo DS. Triple targeting host-guest drug delivery system based on lactose-modified azocalix[4]arene for tumor ablation. MATERIALS HORIZONS 2023; 10:1689-1696. [PMID: 36825769 DOI: 10.1039/d3mh00018d] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Host-guest drug delivery systems (HGDDSs) have been studied in an effort to modify the characteristics of therapeutic agents through noncovalent interactions, reduce toxic side effects and improve therapeutic effects. However, it is still an important task to continuously improve the targeting ability of HGDDSs, which is conducive to the development of precision medicine. Herein, we utilize the lactose-modified azocalix[4]arene (LacAC4A) as a triple targeting drug carrier customized for antitumor purposes. LacAC4A integrates three targeting features, passive targeting through the enhancing permeability and retention effect, active targeting by the interactions of lactose and the asialoglycoprotein receptors on the surface of tumor cells, and stimuli-responsive targeting via the reduction of the azo group under a hypoxia microenvironment. After loading doxorubicin (DOX) in LacAC4A, the supramolecular nanoformulation DOX@LacAC4A clearly showed the effective suppression of tumor growth through in vivo experiments. LacAC4A can achieve effective targeting, rapid release, and improve drug bioavailability. This design principle will provide a new material for drug delivery systems.
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Affiliation(s)
- Juan-Juan Li
- College of Chemistry, Key Laboratory of Functional Polymer Materials (Ministry of Education), State Key Laboratory of Elemento-Organic Chemistry, Collaborative Innovation Center of Chemical Science and Engineering, Nankai University, Tianjin 300071, China.
| | - Rui-Xue Rong
- Department of Medical Microbiology and Immunology, School of Basic Medical Science, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis (Ministry of Education), Key Laboratory of Chemical Biology of Hebei Province, Medical Comprehensive Experimental Center, Hebei University, Baoding 071002, China
| | - Yan Yang
- Department of Medical Microbiology and Immunology, School of Basic Medical Science, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis (Ministry of Education), Key Laboratory of Chemical Biology of Hebei Province, Medical Comprehensive Experimental Center, Hebei University, Baoding 071002, China
| | - Zong-Ying Hu
- College of Chemistry, Key Laboratory of Functional Polymer Materials (Ministry of Education), State Key Laboratory of Elemento-Organic Chemistry, Collaborative Innovation Center of Chemical Science and Engineering, Nankai University, Tianjin 300071, China.
| | - Bing Hu
- College of Chemistry and Environmental Science, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis (Ministry of Education), Key Laboratory of Chemical Biology of Hebei Province, Hebei University, Baoding 071002, China.
| | - Ying-Ying Zhao
- College of Chemistry and Environmental Science, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis (Ministry of Education), Key Laboratory of Chemical Biology of Hebei Province, Hebei University, Baoding 071002, China.
| | - Hua-Bin Li
- College of Chemistry, Key Laboratory of Functional Polymer Materials (Ministry of Education), State Key Laboratory of Elemento-Organic Chemistry, Collaborative Innovation Center of Chemical Science and Engineering, Nankai University, Tianjin 300071, China.
| | - Xin-Yue Hu
- College of Chemistry, Key Laboratory of Functional Polymer Materials (Ministry of Education), State Key Laboratory of Elemento-Organic Chemistry, Collaborative Innovation Center of Chemical Science and Engineering, Nankai University, Tianjin 300071, China.
| | - Ke-Rang Wang
- College of Chemistry and Environmental Science, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis (Ministry of Education), Key Laboratory of Chemical Biology of Hebei Province, Hebei University, Baoding 071002, China.
| | - Dong-Sheng Guo
- College of Chemistry, Key Laboratory of Functional Polymer Materials (Ministry of Education), State Key Laboratory of Elemento-Organic Chemistry, Collaborative Innovation Center of Chemical Science and Engineering, Nankai University, Tianjin 300071, China.
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Hu M, Wen C, Liu J, Cai P, Meng N, Qin X, Xu P, Li Z, Lin XC. Mechanism of Cytotoxic Action of Gold Nanorods Photothermal Therapy for A549 Cell. ACS APPLIED BIO MATERIALS 2023; 6:1886-1895. [PMID: 37079717 DOI: 10.1021/acsabm.3c00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Photothermal therapy has developed into an important field of tumor treatment research, and numerous studies have focused on the preparation of photothermal therapeutic agents, tumor targeting, diagnosis, and treatment integration. However, there are few studies on the mechanism of photothermal therapy acting on cancer cells. Here we investigated the metabolomics of lung cancer cell A549 during gold nanorod (GNR) photothermal treatment by high-resolution LC/MS, and several differential metabolites and corresponding metabolic pathways during photothermal therapy were found. The main differential metabolites contained 18-hydroxyoleate, beta-alanopine and cis-9,10-epoxystearic acid, and phosphorylcholine. Pathway analysis also showed metabolic changes involving cutin, suberine, and wax biosynthesis, pyruvate and glutamic acid synthesis, and choline metabolism. Analysis also showed that the photothermal process of GNRs may induce cytotoxicity by affecting pyruvate and glutamate synthesis, normal choline metabolism, and ultimately apoptosis.
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Affiliation(s)
- Miaomiao Hu
- Guangxi Key Laboratory of Information Materials, School of Materials Science and Engineering, Guilin University of Electronic Technology, Guilin 541004, China
| | - Changchun Wen
- State Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources, School of Chemistry and Pharmacy Sciences, Guangxi Normal University, Guilin 541004, China
| | - Jian Liu
- Guangxi Key Laboratory of Information Materials, School of Materials Science and Engineering, Guilin University of Electronic Technology, Guilin 541004, China
| | - Ping Cai
- Guangxi Key Laboratory of Information Materials, School of Materials Science and Engineering, Guilin University of Electronic Technology, Guilin 541004, China
| | - Nianqi Meng
- State Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources, School of Chemistry and Pharmacy Sciences, Guangxi Normal University, Guilin 541004, China
| | - Xue Qin
- State Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources, School of Chemistry and Pharmacy Sciences, Guangxi Normal University, Guilin 541004, China
| | - Peijing Xu
- State Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources, School of Chemistry and Pharmacy Sciences, Guangxi Normal University, Guilin 541004, China
| | - Zhilang Li
- State Key Laboratory for the Chemistry and Molecular Engineering of Medicinal Resources, School of Chemistry and Pharmacy Sciences, Guangxi Normal University, Guilin 541004, China
| | - Xiang-Cheng Lin
- Guangxi Key Laboratory of Information Materials, School of Materials Science and Engineering, Guilin University of Electronic Technology, Guilin 541004, China
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Abstract
The recently uncovered key role of the peripheral and central nervous systems in controlling tumorigenesis and metastasis has opened a new area of research to identify innovative approaches against cancer. Although the 'neural addiction' of cancer is only partially understood, in this Perspective we discuss the current knowledge and perspectives on peripheral and central nerve circuitries and brain areas that can support tumorigenesis and metastasis and the possible reciprocal influence that the brain and peripheral tumours exert on one another. Tumours can build up local autonomic and sensory nerve networks and are able to develop a long-distance relationship with the brain through circulating adipokines, inflammatory cytokines, neurotrophic factors or afferent nerve inputs, to promote cancer initiation, growth and dissemination. In turn, the central nervous system can affect tumour development and metastasis through the activation or dysregulation of specific central neural areas or circuits, as well as neuroendocrine, neuroimmune or neurovascular systems. Studying neural circuitries in the brain and tumours, as well as understanding how the brain communicates with the tumour or how intratumour nerves interplay with the tumour microenvironment, can reveal unrecognized mechanisms that promote cancer development and progression and open up opportunities for the development of novel therapeutic strategies. Targeting the dysregulated peripheral and central nervous systems might represent a novel strategy for next-generation cancer treatment that could, in part, be achieved through the repurposing of neuropsychiatric drugs in oncology.
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Affiliation(s)
- Claire Magnon
- Laboratory of Cancer and Microenvironment-National Institute of Health and Medical Research (INSERM), Institute of Biology François Jacob-Atomic Energy Commission (CEA), University of Paris Cité, University of Paris-Saclay, Paris, France.
| | - Hubert Hondermarck
- School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
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Parada H, Pichardo MS, Gallo LC, Talavera GA, McDaniels-Davidson C, Penedo FJ, Lee DJ, Tarraf W, Garcia TP, Daviglus ML, González HM. Neurocognitive test performance following cancer among middle-aged and older adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the SOL-Investigation of Neurocognitive Aging Ancillary Study. Cancer Med 2023. [PMID: 36999972 DOI: 10.1002/cam4.5863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/20/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Cancer patients and survivors often experience acute cognitive impairments; however, the long-term cognitive impact remains unclear particularly among Hispanics/Latinos. We examined the association between cancer history and neurocognitive test performance among middle-aged and older Hispanic/Latinos. METHODS Participants included 9639 Hispanic/Latino adults from the community-based and prospective Hispanic Community Health Study/Study of Latinos. At baseline (2008-2011; V1), participants self-reported their cancer history. At V1 and again at a 7-year follow-up (2015-2018; V2), trained technicians administered neurocognitive tests including the Brief-Spanish English Verbal Learning Test (B-SEVLT), Word Fluency Test (WF), and Digit Symbol Substitution Test (DSS). We used survey linear regression to estimate the overall, sex-specific, and cancer site-specific [i.e., cervix, breast, uterus, and prostate] adjusted associations between cancer history and neurocognitive test performance at V1 and changes from V1 to V2. RESULTS At V1, a history of cancer (6.4%) versus no history of cancer (93.6%) was associated with higher WF scores (β = 0.14, SE = 0.06; p = 0.03) and global cognition (β = 0.09, SE = 0.04; p = 0.04). Among women, a history of cervical cancer predicted decreases in SEVLT-Recall scores (β = -0.31, SE = 0.13; p = 0.02) from V1 to V2, and among men, a history of prostate cancer was associated with higher V1 WF scores (β = 0.29, SE = 0.12; p = 0.02) and predicted increases in SEVLT-Sum (β = 0.46, SE = 0.22; p = 0.04) from V1 to V2. CONCLUSION Among women, a history of cervical cancer was associated with 7-year memory decline, which may reflect the impacts of systemic cancer therapies. Among men, however, a history of prostate cancer was associated with improvements in cognitive performance, perhaps due in part to engaging in health promoting behaviors following cancer.
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Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
- UC San Diego Health Moores Cancer Center, La Jolla, California, USA
| | - Margaret S Pichardo
- Department of Surgery, Hospitals of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Corinne McDaniels-Davidson
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California, USA
| | - Frank J Penedo
- Departments of Psychology and Medicine, University of Miami College of Arts and Sciences and Miller School of Medicine, Miami, Florida, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, Michigan, USA
| | - Tayna P Garcia
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Hector M González
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
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Ahles TA, Schofield E, Li Y, Ryan E, Orlow I, Patel SK, Traina T, Root JC. Cognitive function is mediated by deficit accumulation in older, long-term breast cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01365-6. [PMID: 36964293 DOI: 10.1007/s11764-023-01365-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE This study aims to examine whether cognitive function in older, long-term breast cancer survivors is both a direct effect of cancer and cancer treatments and an indirect effect mediated by deficit accumulation. PATIENTS AND METHODS Female breast cancer survivors who had been diagnosed and treated at age 60 or older and were 5-15-year survivors (N = 220) and age- and education-matched non-cancer controls (N = 123) were assessed at enrollment and at 8-, 16-, and 24-month follow-ups with standard neuropsychological tests and the comprehensive geriatric assessment which was used to calculate the deficit accumulation frailty index (DAFI). Blood or saliva samples for APOE genotyping were collected at enrollment. Participants were purposely recruited so that approximately 50% had a history of treatment with chemotherapy or and 50% were not exposed to chemotherapy. RESULTS Latent variable mediation analysis revealed that cognitive performance was mediated by deficit accumulation for all three domains. The direct effect of cancer diagnosis and treatment history was significant for the Language domain (p = 0.04), a trend for the learning and memory domain (p = 0.054), and non-significant for the attention, processing speed, executive function (APE) domain. Carrying the APOE ε4 allele had a significant negative direct effect on the APE domain (p = 0.05) but no indirect effect through deficit accumulation. CONCLUSION Cognitive function in older, long-term breast cancer survivors appears to be primarily mediated through deficit accumulation. IMPLICATIONS FOR CANCER SURVIVORS These findings have important clinical implications suggesting that the most effective intervention to prevent or slow cognitive aging in older cancer survivors may be through prevention or management of comorbidities and interventions that maintain functional capacity (exercise, physical therapy) and social and mental health.
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Affiliation(s)
- Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Molecular Epidemiology Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sunita K Patel
- Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Tiffany Traina
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Franco-Rocha OY, Mahaffey ML, Matsui W, Kesler SR. Remote assessment of cognitive dysfunction in hematologic malignancies using web-based neuropsychological testing. Cancer Med 2023; 12:6068-6076. [PMID: 36221244 PMCID: PMC10028155 DOI: 10.1002/cam4.5331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Cognitive impairment is a frequent adverse effect of cancer and its therapies. As neuropsychological assessment is not often standard of care for patients with non-CNS disease, efficient, practical assessment tools are required to track cognition across the disease course. We examined cognitive functioning using a web-based cognitive testing battery to determine if it could detect differences between patients with cancer and controls. METHODS We enrolled 22 patients with multiple myeloma (MM) or non-Hodgkin lymphoma (NHL) and 40 healthy controls (mean age = 56 ± 11 years, 52% male). Participants completed the BrainCheck cognitive testing battery and online versions of select measures from the Patient Reported Outcome Measures Information System (PROMIS) during a video conference. MANOVA was used to compare BrainCheck and PROMIS scores between groups controlling for age and sex. An exploratory linear regression analysis was conducted within the cancer group to determine potential contributors to cognitive functioning. RESULTS All participants except for one control completed the online assessment measures without difficulty. Compared to controls, the cancer group demonstrated significantly lower scores in objective and subjective cognitive function, physical functioning, and social role performance and elevated fatigue scores. Corticosteroid treatment, immunotherapy, lower physical functioning, lower income, and older age significantly contributed to lower cognitive function (adjusted R2 = 0.925, F = 19.63, p = 0.002). CONCLUSION Remote assessment of cognitive and psychosocial functioning is feasible with patients with cancer following treatments. The BrainCheck cognitive testing battery has the potential to detect differences in cognition between patients with cancer and controls.
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Affiliation(s)
- Oscar Y Franco-Rocha
- Brain Health Neuroscience Lab, School of Nursing, University of Texas at Austin, Austin, Texas, USA
| | - Misty L Mahaffey
- Department of Hematology/Oncology, Stanford Cancer Institute, Stanford Health Care, Palo Alto, California, USA
| | - William Matsui
- Department of Oncology, Dell School of Medicine, University of Texas at Austin, Austin, Texas, USA
| | - Shelli R Kesler
- Brain Health Neuroscience Lab, School of Nursing, University of Texas at Austin, Austin, Texas, USA
- Department of Oncology, Dell School of Medicine, University of Texas at Austin, Austin, Texas, USA
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Prashad N, Melara RD, Root JC, Ahles TA. Pre-Treatment Breast Cancer Patients Show Neural Differences in Frontal Alpha Asymmetry. Clin EEG Neurosci 2023; 54:189-197. [PMID: 35118900 PMCID: PMC9741869 DOI: 10.1177/15500594221074860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Cognitive impairment has been observed consistently in a subset of breast cancer survivors. Yet, still unknown is whether neural and behavioral effects of cancer exist prior to treatment, which may contribute to later cognitive decline. The current study investigated pre-treatment differences in attention performance and frontal alpha asymmetry (FAA), an established neural index of inhibitory control, in non-metastatic breast cancer patients (n = 42) compared with healthy controls (n = 28). We additionally investigated whether differences between groups appear in specific cuing conditions and across different stages of information processing. Participants underwent EEG while completing the Attention Network Task (ANT), a cognitive measure of alerting, orienting, and inhibitory control of attention. Results revealed no behavioral differences between patients and controls but significantly greater right-hemisphere alpha activity (reduced inhibitory control) in patients, particularly to uninformative (no cue, double cue) versus informative (valid cue) cues and in later stages of information processing (400-800 ms post-stimulus). Results suggest neural differences between groups to uncertain stimulus environments that have yet to manifest behaviorally. FAA may thus serve as a unique neural correlate that could potentially be used to predict later cognitive decline.
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Affiliation(s)
- Neelam Prashad
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7 Floor, New York, New York 10022
| | - Robert D. Melara
- Department of Psychology, The City College, City University of New York, 160 Convent Avenue, NAC 7-120, New York, NY 10031
| | - James C. Root
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7 Floor, New York, New York 10022
| | - Tim A. Ahles
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Science Services, 641 Lexington Avenue, 7 Floor, New York, New York 10022
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Microneedles for Efficient and Precise Drug Delivery in Cancer Therapy. Pharmaceutics 2023; 15:pharmaceutics15030744. [PMID: 36986606 PMCID: PMC10057903 DOI: 10.3390/pharmaceutics15030744] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/08/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Cancer is the leading cause of death, acting as a global burden, severely impacting the patients’ quality of life and affecting the world economy despite the expansion of cumulative advances in oncology. The current conventional therapies for cancer which involve long treatment duration and systemic exposure of drugs leads to premature degradation of drugs, a massive amount of pain, side effects, as well as the recurrence of the condition. There is also an urgent demand for personalized and precision-based medicine, especially after the recent pandemic, to avoid future delays in diagnosis or treatments for cancer patients as they are very essential in reducing the global mortality rate. Recently, microneedles which consist of a patch with tiny, micron-sized needles attached to it have been quite a sensation as an emerging technology for transdermal application to diagnose or treat various illnesses. The application of microneedles in cancer therapies is also being extensively studied as they offer a myriad of benefits, especially since microneedle patches offer a better treatment approach through self administration, painless treatment, and being an economically and environmentally friendly approach in comparison with other conventional methods. The painless gains from microneedles significantly improves the survival rate of cancer patients. The emergence of versatile and innovative transdermal drug delivery systems presents a prime breakthrough opportunity for safer and more effective therapies, which could meet the demands of cancer diagnosis and treatment through different application scenarios. This review highlights the types of microneedles, fabrication methods and materials, along with the recent advances and opportunities. In addition, this review also addresses the challenges and limitations of microneedles in cancer therapy with solutions through current studies and future works to facilitate the clinical translation of microneedles in cancer therapies.
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A Systematic Review on the Potential Acceleration of Neurocognitive Aging in Older Cancer Survivors. Cancers (Basel) 2023; 15:cancers15041215. [PMID: 36831557 PMCID: PMC9954467 DOI: 10.3390/cancers15041215] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
As survival rates increase, more emphasis has gone to possible cognitive sequelae in older cancer patients, which could be explained by accelerated brain aging. In this review, we provide a complete overview of studies investigating neuroimaging, neurocognitive, and neurodegenerative disorders in older cancer survivors (>65 years), based on three databases (Pubmed, Web of Science and Medline). Ninety-six studies were included. Evidence was found for functional and structural brain changes (frontal regions, basal ganglia, gray and white matter), compared to healthy controls. Cognitive decline was mainly found in memory functioning. Anti-hormonal treatments were repeatedly associated with cognitive decline (tamoxifen) and sometimes with an increased risk of Alzheimer's disease (androgen deprivation therapy). Chemotherapy was inconsistently associated with later development of cognitive changes or dementia. Radiotherapy was not associated with cognition in patients with non-central nervous system cancer but can play a role in patients with central nervous system cancer, while neurosurgery seemed to improve their cognition in the short-term. Individual risk factors included cancer subtypes (e.g., brain cancer, hormone-related cancers), treatment (e.g., anti-hormonal therapy, chemotherapy, cranial radiation), genetic predisposition (e.g., APOE, COMT, BDNF), age, comorbidities (e.g., frailty, cognitive reserve), and psychological (e.g., depression, (post-traumatic) distress, sleep, fatigue) and social factors (e.g., loneliness, limited caregiver support, low SES). More research on accelerated aging is required to guide intervention studies.
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Sacks-Zimmerman A, Bergquist TF, Farr EM, Cornwell MA, Kanellopoulos D. Rehabilitation of Neuropsychiatric Symptoms in Patients With Long COVID: Position Statement. Arch Phys Med Rehabil 2023; 104:350-354. [PMID: 36272444 PMCID: PMC9581644 DOI: 10.1016/j.apmr.2022.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/12/2022] [Accepted: 10/03/2022] [Indexed: 02/07/2023]
Abstract
Long COVID, a term used to describe ongoing symptoms after COVID-19 infection, parallels the course of other postviral syndromes. Neuropsychiatric symptoms of long COVID can be persistent and interfere with quality of life and functioning. Within the biopsychosocial framework of chronic illness, rehabilitation professionals can address the neuropsychiatric sequelae of long COVID. However, current practice models are not designed to address concurrent psychiatric and cognitive symptoms in adults living with long COVID. Thus, we present a biopsychosocial framework for long COVID and provide treatment strategies based on evidence from current literature of postviral chronic illness. These recommendations will guide rehabilitation professionals in identifying common neuropsychiatric symptoms in long COVID that can be targeted for intervention and addressing these symptoms via integrative interventions taking into account the biopsychosocial presentation of long COVID symptoms.
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Affiliation(s)
- Amanda Sacks-Zimmerman
- Weill Cornell Medicine, Brain & Spine Center, Department of Neurological Surgery, New York, NY.
| | - Thomas F Bergquist
- Mayo Clinic, Department of Physical Medicine and Rehabilitation, Rochester, MN; Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN
| | - Ellen M Farr
- Mayo Clinic, Department of Physical Medicine and Rehabilitation, Rochester, MN
| | - Melinda A Cornwell
- Weill Cornell Medicine, Brain & Spine Center, Department of Neurological Surgery, New York, NY
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46
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Daniel E, Deng F, Patel SK, Sedrak MS, Kim H, Razavi M, Sun CL, Root JC, Ahles TA, Dale W, Chen BT. Cortical thinning in chemotherapy-treated older long-term breast cancer survivors. Brain Imaging Behav 2023; 17:66-76. [PMID: 36369620 PMCID: PMC10156471 DOI: 10.1007/s11682-022-00743-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 11/13/2022]
Abstract
Cognitive decline is an increasing issue for cancer survivors, especially for older adults, as chemotherapy affects brain structure and function. The purpose of this single center study was to evaluate alterations in cortical thickness and cognition in older long-term survivors of breast cancer who had been treated with chemotherapy years ago. In this prospective cohort study, we enrolled 3 groups of women aged ≥ 65 years with a history of stage I-III breast cancer who had received adjuvant chemotherapy 5 to 15 years ago (chemotherapy group, C +), age-matched women with breast cancer but no chemotherapy (no-chemotherapy group, C-) and healthy controls (HC). All participants underwent brain magnetic resonance imaging and neuropsychological testing with the NIH Toolbox Cognition Battery at time point 1 (TP1) and again at 2 years after enrollment (time point 2 (TP2)). At TP1, there were no significant differences in cortical thickness among the 3 groups. Longitudinally, the C + group showed cortical thinning in the fusiform gyrus (p = 0.006, effect size (d) = -0.60 [ -1.86, -0.66]), pars triangularis (p = 0.026, effect size (d) = -0.43 [-1.68, -0.82]), and inferior temporal lobe (p = 0.026, effect size (d) = -0.38 [-1.62, -0.31]) of the left hemisphere. The C + group also showed decreases in neuropsychological scores such as the total composite score (p = 0.01, effect size (d) = -3.9726 [-0.9656, -6.9796], fluid composite score (p = 0.03, effect size (d) = -4.438 [-0.406, -8.47], and picture vocabulary score (p = 0.04, effect size (d) = -3.7499 [-0.0617, -7.438]. Our results showed that cortical thickness could be a candidate neuroimaging biomarker for cancer-related cognitive impairment and accelerated aging in older long-term cancer survivors.
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Affiliation(s)
- Ebenezer Daniel
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Frank Deng
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Sunita K Patel
- Department of Population Science, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Mina S Sedrak
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Heeyoung Kim
- Center for Cancer and Aging, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Can-Lan Sun
- Center for Cancer and Aging, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - James C Root
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tim A Ahles
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William Dale
- Center for Cancer and Aging, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.,Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, 91010, USA. .,Center for Cancer and Aging, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
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47
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Yuan L, Su Y, Yu B, Shen Y, Cong H. D-A-D organic small molecules with AIE effect for fluorescence imaging guided photothermal therapy. Biomater Sci 2023; 11:985-997. [PMID: 36541206 DOI: 10.1039/d2bm01912d] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Near infrared (NIR) fluorescent organic molecules as fluorescent probes accurately guide photothermal therapy as a potential antitumor method. However, the aggregation and quenching of organic fluorescent molecules and poor tissue permeability greatly limit their therapeutic effect and clinical transformation. In this paper, with a D-A-D structure as the molecular skeleton, cyclopentadithiophene (CPDT) as the donor (D), diketopyrrolopyrrole (DPP) as the acceptor (A), and long-chain isooctane as the shielding unit, organic fluorescent small molecules with a strong absorption band and bright NIR-II emission were synthesized. Then, tetraphenylethylene (TPE) molecules with typical AIE structure characteristics were introduced on both sides of the organic fluorescent small molecules, and an organic small molecular fluorophore (TDA) with AIE characteristics and the photothermal effect was designed. Through a series of experimental characterization techniques, it is proved that TDA NPs have good biocompatibility and tissue permeability, and can accurately locate the tumor location through NIR-II fluorescence imaging to achieve local photothermal treatment of tumors.
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Affiliation(s)
- Lin Yuan
- Institute of Biomedical Materials and Engineering, College of Materials Science and Engineering, College of Chemistry and Chemical Engineering, Qingdao University, Qingdao 266071, China.
| | - Yingbin Su
- Institute of Biomedical Materials and Engineering, College of Materials Science and Engineering, College of Chemistry and Chemical Engineering, Qingdao University, Qingdao 266071, China.
| | - Bing Yu
- Institute of Biomedical Materials and Engineering, College of Materials Science and Engineering, College of Chemistry and Chemical Engineering, Qingdao University, Qingdao 266071, China. .,State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China
| | - Youqing Shen
- Institute of Biomedical Materials and Engineering, College of Materials Science and Engineering, College of Chemistry and Chemical Engineering, Qingdao University, Qingdao 266071, China. .,Key Laboratory of Biomass Chemical Engineering of Ministry of Education, Center for Bionanoengineering, and Department of Chemical and Biological Engineering, Zhejiang University, Hangzhou, Zhejiang, 310027, China
| | - Hailin Cong
- Institute of Biomedical Materials and Engineering, College of Materials Science and Engineering, College of Chemistry and Chemical Engineering, Qingdao University, Qingdao 266071, China. .,State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.,School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China.
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48
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Root JC, Gaynor AM, Ahsan A, Jung D, Schofield E, Ryan E, Li Y, Ahles TA. Remote, Computerised Cognitive Assessment for Breast Cancer- and Treatment-Related Cognitive Dysfunction: Psychometric Characteristics of the Cogsuite Neurocognitive Battery. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023:6991200. [PMID: 36655820 PMCID: PMC10369363 DOI: 10.1093/arclin/acac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Cancer-related cognitive dysfunction (CRCD) is a significant concern for breast cancer survivors. The Cogsuite battery was developed to improve sensitivity to CRCD with the use of cognitive experimental measures, clarify specific cognitive processes impacted and to be capable of being administered either in-office or remotely. METHODS In sum, 357 breast cancer survivors and non-cancer controls completed the Cogsuite Battery in-office (n = 76) or remotely (n = 281). Measure validity, sensitivity to demographic factors, correlations with standard neuropsychological measures and intercorrelations of Cogsuite variables were assessed. Test-retest reliability was evaluated in-office (n = 24) and remotely (n = 80). RESULTS Test-retest reliability for most variables assessed was adequate to strong. Internal validity, as indicated by the confirmation of expected condition effects within each measure, was established for all measures. Assessment of external validity found age, but not education, was a significant predictor in the majority of measures. Assessment of criterion validity found that Cogsuite variables were correlated with standard measures in psychomotor speed, working memory and executive function, but not associated with self-reported cognition or mood. CONCLUSIONS Cogsuite is reliable and valid, and is sensitive to the effects of increasing age on cognition. The addition of the Cogsuite battery to standard assessment may improve sensitivity to CRCD and identify underlying processes that may be affected. Remote use of the Cogsuite battery in appropriate settings will lessen the burden for providers, researchers and survivors in research and clinical contexts.
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Affiliation(s)
- James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Alexandra M Gaynor
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10027, USA.,Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY 10027, USA
| | - Anam Ahsan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Elizabeth Ryan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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49
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Nakamura ZM, Deal AM, Park EM, Stanton KE, Lopez YE, Quillen LJ, O'Hare Kelly E, Heiling HM, Nyrop KA, Ray EM, Dees EC, Reeder-Hayes KE, Jolly TA, Carey LA, Abdou Y, Olajide OA, Rauch JK, Joseph R, Copeland A, McNamara MA, Ahles TA, Muss HB. A phase II single-arm trial of memantine for prevention of cognitive decline during chemotherapy in patients with early breast cancer: Feasibility, tolerability, acceptability, and preliminary effects. Cancer Med 2023; 12:8172-8183. [PMID: 36645168 PMCID: PMC10134315 DOI: 10.1002/cam4.5619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cognitive difficulties have been described after chemotherapy for breast cancer, but there is no standard of care to improve cognitive outcomes in these patients. This trial examined the feasibility, tolerability, acceptability, and preliminary effects of memantine to prevent cognitive decline during chemotherapy for breast cancer. METHODS Patients with stage I-III breast cancer, scheduled for neo/adjuvant chemotherapy, completed a cognitive battery prior to and 4 weeks after completing chemotherapy. Memantine (10 mg BID) was administered concurrent with chemotherapy. Our primary cognitive outcome was visual working memory assessed by the Delayed Matching to Sample test. We used the Brief Medication Questionnaire to assess acceptability. RESULTS Of 126 patients approached, 56 (44%) enrolled. Forty-five (80%) received ≥1 dose of memantine and completed pre-post assessments. Seventy-six percent reported taking ≥90% of scheduled doses. Participants were mean age of 56, 77% White, and 57% had stage I disease. Sixty-four percent had stable or improved Delayed Matching to Sample test scores. Stable or improved cognition was observed in 87%-91% across objective cognitive domain composite measures. Sixty-six percent self-reported stable or improved cognitive symptoms. There were seven greater than or equal to grade 3 adverse events; two were possibly related to memantine. Only 5% reported that taking memantine was a disruption to their lives. CONCLUSIONS Memantine was well-tolerated and consistently taken by a large majority of patients receiving breast cancer chemotherapy. The majority demonstrated stable or improved cognition from pre- to post-assessment. Randomized trials are needed to determine memantine's efficacy to ameliorate cognitive loss. TRIAL REGISTRATION ClinicalTrials.gov NCT04033419.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eliza M Park
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kate E Stanton
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yesy E Lopez
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura J Quillen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin O'Hare Kelly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hillary M Heiling
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily M Ray
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - E Claire Dees
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Trevor A Jolly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yara Abdou
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Julia K Rauch
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Ranjit Joseph
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Anureet Copeland
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Megan A McNamara
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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50
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Liu H, Li Y, Li Y, Wang J, Su N, Cui N, Xu K, Sun Y, Cao F. Psychometric properties of the Chinese version of the Cognitive Reserve Assessment Scale in Health in patients with cancer. BMC Psychiatry 2023; 23:5. [PMID: 36597052 PMCID: PMC9811687 DOI: 10.1186/s12888-022-04506-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cognitive reserve is a modifiable factor that could prevent cognitive decline in patients with cancer. The Cognitive Reserve Assessment Scale in Health (CRASH) is an instrument used to assess cognitive reserve. This study aims to develop and examine the psychometric properties of the Chinese version of the CRASH for patients with cancer. METHODS A cross-sectional survey was conducted with 167 cancer patients from four wards of two hospitals in China. Thirty-one patients were re-assessed to examine the test-retest reliability. Four translators and three reviewers developed the Chinese version of the scale. We assessed its structural validity, concurrent validity, internal consistency, test-retest reliability, measurement error, and floor/ceiling effects. RESULTS Confirmatory factor analysis showed a good model fit with the four-factor structure of the original CRASH. The CRASH scores were statistically significantly associated with neuropsychological test scores, indicating sufficient concurrent validity. The internal consistency was acceptable, except for leisure activities, with standardized Cronbach's alphas (0.64-0.94) and standardized Omega (0.66-0.95). There was excellent test-retest reliability, with a high intraclass correlation coefficient (0.914-0.993) of total scores and scores for each domain. The measurement error was acceptable, and no floor or ceiling effects were observed. CONCLUSIONS The Chinese version of the CRASH is a valid and reliable instrument to assess cognitive reserve in patients with cancer. Moreover, cognitive reserve measured by the CRASH was associated with low cognitive performance in cancer patients.
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Affiliation(s)
- Hong Liu
- grid.27255.370000 0004 1761 1174Department of Nursing Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhuaxi Road, Jinan city, 250012 Shandong Province China
| | - Yanyan Li
- grid.11135.370000 0001 2256 9319School of Nursing, Peking University, Beijing, China
| | - Yang Li
- grid.89336.370000 0004 1936 9924School of Nursing, The University of Texas at Austin, Austin, USA
| | - Jianwen Wang
- grid.27255.370000 0004 1761 1174Department of Nursing Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhuaxi Road, Jinan city, 250012 Shandong Province China
| | - Na Su
- grid.440144.10000 0004 1803 8437Imaging Department, Shandong Cancer Hospital and Institute, Jinan, China
| | - Naixue Cui
- grid.27255.370000 0004 1761 1174Department of Nursing Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhuaxi Road, Jinan city, 250012 Shandong Province China
| | - Kun Xu
- grid.440144.10000 0004 1803 8437Department of Gastrointestinal Surgery, Shandong Cancer Hospital and Institute, Jinan, China
| | - Yaoyao Sun
- grid.27255.370000 0004 1761 1174Department of Nursing Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhuaxi Road, Jinan city, 250012 Shandong Province China
| | - Fenglin Cao
- Department of Nursing Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhuaxi Road, Jinan city, 250012, Shandong Province, China.
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