1
|
Santana EDO, Silva LDS, da Silva LAA, Lemos JLDA, Marcondes L, Guimarães PRB, Kalinke LP. Effect of guided imagery relaxation on anxiety in cervical cancer: randomized clinical trial. Rev Bras Enferm 2023; 76:e20210874. [PMID: 37820123 PMCID: PMC10561422 DOI: 10.1590/0034-7167-2021-0874] [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: 07/01/2022] [Accepted: 04/11/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES to evaluate the effect of guided imagery relaxation through virtual reality on anxiety in women with cervical cancer undergoing radiochemotherapy. METHODS randomized, non-blinded, single-center clinical trial conducted at a cancer reference hospital. 52 women participated, with randomized allocation of 24 in the control group and 28 in the experimental group (12 sessions of guided imagery relaxation through virtual reality, applied three times a week). The outcome was evaluated using the State-Trait Anxiety Inventory and statistical analysis was performed using the Generalized Linear Mixed Model. RESULTS n the experimental group, women presented significant anxiety traits (p=0.010) before the intervention. Between the 4th and 12th week of follow-up, there was a reduction in anxiety levels, without statistical significance. CONCLUSIONS guided imagery relaxation through virtual reality provided evidence of anxiety reduction in women with cervical cancer undergoing radiochemotherapy and may contribute to clinical practice. Brazilian Clinical Trial Registry: RBR-7ssvytb.
Collapse
|
2
|
Ramos da Silva J, Bitencourt Rodrigues K, Formoso Pelegrin G, Silva Sales N, Muramatsu H, de Oliveira Silva M, Porchia BFMM, Moreno ACR, Aps LRMM, Venceslau-Carvalho AA, Tombácz I, Fotoran WL, Karikó K, Lin PJC, Tam YK, de Oliveira Diniz M, Pardi N, de Souza Ferreira LC. Single immunizations of self-amplifying or non-replicating mRNA-LNP vaccines control HPV-associated tumors in mice. Sci Transl Med 2023; 15:eabn3464. [PMID: 36867683 DOI: 10.1126/scitranslmed.abn3464] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
As mRNA vaccines have proved to be very successful in battling the coronavirus disease 2019 (COVID-19) pandemic, this new modality has attracted widespread interest for the development of potent vaccines against other infectious diseases and cancer. Cervical cancer caused by persistent human papillomavirus (HPV) infection is a major cause of cancer-related deaths in women, and the development of safe and effective therapeutic strategies is urgently needed. In the present study, we compared the performance of three different mRNA vaccine modalities to target tumors associated with HPV-16 infection in mice. We generated lipid nanoparticle (LNP)-encapsulated self-amplifying mRNA as well as unmodified and nucleoside-modified non-replicating mRNA vaccines encoding a chimeric protein derived from the fusion of the HPV-16 E7 oncoprotein and the herpes simplex virus type 1 glycoprotein D (gDE7). We demonstrated that single low-dose immunizations with any of the three gDE7 mRNA vaccines induced activation of E7-specific CD8+ T cells, generated memory T cell responses capable of preventing tumor relapses, and eradicated subcutaneous tumors at different growth stages. In addition, the gDE7 mRNA-LNP vaccines induced potent tumor protection in two different orthotopic mouse tumor models after administration of a single vaccine dose. Last, comparative studies demonstrated that all three gDE7 mRNA-LNP vaccines proved to be superior to gDE7 DNA and gDE7 recombinant protein vaccines. Collectively, we demonstrated the immunogenicity and therapeutic efficacy of three different mRNA vaccines in extensive comparative experiments. Our data support further evaluation of these mRNA vaccines in clinical trials.
Collapse
Affiliation(s)
- Jamile Ramos da Silva
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil.,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Karine Bitencourt Rodrigues
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Guilherme Formoso Pelegrin
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Natiely Silva Sales
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Hiromi Muramatsu
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mariângela de Oliveira Silva
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Bruna F M M Porchia
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil.,Laboratory of Tumor Immunology, Department of Immunology, Biomedical Sciences Institute, University of São Paulo, São Paulo, SP 05508-000, Brazil.,ImunoTera Soluções Terapêuticas Ltda., São Paulo, SP 05508-000, Brazil
| | - Ana Carolina Ramos Moreno
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Luana Raposo M M Aps
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil.,ImunoTera Soluções Terapêuticas Ltda., São Paulo, SP 05508-000, Brazil
| | - Aléxia Adrianne Venceslau-Carvalho
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - István Tombácz
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Wesley Luzetti Fotoran
- Department of Parasitology, Institute for Biomedical Sciences, University of São Paulo, SP 05508-000, Brazil
| | | | | | - Ying K Tam
- Acuitas Therapeutics, Vancouver, BC V6T1Z3, Canada
| | - Mariana de Oliveira Diniz
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil
| | - Norbert Pardi
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luís Carlos de Souza Ferreira
- Vaccine Development Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP 05508-000, Brazil.,Scientific Platform Pasteur USP, University of São Paulo, São Paulo, SP, 05508-020, Brazil
| |
Collapse
|
3
|
Mutlu L, Tymon-Rosario J, Harold J, Menderes G. Targeted treatment options for the management of metastatic/persistent and recurrent cervical cancer. Expert Rev Anticancer Ther 2022; 22:633-645. [PMID: 35533682 DOI: 10.1080/14737140.2022.2075348] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Cervical cancer is the overall fourth most common malignancy and the fourth most common cause of cancer related deaths worldwide. Despite vaccination and screening programs, many women continue to present with advanced stage cervical cancer, wherein the treatment options have been limited. AREAS COVERED In this review, immunotherapy and the potential targeted therapies that have demonstrated promise in the treatment of persistent, recurrent, and metastatic cervical cancer are discussed. EXPERT OPINION Our global goal in the gynecologic oncology community is to eliminate cervical cancer, by increasing the uptake of preventive vaccination and screening programs. For unfortunate patients who present with metastatic, persistent, and recurrent cervical cancer, pembrolizumab with chemotherapy, with or without bevacizumab is the new first line therapy for PD-L1 positive patients. For this patient population as a second line therapy, tisotumab vedotin (i.e. ADC) has shown significant efficacy in Phase II trials, leading to FDA approval. Combination regimens inclusive of immune checkpoint inhibitors, DNA damage repair inhibitors, antibody drug conjugates are potential breakthrough treatment strategies and are currently being investigated.
Collapse
Affiliation(s)
- Levent Mutlu
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Smilow Cancer Hospital, Yale University, School of Medicine
| | - Joan Tymon-Rosario
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Smilow Cancer Hospital, Yale University, School of Medicine
| | - Justin Harold
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Smilow Cancer Hospital, Yale University, School of Medicine
| | - Gulden Menderes
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, Smilow Cancer Hospital, Yale University, School of Medicine
| |
Collapse
|
4
|
Müller L, Mitter S, Mannewitz M, Keilmann L, Meister S, Kolben MT, Schmoeckel E, Burges A, Trillsch F, Czogalla B, Jeschke U, Kessler M, Mahner S, Kolben T, Beyer S. Die Blutgruppenantigene SLeX, SLeA and Lewis Y als potenziell prognostische Faktoren im Endometrium- und Zervixkarzinom. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- L Müller
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - S Mitter
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - M Mannewitz
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - L Keilmann
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - S Meister
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - M T Kolben
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - E Schmoeckel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - A Burges
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - F Trillsch
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - B Czogalla
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - U Jeschke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - M Kessler
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - S Mahner
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - T Kolben
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - S Beyer
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| |
Collapse
|
5
|
Osei Appiah E, Amertil NP, Oti-Boadi Ezekiel E, Lavoe H, Siedu DJ. Impact of cervical cancer on the sexual and physical health of women diagnosed with cervical cancer in Ghana: A qualitative phenomenological study. WOMEN'S HEALTH (LONDON, ENGLAND) 2021; 17:17455065211066075. [PMID: 34937442 PMCID: PMC8724983 DOI: 10.1177/17455065211066075] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Although cervical cancer is preventable, it is a major gynecological disorder among women currently. More than 500,000 new cases of cervical cancer are being diagnosed across the globe, with one woman dying of cervical cancer every 2 min. In addition, about half of cervical cancer survivors have challenges with their sexual function. Despite these findings, literature regarding the sexual function of women with cervical cancer is scanty. The study aims to assess cervical cancer's impact on the sexual and physical health of women diagnosed with cervical cancer in Ghana. METHODS The researchers of this study employed a qualitative approach with phenomenological design. A purposive sampling technique was used to select 30 participants engaged in face-to-face in-depth interviews that were audio-recorded. The content of the transcripts was analyzed using content analysis. RESULTS This study revealed that cervical cancer patients experienced low libido due to the cervical cancer symptoms and the side effects of chemotherapy. This low libido made them divert their sexual gratification from the vagina to other centers of the body. Findings further revealed that some participants showed apathy toward their partners' sexual feelings. Some physical problems experienced by the participants were also unraveled. CONCLUSION Cervical cancer affects all aspects of a woman's health, including sexual function and physical well-being. Therefore, there is the need for more to help address challenges faced by cervical cancer women about their sexual and physical health.
Collapse
Affiliation(s)
- Evans Osei Appiah
- Department of Midwifery, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | - Ninon P Amertil
- School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | | | | | | |
Collapse
|