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Lopez-Olivo MA, Kachira JJ, Buni M, Kim ST, Lu H, Tayar JH, Duhon GF, Ruiz JI, Bingham CO, Calabrese C, Volk RJ, Suarez-Almazor ME. Learning Needs of Patients with Cancer and a Pre-Existing Autoimmune Disease Who Are Candidates to Receive Immune Checkpoint Inhibitors. Cancers (Basel) 2023; 15:4004. [PMID: 37568819 PMCID: PMC10416973 DOI: 10.3390/cancers15154004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Patients with pre-existing autoimmune disorders and cancer considering immune checkpoint inhibitors (ICIs) need to receive balanced information about the benefits and risk of developing immune-related adverse events (irAEs) and flare-ups of their autoimmune disease. To assess the learning needs of patients with cancer and pre-existing autoimmune disease regarding ICI treatment, we interviewed 29 patients with autoimmune disease and cancer from a comprehensive cancer center, of whom 20 had received ICI and 9 were candidates to receive ICI at a US Cancer Center. In-depth semi-structured interviews were conducted from August 2021 and January 2022. Interviewee's opinions and preferences about content and information delivery methods were collected. We recorded and transcribed interviews and analyzed them using thematic analysis. Half of the participants were female, and their median (SD) age was 62.9 (±10.9) years. The identified health information needs included the following: (1) information on irAEs and autoimmune disease flare-ups; (2) benefits of ICI; (3) ICI mechanism in the context of autoimmune disease; (4) management of flare-ups; (5) reasons for stopping or modifying cancer or autoimmune disease treatment; (6) likelihood of autoimmune disease progression or organ damage; and (7) lifestyle changes that could help avoid irAEs. Patients who had received ICI and those who had not yet received treatment reported similar needs, although patients who had received ICI had more questions about cancer treatment modifications. Patients also expressed the need to better understand when to contact their provider and how to share information with multiple providers. Most patients wanted to receive information in visual formats for review at home and at their own pace. Patients expressed interest in having educational tools to facilitate shared decision-making with their physicians, and they identified several areas of health information concerning therapy with ICI. They also highlighted the importance of communication among their various providers.
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Affiliation(s)
- Maria A. Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.J.K.); (G.F.D.); (J.I.R.); (R.J.V.); (M.E.S.-A.)
| | - Johncy J. Kachira
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.J.K.); (G.F.D.); (J.I.R.); (R.J.V.); (M.E.S.-A.)
| | - Maryam Buni
- Section of Rheumatology and Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.); (S.T.K.); (H.L.); (J.H.T.)
| | - Sang Taek Kim
- Section of Rheumatology and Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.); (S.T.K.); (H.L.); (J.H.T.)
| | - Huifang Lu
- Section of Rheumatology and Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.); (S.T.K.); (H.L.); (J.H.T.)
| | - Jean H. Tayar
- Section of Rheumatology and Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.); (S.T.K.); (H.L.); (J.H.T.)
| | - Gabrielle F. Duhon
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.J.K.); (G.F.D.); (J.I.R.); (R.J.V.); (M.E.S.-A.)
| | - Juan I. Ruiz
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.J.K.); (G.F.D.); (J.I.R.); (R.J.V.); (M.E.S.-A.)
| | - Clifton O. Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA;
| | | | - Robert J. Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.J.K.); (G.F.D.); (J.I.R.); (R.J.V.); (M.E.S.-A.)
| | - Maria E. Suarez-Almazor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.J.K.); (G.F.D.); (J.I.R.); (R.J.V.); (M.E.S.-A.)
- Section of Rheumatology and Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.B.); (S.T.K.); (H.L.); (J.H.T.)
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Muacevic A, Adler JR, Kachira JJ, AlJumaili Z. Synchronous Diagnosis of Squamous Cell Carcinoma of the Lung and Mixed Cellularity Hodgkin Lymphoma of the Nasopharynx. Cureus 2022; 14:e32885. [PMID: 36699799 PMCID: PMC9867922 DOI: 10.7759/cureus.32885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
Hodgkin lymphoma (HL) is a highly curable B cell lymphoproliferative neoplasm with a bimodal age distribution. Lung cancer is the leading cause of cancer-related deaths in both sexes. We present a rare case of synchronous squamous cell carcinoma (SCC) of the lung and mixed cellularity HL of the nasopharynx. A gentleman in his 70s presented with right-sided chest pain and shortness of breath. CT of the chest showed a peripheral lung mass, and a biopsy confirmed SCC of the lung. The patient underwent a positron emission tomography/computed tomography (PET/CT) for staging that revealed an 18F-fluorodeoxyglucose (FDG)-avid mass in the nasopharynx. Flexible nasal endoscopy and biopsy of the nasopharyngeal mass revealed mixed cellularity classical HL. The patient was started on chemoimmunotherapy for lung cancer. Unfortunately, two months after initiation of treatment, the patient died from COVID-19 pneumonia and multiorgan failure.
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