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Geiss C, Hoogland AI, Arredondo B, Rodriguez Y, Bryant C, Chung CH, Patel KB, Gonzalez BD, Jim HSL, Kirtane K, Oswald LB. Psychosocial consequences of head and neck cancer symptom burden after chemoradiation: a mixed-method study. Support Care Cancer 2024; 32:254. [PMID: 38538780 DOI: 10.1007/s00520-024-08424-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/05/2024] [Indexed: 04/18/2024]
Abstract
PURPOSE Patients with head and neck cancer (HNC) experience significant symptom burden from combination chemotherapy and radiation (chemoradiation) that affects acute and long-term health-related quality of life (HRQOL). However, psychosocial impacts of HNC symptom burden are not well understood. This study examined psychosocial consequences of treatment-related symptom burden from the perspectives of survivors of HNC and HNC healthcare providers. METHODS This was a cross-sectional, mixed-method study conducted at an NCI-designated comprehensive cancer center. Participants (N = 33) were survivors of HNC who completed a full course of chemoradiation (n = 20) and HNC healthcare providers (n = 13). Participants completed electronic surveys and semi-structured interviews. RESULTS Survivors were M = 61 years old (SD = 9) and predominantly male (75%), White (90%), non-Hispanic (100%), and diagnosed with oropharynx cancer (70%). Providers were mostly female (62%), White (46%) or Asian (31%), and non-Hispanic (85%) and included physicians, registered nurses, an advanced practice nurse practitioner, a registered dietician, and a speech-language pathologist. Three qualitative themes emerged: (1) shock, shame, and self-consciousness, (2) diminished relationship satisfaction, and (3) lack of confidence at work. A subset of survivors (20%) reported clinically low social wellbeing, and more than one-third of survivors (35%) reported clinically significant fatigue, depression, anxiety, and cognitive dysfunction. CONCLUSION Survivors of HNC and HNC providers described how treatment-related symptom burden impacts psychosocial identity processes related to body image, patient-caregiver relationships, and professional work. Results can inform the development of supportive interventions to assist survivors and caregivers with navigating the psychosocial challenges of HNC treatment and survivorship.
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Affiliation(s)
- Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-AS PRISM, Tampa, FL, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA
| | - Brandy Arredondo
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-AS PRISM, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA
| | - Crystal Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA
| | - Christine H Chung
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, USA
| | - Krupal B Patel
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA
| | - Kedar Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, MRC-EDU, Tampa, FL, 33612, USA.
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Tometich DB, Welniak T, Gudenkauf L, Maconi ML, Fulton HJ, Martinez Tyson D, Zambrano K, Hasan S, Rodriguez Y, Bryant C, Li X, Reed DR, Oswald LB, Galligan A, Small BJ, Jim HSL. "I couldn't connect the wires in my brain." Young adult cancer survivors' experience with cognitive functioning. Psychooncology 2024; 33:e6309. [PMID: 38420860 DOI: 10.1002/pon.6309] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/20/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE There is a dearth of literature describing young adult (YA) cancer survivors' experiences with cancer-related cognitive impairment (CRCI). We aimed to elucidate CRCI among YA cancer survivors and identify potentially modifiable risk factors. METHODS We conducted individual qualitative interviews with YA cancer survivors aged 18-30 years at study enrollment and used applied thematic analysis to identify themes across three topics (i.e., affected cognitive abilities, risk and protective factors influencing the impact of CRCI, and strategies for coping with CRCI). RESULTS YA cancer survivors (N = 20) were, on average, 23 years old at diagnosis and 26 years old when interviewed. Diverse cancer types and treatments were represented; most participants (85%) had completed cancer treatment. Participants described experiences across three qualitative topics: (1) affected cognitive abilities (i.e., concentration and attention, prospective memory, and long-term memory), (2) Risk factors (i.e., fatigue, sleep problems, mood, stress/distractions, and social isolation) and protective factors (i.e., social support), and (3) coping strategies, including practical strategies that helped build self-efficacy (e.g., writing things down, reducing distractions), beneficial emotion-focused coping strategies (e.g., focus on health, faith/religion), strategies with mixed effects (i.e., apps/games, medications/supplements, and yoga), and "powering through" strategies that exacerbated stress. CONCLUSIONS YA cancer survivors experience enduring cognitive difficulties after treatment. Specific concerns highlight the importance of attention and executive functioning impairments, long-term memory recall, and sensitivity to distractions. Future work is needed to improve assessment and treatment of CRCI among YA cancer survivors.
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Affiliation(s)
- Danielle B Tometich
- Moffitt Cancer Center, Tampa, Florida, USA
- University of South Florida, Tampa, Florida, USA
| | | | | | | | | | | | | | - Syed Hasan
- Moffitt Cancer Center, Tampa, Florida, USA
| | | | | | - Xiaoyin Li
- Moffitt Cancer Center, Tampa, Florida, USA
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Gudenkauf LM, Li X, Hoogland AI, Oswald LB, Lmanirad I, Permuth JB, Small BJ, Jim HSL, Rodriguez Y, Bryant CA, Zambrano KN, Walters KO, Reblin M, Gonzalez BD. Feasibility and acceptability of C-PRIME: A health promotion intervention for family caregivers of patients with colorectal cancer. Support Care Cancer 2024; 32:198. [PMID: 38416143 DOI: 10.1007/s00520-024-08395-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE This study aimed to test the feasibility and acceptability of a digital health promotion intervention for family caregivers of patients with advanced colorectal cancer and explore the intervention's preliminary efficacy for mitigating the impact of caregiving on health and well-being. METHODS We conducted a single-arm pilot feasibility trial of C-PRIME (Caregiver Protocol for Remotely Improving, Monitoring, and Extending Quality of Life), an 8-week digital health-promotion behavioral intervention involving monitoring and visualizing health-promoting behaviors (e.g., objective sleep and physical activity data) and health coaching (NCT05379933). A priori benchmarks were established for feasibility (≥ 50% recruitment and objective data collection; ≥ 75% session engagement, measure completion, and retention) and patient satisfaction (> 3 on a 1-5 scale). Preliminary efficacy was explored with pre- to post-intervention changes in quality of life (QOL), sleep quality, social engagement, and self-efficacy. RESULTS Participants (N = 13) were M = 52 years old (SD = 14). Rates of recruitment (72%), session attendance (87%), assessment completion (87%), objective data collection (80%), and retention (100%) all indicated feasibility. All participants rated the intervention as acceptable (M = 4.7; SD = 0.8). Most participants showed improvement or maintenance of QOL (15% and 62%), sleep quality (23% and 62%), social engagement (23% and 69%), and general self-efficacy (23% and 62%). CONCLUSION The C-PRIME digital health promotion intervention demonstrated feasibility and acceptability among family caregivers of patients with advanced colorectal cancer. A fully powered randomized controlled trial is needed to test C-PRIME efficacy, mechanisms, and implementation outcomes, barriers, and facilitators in a divserse sample of family caregivers. TRIAL REGISTRATION The Caregiver Protocol for Remotely Improving, Monitoring, and Extending Quality of Life (C-PRIME) study was registered on clinicaltrials.gov, NCT05379933, in May 2022.
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Affiliation(s)
- Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Iman Lmanirad
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Jennifer B Permuth
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Brent J Small
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Crystal A Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Kellie N Zambrano
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Kerie O Walters
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, Burlington, VT, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
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Smith KS, Hoogland AI, Welniak T, Nguyen OL, Rodriguez Y, Li X, Crowder SL, Oswald LB, Carpenter KM, Fischer SM, Li D, Kinney AY, Berry DL, Gonzalez BD, Jim HSL. Acute cancer-related symptoms and concerns among patients receiving chemotherapy: current state of the science. Support Care Cancer 2024; 32:184. [PMID: 38393418 DOI: 10.1007/s00520-024-08385-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/16/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE This study provides an updated evaluation of the prevalence and severity of acute cancer-related symptoms and quality of life (QOL) concerns among patients treated with emetogenic chemotherapy. METHODS Patients were recruited to a larger, multi-site observational study prior to starting chemotherapy. Participants completed sociodemographic questionnaires and clinical data were abstracted via medical record review. Symptoms and QOL were assessed 5 days after starting moderately or highly emetogenic chemotherapy. Functional Assessment of Cancer Therapy - General assessed QOL concerns. Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events evaluated symptoms. Symptoms were considered severe when participants responded "severe" or "very severe." RESULTS Participants (N = 1174) were on average 58 ± 13 years, mostly female (73%), non-Hispanic (89%), and White (87%). Most participants were diagnosed with breast (38.1%), gynecological (20%), and gastrointestinal (17.1%) cancer. The most common QOL concerns of any severity were fatigue (94%), anhedonia (89%), dissatisfaction with QOL (86%), and sleep disturbance (86%). The most common severe QOL concerns were anhedonia (44%), fatigue (40%), and inability to work (38%). Decreased appetite (74%), pain (71%), and constipation (70%) were the most common symptoms of any severity, as well as most common severe symptoms (13%, 18%, and 18%, respectively). CONCLUSION Herein, updates are provided in regard to QOL concerns and symptoms reported by patients in the days after chemotherapy and demonstrates that concerns and symptoms have shifted in the last decade.
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Affiliation(s)
- Kristen S Smith
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA.
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Taylor Welniak
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Oanh L Nguyen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Sylvia L Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Kristen M Carpenter
- Department of Psychiatry and Behavioral Health, The Ohio State University Medical Center, Columbus, OH, USA
| | - Stacy M Fischer
- Department of General Internal Medicine, University of Colorado Denver, Denver, CO, USA
| | - Daneng Li
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Donna L Berry
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
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Oswald LB, Gudenkauf LM, Li X, De Avila G, Peres LC, Kirtane K, Gonzalez BD, Hoogland AI, Nguyen O, Rodriguez Y, Baz RC, Shain KH, Alsina M, Locke FL, Freeman C, Castaneda Puglianini O, Nishihori T, Liu H, Blue B, Grajales-Cruz A, Jim HSL, Hansen DK. Patient-Reported Outcomes among Multiple Myeloma Patients Treated with Standard of Care Idecabtagene Vicleucel. Cancers (Basel) 2023; 15:4711. [PMID: 37835405 PMCID: PMC10571575 DOI: 10.3390/cancers15194711] [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: 08/26/2023] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
Idecabtagene vicleucel (ide-cel) was the first FDA-approved chimeric antigen receptor T-cell therapy for relapsed/refractory multiple myeloma (RRMM) patients. This was the first study to evaluate patient-reported outcomes (PROs) among RRMM patients receiving ide-cel in standard of care (SOC). We prospectively assessed health-related quality of life (HRQOL) and symptoms from pre-infusion (baseline) through day (D)90 post-infusion. Baseline PRO associations with patient characteristics, mean PRO changes, and time to stable change were evaluated with t-tests, linear mixed-effects models, and Kaplan-Meier analyses, respectively. Within-person change scores and minimally important difference thresholds determined clinical and meaningful significance. Participants (n = 42) were a median of 66 years old (range: 43-81). At baseline, extramedullary disease was associated with worse physical well-being (p = 0.008), global pain (p < 0.001), performance status (p = 0.002), and overall symptom burden (p < 0.001). Fatigue (p < 0.001) and functional well-being (p = 0.003) worsened by D7 before returning to baseline levels. Overall HRQOL (p = 0.008) and physical well-being (p < 0.001) improved by D60. Most participants reported PRO improvement (10-57%) or maintenance (23-69%) by D90. The median time it took to stabile deterioration in functional well-being was 14 days. The median time it took to stabile improvement in physical and emotional well-being was 60 days. Overall, RRMM patients reported improvements or maintenance of HRQOL and symptom burden after SOC ide-cel.
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Affiliation(s)
- Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Gabriel De Avila
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Lauren C. Peres
- Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA;
| | - Kedar Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA;
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Oanh Nguyen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Rachid C. Baz
- Department of Malignant Hematology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (R.C.B.); (K.H.S.); (B.B.); (A.G.-C.)
| | - Kenneth H. Shain
- Department of Malignant Hematology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (R.C.B.); (K.H.S.); (B.B.); (A.G.-C.)
| | - Melissa Alsina
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Frederick L. Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Ciara Freeman
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Omar Castaneda Puglianini
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Hien Liu
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
| | - Brandon Blue
- Department of Malignant Hematology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (R.C.B.); (K.H.S.); (B.B.); (A.G.-C.)
| | - Ariel Grajales-Cruz
- Department of Malignant Hematology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (R.C.B.); (K.H.S.); (B.B.); (A.G.-C.)
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (L.M.G.); (X.L.); (B.D.G.); (A.I.H.); (O.N.); (Y.R.); (H.S.L.J.)
| | - Doris K. Hansen
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, 12902 USF Magnolia Dr., Tampa, FL 33216, USA; (G.D.A.); (M.A.); (F.L.L.); (C.F.); (O.C.P.); (T.N.); (H.L.); (D.K.H.)
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Tometich DB, Hoogland AI, Small BJ, Janelsins MC, Bryant C, Rodriguez Y, Gonzalez BD, Li X, Bulls HW, James BW, Arboleda B, Colon-Echevarria C, Townsend MK, Tworoger SS, Rodriguez P, Oswald LB, Bower JE, Apte SM, Wenham RM, Chon HS, Shahzad MM, Jim HSL. Relationships among Inflammatory Biomarkers and Objectively Assessed Physical Activity and Sleep during and after Chemotherapy for Gynecologic Malignancies. Cancers (Basel) 2023; 15:3882. [PMID: 37568698 PMCID: PMC10416903 DOI: 10.3390/cancers15153882] [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: 05/31/2023] [Revised: 06/28/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
Little is known regarding associations between inflammatory biomarkers and objectively measured physical activity and sleep during and after chemotherapy for gynecologic cancer; thus, we conducted a longitudinal study to address this gap. Women with gynecologic cancer (patients) and non-cancer controls (controls) completed assessments before chemotherapy cycles 1, 3, and 6 (controls assessed contemporaneously), as well as at 6- and 12-month follow-ups. Physical activity and sleep were measured using wrist-worn actigraphs and sleep diaries, and blood was drawn to quantify circulating levels of inflammatory markers. Linear and quadratic random-effects mixed models and random-effects fluctuation mixed models were used to examine physical activity and sleep over time, as well as the associations with inflammatory biomarkers. On average, patients (n = 97) and controls (n = 104) were 62 and 58 years old, respectively. Compared to controls, patients were less active, more sedentary, had more time awake after sleep onset, and had lower sleep efficiency (p-values < 0.05). Across groups, higher levels of TNF-α were associated with more sedentary time and less efficient sleep (p-values ≤ 0.05). Higher levels of IL-1β, TNF-α, and IL-6 were associated with lower levels of light physical activity (p-values < 0.05). Associations between inflammatory biomarkers, physical activity, and sleep did not differ between patients and controls. Given these results, we speculate that inflammation may contribute to less physical activity and more sleep problems that persist even 12 months after completing chemotherapy.
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Affiliation(s)
- Danielle B. Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, FL 33620, USA
| | - Michelle C. Janelsins
- Department of Surgery and Neuroscience, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Crystal Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Hailey W. Bulls
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Brian W. James
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
| | - Bianca Arboleda
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
| | | | - Mary K. Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Paulo Rodriguez
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Julienne E. Bower
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Sachin M. Apte
- Huntsman Cancer Institute, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT 84112, USA
| | - Robert M. Wenham
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Hye Sook Chon
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Mian M. Shahzad
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
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Hoogland AI, Small BJ, Oswald LB, Bryant C, Rodriguez Y, Gonzalez BD, Li X, Janelsins MC, Bulls HW, James BW, Arboleda B, Colon-Echevarria C, Townsend MK, Tworoger SS, Rodriguez PC, Bower JE, Apte SM, Wenham RM, Jim HSL. Relationships among Inflammatory Biomarkers and Self-Reported Treatment-Related Symptoms in Patients Treated with Chemotherapy for Gynecologic Cancer: A Controlled Comparison. Cancers (Basel) 2023; 15:3407. [PMID: 37444517 DOI: 10.3390/cancers15133407] [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: 05/15/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Previous research suggests that inflammation triggers cancer-treatment-related symptoms (i.e., fatigue, depression, and disruptions in sleep and physical activity), but evidence is mixed. This study examined relationships between inflammatory biomarkers and symptoms in patients with gynecologic cancer compared to age-matched women with no cancer history (i.e., controls). Patients (n = 121) completed assessments before chemotherapy cycles 1, 3, and 6, and 6 and 12 months later. Controls (n = 105) completed assessments at similar timepoints. Changes in inflammation and symptomatology were evaluated using random-effects mixed models, and cross-sectional differences between patients and controls in inflammatory biomarkers and symptoms were evaluated using least squares means. Associations among inflammatory biomarkers and symptoms were evaluated using random-effects fluctuation mixed models. The results indicated that compared to controls, patients typically have higher inflammatory biomarkers (i.e., TNF-alpha, TNFR1, TNFR2, CRP, IL-1ra) and worse fatigue, depression, and sleep (ps < 0.05). Patients reported lower levels of baseline physical activity (p = 0.02) that became more similar to controls over time. Significant associations were observed between CRP, depression, and physical activity (ps < 0.05), but not between inflammation and other symptoms. The results suggest that inflammation may not play a significant role in fatigue or sleep disturbance among gynecologic cancer patients but may contribute to depression and physical inactivity.
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Affiliation(s)
- Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL 33612, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Crystal Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Michelle C Janelsins
- Department of Surgery and Neuroscience, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Hailey W Bulls
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Brian W James
- Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA
| | - Bianca Arboleda
- Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA
| | | | - Mary K Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Paulo C Rodriguez
- Department of Immunology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Julienne E Bower
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Sachin M Apte
- Department of Obstetrics and Gynecology, Huntsman Cancer Institute, Salt Lake City, UT 84132, USA
| | - Robert M Wenham
- Department of Gynecologic Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
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8
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Kirtane K, Hoogland AI, Li X, Rodriguez Y, Scheel K, Small BJ, Oswald LB, Muzaffar J, Kish JA, Bonomi M, Bhateja P, Saba NF, Steuer CE, Chung CH, Jim HSL. Patient-reported outcomes in immunotherapy for head and neck cancer. Head Neck 2023. [PMID: 37141438 DOI: 10.1002/hed.27388] [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: 08/12/2022] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Data about patient-reported outcomes (PROs) among patients with head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoint inhibitors are sparse. Our exploratory study evaluated PROs in patients with HNSCC starting treatment with immune checkpoint inhibitor monotherapy or combination therapy with cetuximab. METHODS Patients were recruited prior to receipt of their first checkpoint inhibitor therapy infusion. Participants completed measures of checkpoint inhibitor toxicities and quality of life (QOL) at on-treatment clinic visits. RESULTS Among patients treated with checkpoint inhibitor monotherapy (n = 48) or combination therapy (n = 38) toxicity increased over time (p < 0.05), while overall QOL improved from baseline to 12 weeks, with stable or declining QOL thereafter (p < 0.05). There were no group differences in change in toxicity index or QOL. Toxicity index scores were significantly higher in the combination group at 18-20 weeks and 6 months post-initiation of immune checkpoint inhibitor (p < 0.05). There were no significant group differences at baseline, the 6-8 week (p = 0.13) or 3-month (p = 0.09) evaluations. The combination group reported better emotional well-being at baseline than the monotherapy group (p = 0.04), There were no other group differences QOL at baseline or later timepoints. CONCLUSIONS Despite increasing patient-reported toxicity, checkpoint inhibitor monotherapy and combination therapy were associated with similar transient improvements, then worsening, of QOL in patients with HNSCC.
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Affiliation(s)
- Kedar Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Kelsey Scheel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jameel Muzaffar
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Julie A Kish
- Department of Personalized Medicine, Moffitt Cancer Center, Tampa, Florida, USA
| | - Marcelo Bonomi
- Department of Internal Medicine and The James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Priyanka Bhateja
- Department of Internal Medicine and The James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Conor E Steuer
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Christine H Chung
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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9
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Crowder SL, Welniak TL, Hoogland AI, Small BJ, Rodriguez Y, Carpenter KM, Fischer SM, Li D, Kinney AY, Rotroff D, Mariam A, Brownstein N, Reich RR, Hembree T, Playdon MC, Arthur AE, Vieytes CAM, Li Z, Extermann M, Kim R, Berry DL, Jim HSL. Diet quality indices and changes in cognition during chemotherapy. Support Care Cancer 2022; 31:75. [PMID: 36544032 PMCID: PMC10127432 DOI: 10.1007/s00520-022-07513-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE No evidence-based prevention strategies currently exist for cancer-related cognitive decline (CRCD). Although patients are often advised to engage in healthy lifestyle activities (e.g., nutritious diet), little is known about the impact of diet on preventing CRCD. This secondary analysis evaluated the association of pre-treatment diet quality indices on change in self-reported cognition during chemotherapy. METHODS Study participants (n = 96) completed the Block Brief Food Frequency Questionnaire (FFQ) before receiving their first infusion and the PROMIS cognitive function and cognitive abilities questionnaires before infusion and again 5 days later (i.e., when symptoms were expected to be their worst). Diet quality indices included the Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet (aMED), and a low carbohydrate diet index and their components. Descriptive statistics were generated for demographic and clinical variables and diet indices. Residualized change models were computed to examine whether diet was associated with change in cognitive function and cognitive abilities, controlling for age, sex, cancer type, treatment type, depression, and fatigue. RESULTS Study participants had a mean age of 59 ± 10.8 years and 69% were female. Although total diet index scores did not predict change in cognitive function or cognitive abilities, higher pre-treatment ratio of aMED monounsaturated/saturated fat was associated with less decline in cognitive function and cognitive abilities at 5-day post-infusion (P ≤ .001). CONCLUSIONS Higher pre-treatment ratio of monounsaturated/saturated fat intake was associated with less CRCD early in chemotherapy. Results suggest greater monounsaturated fat and less saturated fat intake could be protective against CRCD during chemotherapy.
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Affiliation(s)
- Sylvia L Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Taylor L Welniak
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Stacy M Fischer
- Department of General Internal Medicine, University of Colorado Denver, Denver, CO, USA
| | - Daneng Li
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Daniel Rotroff
- Department of Quantitative Health Sciences, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, OH, USA
| | - Arshiya Mariam
- Department of Quantitative Health Sciences, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA
| | - Naomi Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Richard R Reich
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Tim Hembree
- Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL, USA
| | - Mary C Playdon
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Anna E Arthur
- Department of Dietetics and Nutrition, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Christian AMaino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Zonggui Li
- Department of Psychology and Neuroscience, Boston College, Newtown, MA, USA
| | - Martine Extermann
- Department of Senior Adult Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Richard Kim
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Donna L Berry
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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10
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Oswald LB, Lyleroehr M, Gudenkauf LM, Armstrong GE, Tometich DB, Sanford SD, Loecher N, Geiss C, Rodriguez Y, Scheel KL, Nieves-Lopez A, Jim HSL, Gonzalez BD, Antoni MH, Penedo FJ, Reed D, Katsanis E, Salsman JM, Victorson D, Fox RS. Development and initial testing of TOGETHER-YA: an eHealth-delivered and group-based psychosocial intervention for young adult cancer survivors. Support Care Cancer 2022; 30:10067-10076. [PMID: 36229547 PMCID: PMC9722531 DOI: 10.1007/s00520-022-07382-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/01/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aimed to (1) develop TOGETHER-YA, an e-Health-delivered and group-based health-related quality of life (HRQOL) intervention for young adult (YA) cancer survivors aged 18-39 (Part 1), and (2) determine its initial feasibility and acceptability in a single-arm pilot trial (Part 2). METHODS TOGETHER-YA is a manualized, 10-week intervention for YA survivors that includes elements of relaxation training, cognitive-behavioral therapy, and health education. In Part 1, content was adapted from existing evidence-based interventions with feedback from YAs (N = 22) in four iterative focus groups. In Part 2, YA survivors (N = 11) participated in a single-arm pilot trial of TOGETHER-YA. Intervention groups were led by a trained facilitator over videoconference. Primary outcomes were feasibility (i.e., recruitment, session attendance, retention) and acceptability (i.e., participant satisfaction). RESULTS Focus groups reacted positively to TOGETHER-YA and provided actionable recommendations for enhancing its relevance and acceptability, which were implemented. In initial testing, all feasibility and acceptability benchmarks were met; 58% of eligible YAs were recruited, participants attended M = 6 intervention sessions (SD = 3), and 82% of participants were retained post-intervention. On average, participants "agreed" to "strongly agreed" with positive statements about the weekly sessions and the overall program. CONCLUSION TOGETHER-YA was developed in collaboration with YA cancer survivors and found to be feasible and acceptable in initial testing. TOGETHER-YA is the first HRQOL intervention for a broad range of YA survivors that is eHealth-delivered for convenience and group-based for peer support. Future large-scale trials should test its efficacy for improving HRQOL. TRIAL REGISTRATION NCT05048316, September 17, 2021; NCT05054569, September 23, 2021.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA.
| | - Madison Lyleroehr
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Grace E Armstrong
- Department of Counseling, The Family Institute of Northwestern University, Evanston, IL, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Nele Loecher
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Kelsey L Scheel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Amarilis Nieves-Lopez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Damon Reed
- Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- University of Arizona College of Nursing, Tucson, AZ, USA
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11
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Barata A, Hoogland AI, Small BJ, Acevedo KI, Antoni MH, Gonzalez BD, Jacobsen PB, Lechner SC, Tyson DM, Meade CD, Rodriguez Y, Salsman JM, Sherman AC, Sutton SK, Jim HSL. Spiritual well-being, distress and quality of life in Hispanic women diagnosed with cancer undergoing treatment with chemotherapy. Psychooncology 2022; 31:1933-1940. [PMID: 36121699 PMCID: PMC10115137 DOI: 10.1002/pon.6038] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/21/2022] [Accepted: 07/12/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Previous studies have examined whether spiritual well-being is associated with cancer outcomes, but minority populations are under-represented. This study examines associations of baseline spiritual well-being and change in spiritual well-being with change in distress and quality of life, and explores potential factors associated with changes in spiritual well-being among Hispanic women undergoing chemotherapy. METHODS Participants completed measures examining spiritual well-being, distress, and quality of life prior to beginning chemotherapy and at weeks 7 and 13. Participants' acculturation and sociodemographic data were collected prior to treatment. Mixed models were used to examine the association of baseline spiritual well-being and change in spiritual well-being during treatment with change in distress and quality of life, and to explore whether sociodemographic factors, acculturation and clinical variables were associated with change in spiritual well-being. RESULTS A total of 242 participants provided data. Greater baseline spiritual well-being was associated with less concurrent distress and better quality of life (p < 0.001), as well as with greater emotional and functional well-being over time (p values < 0.01). Increases in spiritual well-being were associated with improved social well-being during treatment, whereas decreases in spiritual well-being were associated with worsened social well-being (p < 0.01). Married participants reported greater spiritual well-being at baseline relative to non-married participants (p < 0.001). CONCLUSIONS Greater spiritual well-being is associated with less concurrent distress and better quality of life, as well as with greater emotional, functional, and social well-being over time among Hispanic women undergoing chemotherapy. Future work could include developing culturally targeted spiritual interventions to improve survivors' well-being.
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Affiliation(s)
- Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | | | - Michael H. Antoni
- Department of Psychology, Sylvester Comprehensive Cancer Center, University of Miami, and Cancer Control Program, Miami, Florida, USA
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Paul B. Jacobsen
- Healthcare Delivery Research Program, National Cancer Institute, Bethesda, Maryland, USA
| | - Suzanne C. Lechner
- Department of Psychology, Sylvester Comprehensive Cancer Center, University of Miami, and Cancer Control Program, Miami, Florida, USA
| | | | - Cathy D. Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - John M. Salsman
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | - Allen C. Sherman
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Steven K. Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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12
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Oswald LB, Li X, Carvajal R, Hoogland AI, Gudenkauf LM, Hansen DK, Alsina M, Locke FL, Rodriguez Y, Irizarry-Arroyo N, Robinson EJ, Jim HSL, Gonzalez BD, Kirtane K. Longitudinal Collection of Patient-Reported Outcomes and Activity Data during CAR-T Therapy: Feasibility, Acceptability, and Data Visualization. Cancers (Basel) 2022; 14:cancers14112742. [PMID: 35681722 PMCID: PMC9179384 DOI: 10.3390/cancers14112742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Clinicians must closely monitor patients for toxicities after chimeric antigen receptor T-cell therapy (CAR-T). Patient-reported outcomes (PROs) (e.g., toxicities, quality of life) and activity data (e.g., steps, sleep) may complement clinicians’ observations. This study tested the feasibility and acceptability of collecting PROs and activity data from patients with hematologic malignancies during CAR-T and explored preliminary data patterns. Methods: Participants wore a Fitbit tracker and completed PROs at several timepoints through 90-days post-infusion. Feasibility was assessed with a priori benchmarks for recruitment (≥50%), retention (≥70%), PRO completion (≥70%), and days wearing the Fitbit (≥50%). Acceptability was assessed with participant satisfaction (a priori benchmark > 2 on a 0−4 scale). Results: Participants (N = 12) were M = 66 years old (SD = 7). Rates of recruitment (68%), retention (83%), PRO completion (85%), and days wearing the Fitbit (85%) indicated feasibility. Satisfaction with completing the PROs (M = 3.2, SD = 0.5) and wearing the Fitbit (M = 2.9, SD = 0.5) indicated acceptability. Preliminary data patterns suggested that participants with better treatment response (vs. progressive disease) had a higher toxicity burden. Conclusions: Longitudinal PRO and activity data collection was feasible and acceptable. Data collected on a larger scale may be used to specify risk prediction models to identify predictors of severe CAR-T-related toxicities and inform early interventions.
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Affiliation(s)
- Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
- Correspondence:
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | - Rodrigo Carvajal
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | - Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | - Doris K. Hansen
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL 33612, USA; (D.K.H.); (M.A.); (F.L.L.)
| | - Melissa Alsina
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL 33612, USA; (D.K.H.); (M.A.); (F.L.L.)
| | - Frederick L. Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL 33612, USA; (D.K.H.); (M.A.); (F.L.L.)
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | - Nathaly Irizarry-Arroyo
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | | | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 USF Magnolia Dive, MFC-HOB, Tampa, FL 33612, USA; (X.L.); (A.I.H.); (L.M.G.); (Y.R.); (N.I.-A.); (H.S.L.J.); (B.D.G.)
| | - Kedar Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA;
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13
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Kirtane K, Muzaffar J, Kish J, Oswald LB, Gonzalez BD, Welniak T, Rodriguez Y, Chung CH. YIA22-004: The Feasibility of a Digitized Peer-To-Peer Patient Support System for Patients With Locally Advanced Head and Neck Cancer Undergoing Chemoradiation. J Natl Compr Canc Netw 2022. [DOI: 10.6004/jnccn.2021.7152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Barata A, Hoogland AI, Hyland KA, Otto AK, Kommalapati A, Jayani RV, Irizarry-Arroyo N, Collier A, Rodriguez Y, Welniak TL, Booth-Jones M, Logue J, Small BJ, Jain MD, Reblin M, Locke FL, Jim HSL. Quality of life in caregivers of patients receiving chimeric antigen receptor T-cell therapy. Psychooncology 2021; 30:1294-1301. [PMID: 33739548 PMCID: PMC9828891 DOI: 10.1002/pon.5674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/06/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Informal family caregivers provide critical support for patients receiving chimeric antigen receptor (CAR) T-cell therapy. However, caregivers' experiences are largely unstudied. This study examined quality of life (QOL; physical functioning, pain, fatigue, anxiety, and depression), caregiving burden, and treatment-related distress in caregivers in the first 6 months after CAR T-cell therapy, when caregivers were expected to be most involved in providing care. Relationships between patients' clinical course and caregiver outcomes were also explored. METHODS Caregivers completed measures examining QOL and burden before patients' CAR T-cell therapy and at days 90 and 180. Treatment-related distress was assessed at days 90 and 180. Patients' clinical variables were extracted from medical charts. Change in outcomes was assessed using means and 99% confidence intervals. Association of change in outcomes with patient clinical variables was assessed with backward elimination analysis. RESULTS A total of 99 caregivers (mean age 59, 73% female) provided data. Regarding QOL, pain was significantly higher than population norms at baseline but improved by day 180 (p < .01). Conversely, anxiety worsened over time (p < .01). Caregiver burden and treatment-related distress did not change over time. Worsening caregiver depression by day 180 was associated with lower patient baseline performance status (p < .01). Worse caregiver treatment-related distress at day 180 was associated with lower performance status, intensive care unit admission, and lack of disease response at day 90 (ps < 0.01). CONCLUSIONS Some CAR T-cell therapy caregivers experience pain, anxiety, and burden, which may be associated patients' health status. Further research is warranted regarding the experience of CAR T-cell therapy caregivers.
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Affiliation(s)
- Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Kelly A. Hyland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA,Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Amy K. Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Anuhya Kommalapati
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Reena V. Jayani
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Aaron Collier
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Taylor L. Welniak
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Margaret Booth-Jones
- Department of Supportive Care Medicine, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jennifer Logue
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Michael D. Jain
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Frederick L. Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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Barata A, Hoogland AI, Hyland K, Kommalapati A, Irizarry-Arroyo N, Rodriguez Y, Booth-Jones M, Jain MD, Locke FL, Jim HS. Patient-Reported Toxicities in Axicabtagene Ciloleucel Recipients: 1-Year Follow-up. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00485-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Hoogland AI, Jayani RV, Collier A, Irizarry-Arroyo N, Rodriguez Y, Jain MD, Booth-Jones M, Hyland KA, James BW, Barata A, Bachmeier CA, Chavez JC, Khimani F, Krivenko GS, Lazaryan A, Liu HD, Nishihori T, Pinilla-Ibarz J, Shah BD, Abidi M, Locke FL, Jim HSL. Acute patient-reported outcomes in B-cell malignancies treated with axicabtagene ciloleucel. Cancer Med 2021; 10:1936-1943. [PMID: 33641257 PMCID: PMC7957158 DOI: 10.1002/cam4.3664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/27/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022] Open
Abstract
Chimeric antigen receptor T‐cell therapy with axicabtagene ciloleucel (axi‐cel) has considerably improved survival in adults with relapsed/refractory large B‐cell lymphoma. This study reports patient‐reported outcomes (PROs) such as quality of life (QOL) and toxicity in the first 90 days after treatment. Hematologic cancer patients treated with axi‐cel (N = 103, mean age = 61, 39% female) completed SF‐36 or PROMIS‐29 QOL questionnaires prior to treatment and 90 days after. PRO‐Common Terminology Criteria for Adverse Events toxicity items were completed by patients at baseline and 14, 30, 60, and 90 days after treatment. Mixed models examined change in PROs over time. From preinfusion to 90 days later, patients reported improvements in physical functioning, pain, and fatigue (ps < 0.01), but worsening of anxiety (p = 0.02). Patient‐reported toxicities worsened by day 14 with improvement thereafter. The five most severe symptoms at day 14 included fatigue, decreased appetite, dry mouth, diarrhea frequency, and problems with concentration. Results indicate improvement in some domains of QOL over time with transient patient‐reported toxicities.
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Affiliation(s)
- Aasha I Hoogland
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Reena V Jayani
- Vanderbilt University Medical Center, Department of Medicine, Division of Hematology/Oncology, Nashville, TN, USA
| | - Aaron Collier
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | | | - Yvelise Rodriguez
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Michael D Jain
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | | | - Kelly A Hyland
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Brian W James
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Anna Barata
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Christina A Bachmeier
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | - Julio C Chavez
- Moffitt Cancer Center, Department of Malignant Hematology, Tampa, FL, USA
| | - Farhad Khimani
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | - Gabriel S Krivenko
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | - Aleksandr Lazaryan
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | - Hien D Liu
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | - Taiga Nishihori
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | | | - Bijal D Shah
- Moffitt Cancer Center, Department of Malignant Hematology, Tampa, FL, USA
| | - Muneer Abidi
- Spectrum Health Cancer Center, Michigan State University, Grand Rapids, MI, USA
| | - Frederick L Locke
- Moffitt Cancer Center, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Tampa, FL, USA
| | - Heather S L Jim
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
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Wein N, Simmons T, Rajakumar D, Lesman D, Li D, Gaffney C, Rafferty R, Huang N, Rodriguez Y, Young C, Spencer M, Flanigan K. DMD – ANIMAL MODELS & PRECLINICAL TREATMENT. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Gerona-Navarro G, Zhang G, Barragan F, Elie B, Wilson K, Herskovits A, Rodriguez Y, Cornejo M. An allosteric modulator of PRC2 methyltransferase activity inhibits renal cancer cell proliferation. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31127-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Vatapalli R, Sagar V, Rodriguez Y, Zhao JC, Unno K, Pamarthy S, Lysy B, Anker J, Han H, Yoo YA, Truica M, Chalmers ZR, Giles F, Yu J, Chakravarti D, Carneiro B, Abdulkadir SA. Histone methyltransferase DOT1L coordinates AR and MYC stability in prostate cancer. Nat Commun 2020; 11:4153. [PMID: 32814769 PMCID: PMC7438336 DOI: 10.1038/s41467-020-18013-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 07/20/2020] [Indexed: 12/19/2022] Open
Abstract
The histone methyltransferase DOT1L methylates lysine 79 (K79) on histone H3 and is involved in Mixed Lineage Leukemia (MLL) fusion leukemogenesis; however, its role in prostate cancer (PCa) is undefined. Here we show that DOT1L is overexpressed in PCa and is associated with poor outcome. Genetic and chemical inhibition of DOT1L selectively impaired the viability of androgen receptor (AR)-positive PCa cells and organoids, including castration-resistant and enzalutamide-resistant cells. The sensitivity of AR-positive cells is due to a distal K79 methylation-marked enhancer in the MYC gene bound by AR and DOT1L not present in AR-negative cells. DOT1L inhibition leads to reduced MYC expression and upregulation of MYC-regulated E3 ubiquitin ligases HECTD4 and MYCBP2, which promote AR and MYC degradation. This leads to further repression of MYC in a negative feed forward manner. Thus DOT1L selectively regulates the tumorigenicity of AR-positive prostate cancer cells and is a promising therapeutic target for PCa. Histone methyltransferase, DOTL1 is implicated in the pathogenesis of MLL-rearranged leukemia, however, not much is known of its role in prostate cancer (PCa). Here, the authors report that DOTL1 inhibition suppresses both androgen receptor and MYC pathways in a negative feed forward manner to reduce growth of AR-positive PCa.
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Affiliation(s)
- R Vatapalli
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - V Sagar
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Y Rodriguez
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - J C Zhao
- Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - K Unno
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Pamarthy
- Atrin Pharmaceuticals, Pennsylvania Biotechnology Center, Doylestown, PA, USA
| | - B Lysy
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - J Anker
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - H Han
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Y A Yoo
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Truica
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Z R Chalmers
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - F Giles
- Developmental Therapeutics Consortium, Chicago, IL, USA
| | - J Yu
- Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D Chakravarti
- Division of Reproductive Science in Medicine, Department of OB/GYN, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - B Carneiro
- Lifespan Cancer Institute, Division of Hematology/Oncology, Alpert Medical School, Brown University, Providence, RI, USA
| | - S A Abdulkadir
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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20
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Barata A, Hoogland A, Hyland K, Kommalapati A, Jayani R, Irizarry-Arroyo NE, Rodriguez Y, Alla R, James B, Lafranchise E, Jain MD, Locke FL, Jim HS. Subjective cognition in chimeric antigen receptor T-cell therapy recipients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.7020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7020 Background: Chimeric antigen receptor T-cell (CAR-T) therapy can lead to durable responses in chemorefractory patients with hematologic malignancies. CAR-T, however, can be associated with neurotoxicity. There is a significant body of literature describing patient-reported concerns with cognition in hematopoietic cell transplant (HCT) recipients, a similar treatment group. However, little is known about subjective cognition in CAR-T patients. This study examined changes in subjective cognition over time in CAR-T recipients and compared their outcomes with allogeneic HCT recipients. Methods: At baseline and 90 days after infusion, participants completed the Everyday Cognition Questionnaire (ECog). The ECog provides scores for total cognition, memory, language, visuospatial abilities, planning, organization, divided attention, and satisfaction with cognition. Comparison data from allogeneic HCT recipients came from a previous observational study. Linear mixed models compared changes in subjective cognition between recipients of CAR-T and allogeneic HCT over time. Models were adjusted by age, marital status, education, and Karnofsky performance status. Results: Participants were 111 CAR-T recipients (mean age 60 years, 37% female) and 190 allogeneic HCT recipients (mean age 53, 42% female). Linear mixed models indicated CAR-T recipients’ subjective cognition didn’t change within the 90 days after infusion (p’s > .05). At baseline, there were no group differences between CAR-T and allogeneic HCT recipients in subjective cognition (p’s > 0.05). Over time, however, subjective cognition between groups differed. Specifically, CAR-T recipients reported stable subjective cognition whereas allogeneic HCT recipients reported worsening total subjective cognition (p = 0.04), memory (p = 0.02), visuospatial abilities (p = 0.01), planning (p = 0.01), and divided attention (p = 0.01). At follow-up, CAR-T recipients reported better total subjective cognition (p < 0.01), memory (p < 0.01), language (p = 0.01), visuospatial abilities (p < 0.01), planning (p < 0.01), and divided attention (p < 0.01) than allogeneic HCT recipients. Conclusions: Despite the neurotoxicity associated with CAR-T, patients can expect to perceive similar subjective cognition at day 90 compared to baseline. Future studies should also evaluate objective cognition in CAR-T recipients.
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Affiliation(s)
- Anna Barata
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Aasha Hoogland
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Kelly Hyland
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | | | | | | | | | | | | | - Michael D. Jain
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
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Norris K, Harford R, Flaque J, Rodriguez Y, Harford M. SUN-192 MISSED HEMODIALYSIS TREATMENTS AND MORTALITY IN PUERTO RICO BEFORE AND AFTER THE 2017 HURRICANES: A MEDIUM DIALYSIS ORGANIZATION EXPERIENCE. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Cantor E, Segovia J, Niño C, Rodriguez Y, Valencia O. PCN62 PRELIMIANARY ANALYSIS OF TIROSINE KINASE INHIBITOR THERAPY IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA A FIVE YEARS FOLLOW-UP FROM A REAL WORLD COHORT. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Hoogland AI, Lechner SC, Gonzalez BD, Small BJ, Tyson DM, Asvat Y, Barata A, Gomez MF, Rodriguez Y, Jim HSL, Antoni MH, Jacobsen PB, Meade CD. Efficacy of a Spanish-Language Self-Administered Stress Management Training intervention for Latinas undergoing chemotherapy. Psychooncology 2018; 27:1305-1311. [PMID: 29462503 DOI: 10.1002/pon.4673] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cancer patients often report increased stress during chemotherapy. Stress management training has been shown to reduce this adverse outcome, but few interventions exist for Spanish-speaking Hispanic and Latina women (Latinas). METHODS Following community feedback (including focus groups/in-depth interviews), we transcreated the Spanish-Language Self-Administered Stress Management Training (SL-SAT) intervention based on our previously developed and implemented English-based intervention. Latinas about to begin chemotherapy were randomized to SL-SAT (n = 121) or usual care (n = 119). A Spanish-speaking interventionist met with SL-SAT participants who received the SL-SAT toolkit containing instructions in 3 well-established stress management techniques (deep breathing, progressive muscle relaxation and guided imagery, and use of coping self-statements). Usual care participants received an educational booklet about coping with chemotherapy. All patients were instructed by nurses on their chemotherapy medications and given a resource listing of local support groups. Outcomes were obtained at baseline, and 7 and 13 weeks after starting chemotherapy. Primary outcomes included anxiety and depression, cancer-related distress, emotional well-being, and spiritual well-being. Secondary outcomes included functional well-being, social/family well-being, physical well-being, symptom severity, and self-efficacy for managing stress. Data were analyzed by using mixed models. RESULTS In both groups, improvements were observed in emotional well-being (P = .01), and declines were observed in functional well-being (P = .05), and physical well-being (P < .0001). Symptom severity increased across the follow-up period (P < .001). CONCLUSIONS To be effective, stress management interventions for Latinas receiving chemotherapy may necessitate more attention from an interventionist, delivery of the intervention over a longer interval, and/or a group-based format.
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Affiliation(s)
- Aasha I Hoogland
- Moffitt Cancer Center, Tampa, FL, USA.,University of South Florida, Tampa, FL, USA
| | | | | | | | | | | | - Anna Barata
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | | | - Paul B Jacobsen
- Healthcare Delivery Research Program, National Cancer Institute, Bethesda, MD, USA
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Rodriguez Y, Heilos D, Sulyok M, Berger W, Fleiss RD, Berrada H. Enniatin B and beauvericin distribution and persistence in mice after intraperitoneal administration. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morlett Paredes A, Rivera D, Olivera S, Galarza J, Rabago B, Rodriguez Y, Longoni M, Schebela S, Bringas M, Arango Lasprilla J. C-92Effects of Age and Education on the Performance of Neuropsychological Tests in Individuals from Latin America. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Cano J, Rueda D, Garcia J, Inglada L, Osorio I, Arriba M, Perez J, Rodriguez Y, Gaspar M, Gonzalez-Sarmiento R, Urioste M, Perea J. 2177 Morphological, clinical and molecular comparative study of colorectal cancer based on age of onset and tumor location: Contribution to molecular classification. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Arango-Lasprilla J, Rivera D, De Los Reyes C, Olivera S, Longoni M, Ocampo N, Rodriguez W, Rodriguez Y, Galarza J, Aliaga Á, Perrin P. DIVERSITYC-11Hopkins Verbal Learning Test–Revised: Normative Data for an Illiterate Adult Population from 6 Latin American Countries. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Rivera D, Guardia J, Perrin P, Rodriguez Y, Rodriguez W, Bringas M, Ocampo N, Esenarro L, Arango-Lasprilla J. A-39 * A Normative Study of the Symbol Digit Modalities Test across Latin American Countries. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Calvo I, Marvillet I, Lόpez B, Marco A, Rodriguez Y, Bou R, Ricart S, Calzada J, Torrent V, Antόn J. AB1158 Efficacy and security of anakinra treatment in patients with systemic-onset juvenil idiopathic arthritis: “Initial results from a register of two pediatric reumatologic units from spain”:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Calvo I, Lopez B, Marco A, Henriquez S, Rodriguez Y, Aviño J, Martinez R, Harto M. AB1157 Biological therapy in patients with chronic juvenile idiopathic arthritis-associated uveitis: Results of follow-up in a multidisciplinary unit:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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31
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Courtney A, Rodriguez Y, Abraham T, Conger A, Conger D, Greenberg B, Remington G, Frohman E. A Large Tertiary Care Multiple Sclerosis Center Experience with Oral Fingolimod (FTY 720) (P04.146). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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32
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Turrini F, Gallina L, Rodriguez Y, Alfonso P, Scagliarini A. Contagious ecthyma in Cuba: Evidence for a unique causative viral strain. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.08.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Salazar C, Garcia L, Rodriguez Y, Garcia J, Quintana R, Rieumont J, Nieto-Villar J. Theoretical Models of Chronotherapy: I. Periodic Perturbations in Oscillating Chemical Reactions. BIOL RHYTHM RES 2010. [DOI: 10.1076/brhm.34.3.241.18813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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34
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Carbonell JL, Velazco A, Rodriguez Y, Tanda R, Sánchez C, Barambio S, Valera L, Chami S, Valero F, Aragón S, Marí J. Oral versus vaginal misoprostol for cervical priming in first-trimester abortion: a randomized trial. EUR J CONTRACEP REPR 2009. [DOI: 10.1080/ejc.6.3.134.140] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Toro-Nieves DM, Rodriguez Y, Plaud M, Ciborowski P, Duan F, Pérez Laspiur J, Wojna V, Meléndez LM. Proteomic analyses of monocyte-derived macrophages infected with human immunodeficiency virus type 1 primary isolates from Hispanic women with and without cognitive impairment. J Neurovirol 2008; 15:36-50. [PMID: 19115125 DOI: 10.1080/13550280802385505] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The signature for human immunodeficiency virus type 1 (HIV-1) neurovirulence remains a subject of intense debate. Macrophage viral tropism is one prerequisite but others, including virus-induced alterations in innate and adaptive immunity, remain under investigation. HIV-1-infected mononuclear phagocytes (MPs; perivascular macrophages and microglia) secrete toxins that affect neurons. The authors hypothesize that neurovirulent HIV-1 variants affect the MP proteome by inducing a signature of neurotoxic proteins and thus affect cognitive function. To test this hypothesis, HIV-1 isolates obtained from peripheral blood of women with normal cognition (NC) were compared to isolates obtained from women with cognitive impairment (CI) and to the laboratory adapted SF162, a spinal fluid R5 isolate from a patient with HIV-1-associated dementia. HIV-1 isolates were used to infect monocyte-derived macrophages (MDMs) and infection monitored by secreted HIV-1 p24 by enzyme-linked immunosorbent assay (ELISA). Cell lysates of uninfected and HIV-1-infected MDMs at 14 days post infection were fractionated by cationic exchange chromatography and analyzed by surface enhanced laser desorption ionization time of flight (SELDI-TOF) using generalized estimating equations statistics. Proteins were separated by one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (1D SDS-PAGE) and identified by tandem mass spectrometry. Levels of viral replication were similar amongst the HIV-1 isolates, although higher levels were obtained from one viral strain obtained from a patient with CI. Significant differences were found in protein profiles between virus-infected MDMs with NC, CI, and SF162 isolates (adjusted P value after multiple testing corrections, or q value <.10). The authors identified 6 unique proteins in NC, 7 in SF162, and 20 in CI. Three proteins were common to SF162 and CI strains. The MDM proteins linked to infection with CI strains were related to apoptosis, chemotaxis, inflammation, and redox metabolism. These findings support the hypothesis that the macrophage proteome differ when infected with viral isolates of women with and without CI.
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Affiliation(s)
- D M Toro-Nieves
- Department of Microbiology and Medical Zoology, Specialized Neurosciences Research Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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Ringman JM, Diaz-Olavarrieta C, Rodriguez Y, Chavez M, Fairbanks L, Paz F, Varpetian A, Maldonado HC, Macias-Islas MA, Murrell J, Ghetti B, Kawas C. Neuropsychological function in nondemented carriers of presenilin-1 mutations. Neurology 2006; 65:552-8. [PMID: 16116115 PMCID: PMC3373251 DOI: 10.1212/01.wnl.0000172919.50001.d6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prospective and case-control studies have demonstrated that memory loss and executive dysfunction occur early in Alzheimer disease (AD). OBJECTIVE To investigate these observations by the study of persons at risk for autosomal dominant forms of AD. METHODS Neuropsychological and genetic tests were performed on 51 nondemented at-risk members of 10 Mexican families with two distinct presenilin-1 (PS1) mutations. Test scores were compared between PS1 mutation carriers (MCs; n = 30) and noncarriers (NCs; n = 21) by analyses of variance, co-varying for family and specific mutation. Regression analyses were performed, taking into account age relative to the median age at dementia diagnosis in the family (adjusted age), gender, Beck Depression Inventory (BDI) scores, education, and number of APOE epsilon4 alleles. Subjects were divided into age tertiles and scores compared within these groups. Composite scores for Verbal Memory, Executive Function/Working Memory, Language, and Visuospatial Function were created, and these scores compared between MCs and NCs. RESULTS MCs performed worse than NCs on the Mini-Mental State Examination, Trails Making Tests A and B, Delayed Recall of a 10-Word List, and Wechsler Adult Intelligence Scale WAIS Block Design. In multiple linear regression analyses, BDI score, gender, and number of APOE epsilon4 alleles did not consistently affect test scores. The differences seen between MCs and NCs were due to differences in the oldest tertile. MCs had lower Visuospatial and Executive Function/Working Memory but not Verbal Memory or Language composite scores. CONCLUSIONS This study is consistent with findings in sporadic Alzheimer disease of early problems with memory, visuospatial function, and particularly with executive function in PS1 mutation carriers. Depression, gender, and presence of an APOE epsilon4 allele did not demonstrate large influences on neuropsychological performance.
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Affiliation(s)
- J M Ringman
- Alzheimer's Disease Center, University of California, Los Angeles, CA 90095-1769, USA.
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Ringman JM, Diaz-Olavarrieta C, Rodriguez Y, Chavez M, Paz F, Murrell J, Macias MA, Hill M, Kawas C. Female preclinical presenilin-1 mutation carriers unaware of their genetic status have higher levels of depression than their non-mutation carrying kin. J Neurol Neurosurg Psychiatry 2004; 75:500-2. [PMID: 14966176 PMCID: PMC1738985 DOI: 10.1136/jnnp.2002.005025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To study depressive symptoms in preclinical presenilin-1 (PS1) related Alzheimer's disease. METHODS Participants were 33 Mexican women at risk for inheriting PS1 mutations who were not demented. They were interviewed, underwent cognitive testing, and completed the Beck depression inventory (BDI). PS1 mutation status was determined. Mean BDI scores were compared between PS1 mutation carriers and non-carriers. The percentage of subjects who reported seeing a psychiatric professional, and the percentage complaining of memory loss were compared between groups. Regression analysis was used to determine whether mutation status predicted BDI scores after adjusting for age, education, mini-mental state examination, and subjective memory function. RESULTS PS1 mutation carriers (n = 17) scored significantly higher than non-carriers (n = 16) on the BDI (mean score, 14.4 v 6.5, p = 0.017); 24% of mutation carriers and 12.5% of non-carriers admitted having sought help from a psychiatric professional (NS). Mutation status remained a significant predictor of BDI scores after adjusting for potential covariates. Though not demented, mutation carriers tended to score lower than non-carriers on several neuropsychological tests. CONCLUSIONS Depressive symptoms can occur early in the course of PS1 related Alzheimer's disease, at least in women. This supports the hypothesis that depression may occur as a direct result of the neuropathology underlying Alzheimer's disease.
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Affiliation(s)
- J M Ringman
- Alzheimer's Disease Center, UCLA Department of Neurology, Los Angeles, California 90095-1769, USA.
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Carbonell JL, Velazco A, Rodriguez Y, Tanda R, Sánchez C, Barambio S, Valera L, Chami S, Valero F, Aragón S, Marí J. Oral versus vaginal misoprostol for cervical priming in first-trimester abortion: a randomized trial. EUR J CONTRACEP REPR 2001; 6:134-40. [PMID: 11763976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The objective of this study was to compare the oral and vaginal administration of misoprostol for cervical priming before surgical abortion up to 63 days' gestation. A total of 900 pregnant women, with ages ranging from 18 to 42 years, who asked for pregnancy termination, were included in this study. Women were randomly allocated to one of the following groups: oral administration of 400 microg misoprostol, 8 h before aspiration; and vaginal self-administration of 400 microg misoprostol, 4 h before aspiration. During admission, all subjects were checked on a 15-min basis. The preoperative cervical dilatation achieved was the main outcome assessed. The cervix was dilated (Hegar > or = 8) in 348 (78%) subjects from the oral treatment group and in 391 (87%) women from the vaginal treatment group; this difference was statistically significant (p = 0.0004). The mean dilatation achieved in the oral treatment group was 8.1 mm (SD 1.6 mm) and it was 8.5 mm (SD 1.5 mm) in the vaginal treatment group; this difference was statistically significant (p = 0.0001). The frequencies of side-effects such as nausea, vomiting, diarrhea and chills reported by women from the vaginal misoprostol group were 10, 8, 18 and 4 times lower, respectively, than those reported by subjects from the oral misoprostol group. In conclusion, vaginal self-administration of misoprostol was the best administration route, as it obtained the same or greater priming effectiveness of the cervix in half the time with a much lower frequency of side-effects.
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Affiliation(s)
- J L Carbonell
- Clínica Mediterrania Medica, Valencia, Castelló, Spain
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Lewis J, Devin A, Miller A, Lin Y, Rodriguez Y, Neckers L, Liu ZG. Disruption of hsp90 function results in degradation of the death domain kinase, receptor-interacting protein (RIP), and blockage of tumor necrosis factor-induced nuclear factor-kappaB activation. J Biol Chem 2000; 275:10519-26. [PMID: 10744744 DOI: 10.1074/jbc.275.14.10519] [Citation(s) in RCA: 259] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The death domain kinase, receptor interacting protein (RIP), is one of the major components of the tumor necrosis factor receptor 1 (TNFR1) complex and plays an essential role in tumor necrosis factor (TNF)-mediated nuclear factor kappaB (NF-kappaB) activation. The activation of NF-kappaB protects cells against TNF-induced apoptosis. Heat-shock proteins (Hsps) are chaperone molecules that confer protein stability and help to restore protein native folding following heat shock and other stresses. The most abundant Hsp, Hsp90, is also involved in regulating the stability and function of a number of cell-signaling molecules. Here we report that RIP is a novel Hsp90-associated kinase and that disruption of Hsp90 function by its specific inhibitor, geldanamycin (GA), selectively causes RIP degradation and the subsequent inhibition of TNF-mediated IkappaB kinase and NF-kappaB activation. MG-132, a specific proteasome inhibitor, abrogated GA-induced degradation of RIP but failed to restore the activation of IkappaB kinase by TNF, perhaps because, in the presence of GA and MG-132, RIP accumulated in a detergent-insoluble subcellular fraction. Most importantly, the degradation of RIP sensitizes cells to TNF-induced apoptosis. These data indicate that Hsp90 plays an important role in TNF-mediated NF-kappaB activation by modulating the stability and solubility of RIP. Thus, inhibition of NF-kappaB activation by GA may be a critical component of the anti-tumor activity of this drug.
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Affiliation(s)
- J Lewis
- Department of Cell and Cancer Biology, Medicine Branch, Division of Clinical Sciences, NCI, National Institutes of Health, Bethesda, Maryland 20892, USA
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Devin A, Cook A, Lin Y, Rodriguez Y, Kelliher M, Liu Z. The distinct roles of TRAF2 and RIP in IKK activation by TNF-R1: TRAF2 recruits IKK to TNF-R1 while RIP mediates IKK activation. Immunity 2000; 12:419-29. [PMID: 10795740 DOI: 10.1016/s1074-7613(00)80194-6] [Citation(s) in RCA: 356] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The death domain kinase RIP and the TNF receptor-associated factor 2 (TRAF2) are essential effectors in TNF signaling. To understand the mechanism by which RIP and TRAF2 regulate TNF-induced activation of the transcription factor NF-kappaB, we investigated their respective roles in TNF-R1-mediated IKK activation using both RIP-/- and TRAF2-/- fibroblasts. We found that TNF-R1-mediated IKK activation requires both RIP and TRAF2 proteins. Although TRAF2 or RIP can be independently recruited to the TNF-R1 complex, neither one of them alone is capable of transducing the TNF signal that leads to IKK activation. Moreover, we demonstrated that IKK is recruited to the TNF-R1 complex through TRAF2 upon TNF treatment and that IKK activation requires the presence of RIP in the same complex.
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MESH Headings
- Antigens, CD/analysis
- Antigens, CD/chemistry
- Antigens, CD/physiology
- Apoptosis/physiology
- Cells, Cultured
- Enzyme Activation
- Fibroblasts/cytology
- Humans
- I-kappa B Kinase
- Macromolecular Substances
- NF-kappa B/physiology
- Protein Serine-Threonine Kinases/chemistry
- Protein Serine-Threonine Kinases/physiology
- Proteins/physiology
- Receptor-Interacting Protein Serine-Threonine Kinases
- Receptors, Tumor Necrosis Factor/analysis
- Receptors, Tumor Necrosis Factor/chemistry
- Receptors, Tumor Necrosis Factor/physiology
- Receptors, Tumor Necrosis Factor, Type I
- Recombinant Fusion Proteins/physiology
- Signal Transduction/physiology
- TNF Receptor-Associated Factor 2
- Transcription, Genetic
- Transfection
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Affiliation(s)
- A Devin
- Department of Cell and Cancer Biology, Medicine Branch, Division of Clinical Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
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Abstract
Although the molecular mechanisms of TNF signaling have been largely elucidated, the principle that regulates the balance of life and death is still unknown. We report here that the death domain kinase RIP, a key component of the TNF signaling complex, was cleaved by Caspase-8 in TNF-induced apoptosis. The cleavage site was mapped to the aspartic acid at position 324 of RIP. We demonstrated that the cleavage of RIP resulted in the blockage of TNF-induced NF-kappaB activation. RIPc, one of the cleavage products, enhanced interaction between TRADD and FADD/MORT1 and increased cells' sensitivity to TNF. Most importantly, the Caspase-8 resistant RIP mutants protected cells against TNF-induced apopotosis. These results suggest that cleavage of RIP is an important process in TNF-induced apoptosis. Further more, RIP cleavage was also detected in other death receptor-mediated apoptosis. Therefore, our study provides a potential mechanism to convert cells from life to death in death receptor-mediated apoptosis.
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Affiliation(s)
- Y Lin
- Department of Cell and Cancer Biology, Medicine Branch, Division of Clinical Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
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Díaz-Olavarrieta C, Ostrosky-Solis F, Garcia de la Cadena C, Rodriguez Y, Alonso E. Neuropsychological changes in subjects at risk of inheriting Alzheimer's disease. Neuroreport 1997; 8:2449-53. [PMID: 9261807 DOI: 10.1097/00001756-199707280-00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Subjects from four Mexican families at risk of inheriting Alzheimer's disease (AD) were studied using a complete neuropsychological battery. These tests were repeated and compared 1 year later. Some of the experimental subjects belong to an international protocol on molecular chromosomal study. A control group matched in age and schooling was included. The subjects at risk underwent a complete physical, neurological and neuropsychological assessment. A neuropsychological battery of cognitive domains designed for the the study of dementia syndromes was administered to all subjects. Six of the subjects showed abnormal performance in cognitive functions, memory, visuospatial functions or language which persisted 1 year later. The present work describes the initial findings of a long-term prospective study aimed at delineating the neuropsychological profile of subjects at risk and to validate subtle abnormalities which in some cases could be the incipient changes of AD.
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Affiliation(s)
- C Díaz-Olavarrieta
- Laboratory of Experimental Psychology, Instituto Nacional de Neurología y Neurocirugía de México, Mexico City
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Tancioni F, Gaetani P, Villani L, Zappoli F, Rodriguez Y, Baena R. Neurinoma of the trigeminal root and atypical trigeminal neuralgia: case report and review of the literature. Surg Neurol 1995; 44:36-42. [PMID: 7482252 DOI: 10.1016/0090-3019(95)00173-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Neurinomas of the trigeminal nerve are a rare entity: those located in the posterior fossa account for 20% of all cases. In the majority of cases, the clinical presentation begins with fifth cranial nerve involvement producing a constant pain associated with other cranial nerve palsy and cerebellar signs. METHODS We report the clinical features, neuroradiological imagings, and management of a case of trigeminal neurinoma located in the cerebellopontine angle, arising from the Vth cranial nerve root, presenting with an atypical trigeminal neuralgia; moreover, we analyze similar cases reported in the literature and we discuss whether pain can be produced by a neurinoma that arises central to the ganglion. RESULTS The tumor presented with an atypical trigeminal neuralgia characterized by constant trigeminal pain with paroxystical burns, hyperesthesia and hyperactive autonomic dysfunction. Neuroradiological examinations provided the best preoperative localization of this lesion, allowing better planning of the surgical approach, considering the large size of this tumor. A retromastoid incision and posterior fossa craniectomy approach was used, with complete excision of the tumor. The paraxysmal sharp pain and hyperesthesia disappeared completely, but the constant burning pain persisted although it was less intense. At an 8-month follow-up examination, the patient showed a progressive improvement of clinical symptoms and control magnetic resonance imaging (MRI) showed the complete removal of the neoplasm and the absence of residuals or recurrences. CONCLUSION Although in a high percentage of cases of atypical trigeminal neuralgia a neurovascular conflict might be suspected, the review of the present case suggests that the hypothesis of a trigeminal neurinoma must be investigated both with adequate neuroradiological procedures and/or microsurgical exploration of the trigeminal root.
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Affiliation(s)
- F Tancioni
- Department of Surgery, Neurosurgery, IRCCS Policlinico S. Matteo, Pavia, Italy
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Perez Hidalgo C, Torres P, Chavez A, Rodriguez Y. [Changes of the nutritional status in a group of Mexican athletes]. Prensa Med Mex 1969; 34:129-36. [PMID: 5386322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Penna M, Rodriguez Y, Rovere A, Fernandez MA, Novaković L. Influence of drugs, rate changes and temperature on myocardial stimulation by hypoxia. Arzneimittelforschung 1967; 17:300-5. [PMID: 4296809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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