Influenza activity and regional mortality for non-small cell lung cancer

Lung cancer is the leading cause of cancer deaths in the United States and worldwide. While influenza illness is known to be particularly dangerous for frail and elderly patients, the relationship between influenza illness and outcomes in patients with cancer remains largely unknown. The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify patients with non-small cell lung cancer (NSCLC) diagnosed between 2009 and 2015. Influenza-like illness (ILI) activity, provided by the Outpatient Influenza-like Illness Surveillance Network of the Center of Disease for Control and Prevention, was merged with the SEER dataset on the state-month level. Regional monthly mortality rates were compared during low versus high flu months in this ecological cohort study. 202,485 patients with NSCLC from 13 SEER-reporting states were included in the analysis. 53 of 1049 state-months (5.1%) had high flu activity. Monthly mortality rates during low and high flu months were 0.041 (95% CI 0.041-0.042) and 0.051 (95% CI 0.050-0.053), respectively (RR 1.24 [95% CI 1.21-1.27]). The association between ILI activity and mortality was observed at the individual state level and in all clinical and regional subgroups. Increased regional influenza activity is associated with higher mortality rates for patients with NSCLC. Vaccine-directed initiatives and increased awareness amongst providers will be necessary to address the growing but potentially preventable burden of influenza-related lung cancer deaths in the U.S.

Influenza and mortality for non-small cell lung cancer

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Background: Lung cancer is the leading cause of cancer deaths in the United States and worldwide. While influenza illness is known to be particularly dangerous for frail and elderly patients, the relationship between influenza illness and outcomes in cancer patients remains largely unknown. Methods: Monthly mortality rates for all patients at risk, as well as newly diagnosed patients, with non-small cell lung cancer (NSCLC) diagnosed between 2009 and 2015 were compared during high and low flu months using data from the Surveillance, Epidemiology, and End Results (SEER) Program and the Center for Disease Control and Prevention (CDC) website. Influenza severity was determined by the percentage of outpatient visits to healthcare providers for influenza-like illness (ILI). CDC ILI activity levels were matched with SEER data by month and state. State-months with an ILI activity level of 8 or higher were considered to be high flu months, as defined by the CDC. Results: 195,038 patients with NSCLC from 13 states were included in the analysis. 52 out of 1,081 state-months (5.1%) had high flu activity. Monthly mortality rates for low and high flu months were 4.9 and 5.7%, respectively (p = .001). The monthly mortality rate for newly diagnosed patients was also significantly higher during high flu months (9.4 vs. 10.2%, p = .01). When the analysis was limited to winter months only, monthly mortality rates for low and high flu months were 4.7 and 5.3%, respectively (p = .02). The relationship between flu severity and mortality was also observed at the individual state level. Conclusions: Increased influenza severity is associated with higher mortality rates for NSCLC patients. Future research should elucidate the relationship between vaccination and survival in lung cancer patients.

Quantitative real-time measurements of DNA hybridization with alkylated nonoxidized silicon nanowires in electrolyte solution

The quantitative, real-time detection of single-stranded oligonucleotides with silicon nanowires (SiNWs) in physiologically relevant electrolyte solution is demonstrated. Debye screening of the hybridization event is circumvented by utilizing electrostatically adsorbed primary DNA on an amine-terminated NW surface. Two surface functionalization chemistries are compared: an amine-terminated siloxane monolayer on the native SiO2 surface of the SiNW, and an amine-terminated alkyl monolayer grown directly on a hydrogen-terminated SiNW surface. The SiNWs without the native oxide exhibit improved solution-gated field-effect transistor characteristics and a significantly enhanced sensitivity to single-stranded DNA detection, with an accompanying 2 orders of magnitude improvement in the dynamic range of sensing. A model for the detection of analyte by SiNW sensors is developed and utilized to extract DNA-binding kinetic parameters. Those values are directly compared with values obtained by the standard method of surface plasmon resonance (SPR) and demonstrated to be similar. The nanowires, however, are characterized by higher detection sensitivity. The implication is that SiNWs can be utilized to quantitate the solution-phase concentration of biomolecules at low concentrations. This work also demonstrates the importance of surface chemistry for optimizing biomolecular sensing with silicon nanowires.