Validation of inflammatory genetic variants associated with long-term cancer related fatigue in a large breast cancer cohort

BACKGROUND

Studies to date have reported several associations between single nucleotide polymorphisms (SNPs) and cancer related fatigue (CRF), but have been limited by small sample sizes, missing adjustment for relevant covariates or multiple testing, as well as varying CRF definitions, i.e. time and method of assessment. This study aimed to validate previously reported associations using the largest independent breast cancer sample to date and to evaluate further functional cytokine variants in relation to total CRF and all relevant CRF subdomains (physical, cognitive, and affective CRF).

METHOD

45 candidate SNPs in inflammatory pathway genes were selected based on previous reports (16 SNPs) or regulatory function (29 SNPs). Breast cancer patients recruited between 2002 and 2005 provided information on CRF at first follow-up (FU1) (N = 1389) and second follow-up (FU2) (N = 950), a median of 6.2 years and 11.7 years respectively after diagnosis. SNP associations were assessed using linear regression models on CRF scores separately for FU1 and FU2. Additionally, patients with persistent fatigue (fatigued at both time-points) were compared to those never fatigued using logistic regression models (N = 684). All analyses were adjusted for relevant covariates. Secondary analyses were conducted for CRF subdomains.

RESULTS

For total CRF none of the previously reported associations were confirmed after correction for multiple testing. The p-value distribution of all SNPs was not different than the one expected by chance. Analyses of CRF subdomains yielded a significant association between TNF-α rs3093662 and persistent physical CRF (Odds Ratio (OR) = 3.23, 95% Confidence Interval (CI) = 1.71-6.10, p = 0.0003).

CONCLUSION

We were unable to confirm previously reported findings, suggesting that individual SNPs are unlikely to be of clinical utility. Further investigations in well powered studies are warranted, which consider genetic heterogeneity according to subdomains of CRF.

Quantitative study of 10 Hz operation of a soft x-ray laser-energy stability and target considerations

A soft x-ray laser from Ni-like Mo, pumped in grazing incidence (GRIP), is analyzed with regard to high repetition rate operation. Reliable lasing is obtained, but with significant energy fluctuations attributed mainly to beam pointing jitter from the pump laser. Two modes of operation are compared: continuously moving target and stationary target. With a moving target the soft X-ray output is constant on average, whereas the repeated use of the same target position leads to a pulse energy which increases for several tens of shots. This effect might be caused by improved guiding of the pump laser in the formed groove and the removal, through laser ablation, of the oxide layer on the target surface.

Optimization toward a high-average-brightness soft-x-ray laser pumped at grazing incidence

We report the near-field imaging characterization of a 10 Hz Ni-like 18.9 nm molybdenum soft-x-ray laser pumped in a grazing incidence pumping (GRIP) geometry with a table-top laser driver. We investigate the effect of varying the GRIP angle on the spatial behavior of the soft-x-ray laser source. After multiparameter optimization, we were able to find conditions to generate routinely a high-repetition-rate soft-x-ray laser with an energy level of up to 3 microJ/pulse and to 6x10(17) photons/s/mm2/mrad2/(0.1% bandwidth) average brightness and 1x10(28) photons/s/mm2/mrad2/(0.1% bandwidth) peak brightness.