Influence of Coping Strategy on Perception of Anxiety and Depression in Patients with Non-small Cell Lung Cancer

Inhibition of human UDP-glucuronosyltransferase enzyme by entrectinib: Implications for drug-drug interactions

As a new type of oral tyrosine kinase inhibitor, entrectinib can act on multiple targets and exert efficacy and has been approved for the treatment of non-small cell lung cancer (NSCLC) and solid tumors. However, whether entrectinib affects the activities of recombinant human UDP-glucuronosyltransferases (UGTs) remains unclear. Herein, we aimed to investigate the inhibitory effects of entrectinib on human UGTs and to assess the potential risk of causing drug-drug interactions (DDIs) based on the inhibition against UGTs. High-performance liquid chromatography (HPLC) was used to evaluate the inhibitory effects of entrectinib on UGTs according to the product formation rate of UGT substrate with or without entrectinib, and the inhibition kinetics experiment was conducted to assess the inhibitory type of entrectinib on UGTs. Our results showed that entrectinib exhibited extensive inhibitory effects on most human UGTs, and especially inhibited the activities of UGT1A7, UGT1A8, and UGT2B15 with Ki (Inhibition constant) of lower than 5 μM (0.95-4.38 μM). Furthermore, the results from quantitative prediction research suggested that the combination of entrectinib at 600 mg/day with substrates primarily metabolized by hepatic UGT2B15 or intestinal UGT1A7 and UGT1A8 might cause clinical DDIs. Thus, special attention should be paid to avoid adverse reactions induced by DDIs when co-administration of entrectinib and drugs metabolized by UGTs.

Effectiveness of Roy Adaptation Model-Based Cognitive Stimulation Therapy in Elderly Patients with Non-Small Cell Lung Cancer Undergoing Curative Resection

This study aimed to investigate the effects of a Roy adaptation model (RAM)-based cognitive stimulation therapy (CST) intervention on elderly patients diagnosed with primary non-small cell lung cancer (NSCLC) undergoing curative resection. A total of 280 patients diagnosed with primary NSCLC were randomized into RAM-based CST group and control group. Outcomes were assessed at three intervals: pre-surgery, discharge, and one-month post-discharge. Cognitive function was evaluated using Mini-Cognitive test. Postoperative delirium prevalence was determined within 48 hours post-surgery using Nursing Delirium Screening Scale. The Hospital Anxiety and Depression Scale evaluated anxiety and depression symptoms, while Quality of Life (QoL) was assessed via Short Form-36 (SF36) Health Survey. The RAM-based CST group demonstrated significantly higher Mini-Cog test scores than the control group upon discharge and post-intervention. Patients with RAM-based CST exhibited a decrease in postoperative delirium compared to the control group. The RAM-based CST intervention yielded an improvement in anxiety and depression at discharge and 1-month post-discharge compared to preoperative levels. Additionally, the RAM-based CST group exhibited substantial enhancements in SF36 subcategory scores at 1-month post-discharge compared to pre-surgery. At post-intervention, the RAM-based CST group demonstrated significantly higher scores than the control group across various health-related domains, including role limitations due to emotional problems, mental health, general health perception, bodily pain, and role limitations due to physical problems. The RAM-based CST intervention in elderly NSCLC patients undergoing curative resection yielded significant enhancements in cognitive function, reduced delirium incidence, improved emotional well-being, and better QoL postoperatively.

Application of a revised model for coping with advanced cancer to qualitatively explore lung cancer survivors' experiences of ongoing physical effects, novel treatments, uncertainty, and coping

PURPOSE

Lung cancer remains underrepresented in cancer survivorship research. This study aimed to understand survivors' physical/psychological challenges, experiences of immunotherapy (IO) and targeted therapy (TT), and psychological adjustment through application of the Roberts et al. (2017) advanced cancer adaptation of Folkman and Greer's appraisal and coping model.

METHODS

Adults 6-24 months post-initial treatment completion were recruited via an Australian cohort study. Participant demographic, clinical, quality of life, and distress data were obtained through the cohort database. Qualitative interviews were conducted and analyzed using Framework methods. Roberts et al. (2017)'s model informed data interpretation and presentation.

RESULTS

Twenty interviews were conducted (10 females; average age 69 years). Participants' diagnostic stages varied (stage I = 2, stage II = 4, stage III = 8, stage IV = 6); most had received IO/TT (n = 14) and were on average 17 months (range 10-24) post-diagnosis. Three themes were identified and mapped to the Roberts' framework: (1) Ongoing illness events: most participants reported functioning well despite ongoing physical effects. Those on IO/TT reported side effects; some were unexpected/serious. (2) Adjusting to life with lung cancer: most expressed hope for the future while simultaneously preparing for disease progression. Those receiving IO/TT experienced uncertainty given limited survival information. (3) Learning to live with lung cancer: participants described emotion, problem, and meaning based on coping strategies.

CONCLUSIONS

Findings may guide development of supportive care resources/interventions focused on uncertainty, IO/TT communication and decision-making, and coping.

IMPLICATIONS FOR CANCER SURVIVORS

Many people with lung cancer are living well with their ongoing illness. Despite challenges, many survivors are adapting to issues as they arise and are maintaining a sense of hope and optimism.

Support and information needs for patients with non-small cell lung cancer receiving concurrent chemo-radiotherapy treatment with curative intent: Findings from a qualitative study

PURPOSE

Concurrent chemotherapy and radiotherapy treatment (CCRT) is used to treat locally advanced Non-Small Cell Lung Cancer (NSCLC) in patients with suitable fitness. CCRT is associated with significant toxicity and time spent receiving treatment. Our aim was to identify the support and information needs of patients, and where possible their informal caregivers (IC), at key points along the CCRT pathway.

METHODS

Participants were NSCLC patients who were either about to undergo, currently receiving or had finished CCRT. Semi-structured interviews were conducted with participants, and their IC where applicable, at the treatment centre or participants' home. Interviews were audio recorded and transcribed prior to undergoing thematic analysis.

RESULTS

Fifteen patients were interviewed; five were interviewed with their IC. Themes of physical, psychological, and practical support needs are identified with associated subthemes exploring specific needs, such as dealing with late treatment effects, and how patients seek support. Information needs prior to, during and following CCRT were also established as predominant themes with subthemes detailing the needs at these time points. Examples include differences in participant desire for toxicity information and life after treatment.

CONCLUSIONS

The need for disease, treatment and symptom related information and support remains consistent throughout CCRT and beyond. Further information and support for other matters including engaging in regular activities may also be desired. Time allocated within consultations to establish changes in needs or desire for further information may benefit patient and IC experience and QOL.

Application of Narrative Nursing Combined With Focused Solution Model to Anxiety and Depression in Patients With Lung Tumor During Perioperative Period

Background

In the face of the dual pressure of disease and operation, patients with lung tumors in the perioperative period often have adverse psychological states such as anxiety and depression. There are many risk factors affecting the psychological state of patients in the perioperative period, and there is still a lack of effective nursing countermeasures in clinical practice.

Materials and Methods

We accessed our institutional database and retrospectively selected all patients with lung tumors who underwent surgical treatment between August 2018 and December 2018. Multivariate Logistic regression model was used to analyze the risk factors affecting the psychological state of patients during the perioperative period, and the HAD score, medication behavior, INR monitoring behavior and life behavior before and after narrative nursing combined with focused solution model nursing were compared with those of patients receiving conventional nursing plan.

Results

According to the inclusion and exclusion criteria, 148 cases of lung tumor patients undergoing surgical treatment were studied in this study. There were 45 cases without anxiety and depression and 103 cases with anxiety and depression in 148 patients. Income, medical environment, worry about work, family members' psychological state, family care, sleep quality, mental history, worry about postoperative pain, patients' knowledge of the diagnosis of the condition and the nature of the tumor were the single factors that affected the psychological state of patients with pulmonary tumor during perioperative period (P < 0.05). Multivariate analysis showed that income status, sleep quality, psychological status of family members, fear of postoperative pain and nature of tumor were the independent risk factors for psychological status of patients with lung tumor during perioperative period (P < 0.05). There was no difference in HAD score, medication behavior, INR monitoring behavior and life behavior score between the two groups when entering the group (P > 0.05). At the time of discharge, the HAD scores of the two groups were decreased, and those in the study group were lower than those in the control group (P < 0.05). At the time of discharge, medication behavior, INR monitoring behavior and life behavior of the two groups were increased, and the study group was higher than the control group (P < 0.05).

Conclusion

Income status, sleep quality, fear of postoperative pain, Patient's knowledge of their condition and nature of tumor are the independent risk factors affecting the psychological state of patients with lung tumor during perioperative period. Narrative nursing combined with focused solution model can effectively improve the anxiety and depression status of patients with lung tumor during perioperative period and enhance their compliance behavior, which is worthy of promotion.

Cognitive appraisal of the disease and stress level in lung cancer patients. The mediating role of coping styles

PURPOSE

The aim of the study was to provide support for the hypothesis that there was a correlation between the subjective appraisal of one's disease and the level of stress, as well as the hypothesis that coping styles may have a mediating role on the relationship between the perception of the disease and stress level in patients diagnosed with lung cancer.

METHODS

The study involved 97 respondents diagnosed with lung cancer, including 50 men and 47 women. The following methods were used for the study: the Disease-Related Appraisals Scale, the Coping Inventory for Stressful Situations, and the Perceived Stress Scale. Socio-demographic data were also collected.

RESULTS

The results show that emotion-oriented coping (EOC) acts as a mediator on the relationship between the appraisal of the disease and stress level in patients diagnosed with lung cancer. A total of 4 multiple mediation models were tested.

CONCLUSION

The research findings provide support for the hypothesis that coping style is crucial for the way patients appraise their disease and for their stress level. It is important to diagnose individual specific needs of lung cancer patients. The research results are an important source of information for those responsible for training medical staff on how to support cancer patients in their illness.

Coping, Anxiety, and Pain Intensity in Patients Requiring Thoracic Surgery

Stress, anxiety, and post-surgical chest pain are common problems among patients with thoracic surgical pathology. The way in which psychological distress is managed-the coping style-can influence the postsurgical evolution and quality of life of patients. In our study, we monitored the influence of coping style on patients' anxiety and the intensity of post-operative chest pain. We conducted a cross-sectional study on 90 subjects with thoracic surgical pathology. One month after their surgeries, patients completed the following scales and questionnaires, translated, adapted, and validated for the Romanian population: COPE scale inventory, Generalized Anxiety Disorder-7 Questionnaire, McGill Pain Questionnaire, and Numeric Pain Rating Scale. Anxiety (evaluated using the Generalized Anxiety Disorder-7 Questionnaire) and postoperative thoracic pain intensity (evaluated by means of the Numeric Pain Rating Scale, Number of Words Chosen, and McGill Pain Questionnaire) were significantly higher in patients exhibiting social-focused coping than in patients presenting emotion-focused or problem-focused coping as their main coping style (Kruskal-Wallis, p = 0.028, p = 0.022, p = 0.042, p = 0.007). In our study, there were no differences observed in pain intensity relative to level of anxiety. Coping style is an important concept in the management of anxiety and pain experienced by patients undergoing chest surgery. Therefore, a multidisciplinary approach should be considered in clinical practice.

Serum tumor necrosis factor-α, interleukin-1β, interleukin-6, and interleukin-17 relate to anxiety and depression risks to some extent in non-small cell lung cancer survivor

Introduction

Inflammatory cytokines are proposed as modulators for the pathogenesis of anxiety and depression (anxiety/depression), and anxiety/depression are frequently existed in non‐small cell lung cancer (NSCLC) survivors. However, no published study has explored the association of inflammation cytokines with anxiety/depression in NSCLC survivors.

Objectives

We aimed to evaluate serum tumor necrosis factor‐α (TNF‐α), interleukin‐1 beta (IL‐1β), interleukin‐6 (IL‐6), interleukin‐17 (IL‐17) levels, and their correlations with anxiety/depression in NSCLC survivors.

Methods

Totally, 217 NSCLC survivors and 200 controls were recruited. Then, inflammatory cytokines in serum samples were detected by enzyme‐linked immunosorbent assay (ELISA). Besides, their anxiety/depression status was assessed by Hospital Anxiety and Depression Scale (HADS).

Results

HADS‐anxiety score, anxiety rate, anxiety severity, HADS‐depression score, depression rate, and depression severity were all increased in NSCLC survivors compared with controls (all P < 0.001). Regarding inflammatory cytokines, TNF‐α, IL‐1β, and IL‐17 levels were higher (all P < 0.01), while IL‐6 (P = 0.105) level was of no difference in NSCLC survivors compared with controls. Furthermore, TNF‐α, IL‐1β, IL‐6, and IL‐17 were all positively associated with HADS‐A score (all P < 0.05), anxiety occurrence (all P < 0.05), HADS‐D score (all P < 0.05), and depression occurrence (all P < 0.05) in NSCLC survivors, while the correlation‐coefficients were weak. Additionally, multivariate logistic regression analyses disclosed that TNF‐α (both P < 0.05) and IL‐1β (both P < 0.001) were independently correlated with increased anxiety and depression risks in NSCLC survivors.

Conclusion

Serum TNF‐α, IL‐1β, IL‐6, and IL‐17 are related to increased anxiety and depression risks to some extent in NSCLC survivors.

Relationship between social support, coping strategy against COVID-19, and anxiety among home-quarantined Chinese university students: A path analysis modeling approach

With the continued spread of the COVID-19 pandemic and the strict implementation of quarantine policy, the levels of anxiety among university students surged in the lockdown period. Previous studies confirmed the effectiveness of social support in mitigating anxiety, so offering social support should be of high priority in COVID-19, especially in quarantine. However, various coping strategies against the pandemic may explain the link between social support and anxiety. The purpose of this study was to investigate the associations of social support, coping strategy against COVID-19, and anxiety, identifying the potential mediating effect of coping strategy between social support and anxiety during the COVID-19 quarantine. Home-quarantined Chinese university students (N = 2640; 68.79% female) completed online ratings of social support, coping, and anxiety from February 21st to 24th, 2020, when they had been confined to their homes in the peak of the pandemic. Sex and academic attainment being covariates, path analysis with parallel mediation were conducted using "lavaan" package in R environment. Anxiety was significantly negatively related to subjective support and counselor support, while family support did not demonstrate substantive associations with anxiety. The mediating role of cognitive coping was found between all the three social support sources and anxiety. Emotional coping and behavioral coping were found to partially mediate the relationship between subjective support and anxiety, fully mediate the associations of family support and anxiety. However, the impact of counselor support on anxiety was not found to be mediated by emotional coping and behavioral coping. This large-scale online study provides initial evidence that various coping strategies may mediate the relationship between three sources of social support and anxiety in quarantine to some extent. Given that coping against COVID-19 is a valuable reasearch goal upon the global ongoing challenge, the findings will shed more light on the mechanism in the link between coping, social support, and anxiety.

Cancer pain and lower functional status predict poor trajectories of symptom and fatigue distress in patients with lung cancer

OBJECTIVE

To identify distinct subgroups of patients newly diagnosed with lung cancer (LC) over time and to explore the predictors of distinct trajectories of symptom and fatigue distress in LC patients.

METHODS

A total of 120 patients newly diagnosed with LC were recruited in this longitudinal prospective study. Our survey investigated patients' symptoms in 6 months. Latent growth curve analysis (LGCA) was conducted to identify patients with distinct trajectories of symptom and fatigue distress. The characteristics of the patients among groups were compared for statistical differences by the chi-square test or ANOVA.

RESULTS

The results of LGCA revealed that the linear three-trajectory model had the best model fit for symptom and fatigue distress. Patients' symptom and fatigue distress improved with time, except for patients with increasing trajectories. Patients' trajectories of symptom and fatigue distress were affected by pain, lower functional status, total symptom score and depression. Moreover, patients with increasing trajectories of symptom and fatigue distress experienced more pain, physiological symptoms and depression from 1 to 6 months.

CONCLUSIONS

Pain and functional status were the major factors that deteriorated the recovery of trajectory in symptom distress and fatigue distress among patients with increasing trajectories.

Research on the effect of health care integration on patients’ negative emotions and satisfaction with lung cancer nursing activities

BACKGROUND

Lung cancer is a clinical disease with multiple malignant tumors. Currently, it is difficult for patients to benefit from routine clinical nursing due to the lack of a pertinent and systematic approach.

AIM

To investigate the effect of integrated nursing care on the negative emotions and satisfaction of lung cancer patients.

METHODS

From January 2018 to December 2019, 92 patients with lung cancer were selected and divided into the study group and the control group; there were 46 patients in each group. The control group received routine nursing, and the study group received integrated medical care in addition to the care received by the control group. Negative emotions before and after the intervention, the self-management ability score after the intervention, family care burden after the intervention and nursing satisfaction after the intervention were measured in the two groups.

RESULTS

After the intervention, the self-rating anxiety scale and self-rating depression scale scores in the study group were lower than those in the control group (P < 0.05); the scores for health knowledge, self-concept, self-responsibility and self-care skills in the study group were higher than those in the control group (P < 0.05); the scores for individual burden and responsibility burden in the study group were lower than those before the intervention (P < 0.05); and the nursing satisfaction in the study group (93.48%) was higher than that in the control group (78.26%, P < 0.05).

CONCLUSION

An integrated nursing care approach for lung cancer patients can effectively relieve the patient’s negative feelings, improve their self-management ability, help to reduce the burden of family care and improve patient satisfaction with nursing activities.

Rab14 Overexpression Promotes Proliferation and Invasion Through YAP Signaling in Non-Small Cell Lung Cancers

Introduction

Several reports have shown that Rab14 is dysregulated in human cancers suggesting that it is an oncogenic protein closely related to tumorigenesis. However, whether Rab14 plays a role in the development and progression of human non-small cell lung cancer (NSCLC) remains unclear.

Methods

Rab14 protein levels were examined in 115 cases of NSCLC tissues and 6 cancer cell lines. Rab14 knockdown was performed in H1299 and A549 cell lines. Rab14 plasmid transfection was performed in the LK2 cell line. The biological roles and mechanisms of Rab14 were examined using MTT, colony formation, Matrigel invasion assay, migration assay, cell cycle analysis, Western blotting, and RT-qPCR.

Results

We found that Rab14 was upregulated in 65 of 115 lung cancer tissues. Rab14 high expression was significantly correlated with advanced TNM stage and nodal metastasis. Rab14 protein levels were higher in lung cancer cell lines than in normal bronchial cell line. Functionally, Rab14 overexpression increased growth rate, colony formation, invasion/migration ability and cell cycle progression, while Rab14 siRNA decreased the cell proliferation rate, colony numbers and inhibited invasion/migration ability and cell cycle progression. Rab14 upregulated cyclin D1, cyclin E, connective tissue growth factor (CTGF) and downregulated p27 protein and mRNA levels in both A549 and H1299 cell lines, while Rab14 siRNA produced the opposite effects. Further study showed that Rab14 overexpression increased luciferase reporter activity from transcriptional enhanced associate domain (TEAD) protein. Accordingly, Rab14 increased total Yes-associated protein (YAP) and nuclear YAP protein while decreased phosphorylated (p)-YAP and cytoplasmic YAP protein expression. Cycloheximide treatment showed that Rab14 downregulated the level of YAP degradation. Depletion of YAP using siRNA abolished the influence of Rab14 on cyclin D1, cyclin E, and CTGF. YAP knockdown also partly abolished the effects of Rab14 on cell proliferation and invasion.

Conclusion

In summary, our data showed that Rab14 is overexpressed in human NSCLC. Rab14 facilitated proliferation and invasion, possibly through regulation of YAP signaling.