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Merluzzi TV, Salamanca-Balen N, Philip EJ. Perceived discrimination and quality of life for African American and Caucasian American cancer patients: a coping mediation analysis of subtle and overt microaggressions. Ethn Health 2024:1-21. [PMID: 38698588 DOI: 10.1080/13557858.2024.2347569] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/21/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE Perceived discrimination (PD; e.g. racism, agism, sexism, etc.) negatively impacts quality of life (QOL) among cancer patients. Prior research has established that for African American Cancer Patients (AACPs) only disengagement/denial coping mediated the PD-QOL relationship. In contrast, for Caucasian American Cancer Patients (CACPs), both agentic and disengagement/denial coping were mediators of the PD-QOL relationship. However, according to social constraint theory there may be a difference between subtle and overt PD in terms of the utility of certain coping mechanisms in relation to QOL, especially for AACPs. METHOD 217 AACPs and 121 CACPs completed measures of PD, coping (agentic, disengagement/denial, adaptive disengagement) and QOL. PD items were classified as subtle or overt microaggressions. PD was mainly attributed to race/ethnicity by AACPs and to income, age, and physical appearance for CACPs. RESULTS : In both subtle and overt microaggression models with CACPs, agentic coping and disengagement/denial coping were significant mediators of PD-QOL. Like CACPs, for AACPs, agentic and disengagement/denial coping were significant in the context of subtle microaggressions. In contrast, for overt microaggression only disengagement/denial coping was a significant mediator of the PD-QOL relationship for AACPs. Adaptive disengagement was related to QOL only for AACPs. CONCLUSIONS : Whereas more research is needed, it appears that overt microaggressions for AACPs, that consist mainly of racial and ethnic maltreatment, constitute a class of social contexts that may raise above the threshold for serious threat and harm, and, as a result, disengagement/constraint may reduce negative consequences. This additional burden for AACPs contributes to disparities in QOL. Future research is needed on the utility of adaptive disengagement for AACPs in relation to PD.
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Affiliation(s)
- Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | | | - Errol J Philip
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
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Castro DV, Prajapati SR, Feng MI, Chan EH, Lee KO, Paul T, Sehgal I, Patel J, Li X, Zengin ZB, Ebrahimi H, Govindarajan A, Meza L, Mercier BD, Chawla NS, Dizman N, Philip EJ, Hsu J, Bergerot CD, Chehrazi-Raffle A, Rock A, Liu S, Tripathi A, Dorff TB, Pal SK. Assessment of eligibility criteria in renal cell carcinoma trials evaluating systemic therapy. BJU Int 2024; 133:297-304. [PMID: 37548533 DOI: 10.1111/bju.16148] [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] [Indexed: 08/08/2023]
Abstract
OBJECTIVES To characterise the restrictiveness of eligibility criteria in contemporary renal cell carcinoma (RCC) trials, using recommendations from the American Society of Clinical Oncology (ASCO)-Friends of Cancer Research (FCR) initiative. METHODS vPhase I-III trials assessing systemic therapies in patients with RCC starting between 30 June 2012 and 30 June 2022 were identified. Eligibility criteria regarding brain metastases, prior or concurrent malignancies, hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, and human immunodeficiency virus (HIV) infection were identified and stratified into three groups: exclusion, conditional inclusion, and not reported. Descriptive statistics were used to determine the frequency of eligibility criteria. Fisher's exact test or chi-square test were used to calculate their associations with certain trial characteristics. RESULTS A total of 423 RCC trials were initially identified of which 112 (26.5%) had sufficient accessible information. Exclusion of patients with HIV infection, HBV/HCV infection, brain metastases, and prior or concurrent malignancies were reported in 74.1%, 53.6%, 33.0%, and 8.0% of trials, respectively. In the context of HIV and HBV/HCV infection, patients were largely excluded from trials evaluating immunotherapy (94.4% and 77.8%, respectively). In addition, brain metastases were excluded in trials assessing targeted therapy (36.4%), combined therapy (33.3%), and immunotherapy (22.2%). Exclusion of patients with prior or concurrent malignancies was less frequently reported, accounting for 9.1%, 8.3%, and 5.6% targeted therapy, combined therapy and immunotherapy trials, respectively. CONCLUSION A substantial proportion of RCC trials utilise restrictive eligibility criteria, excluding patients with fairly prevalent comorbidities. Implementing the ASCO-FCR recommendations will ensure resulting data are more inclusive and aligned with patient populations in the real-world.
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Affiliation(s)
- Daniela V Castro
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sweta R Prajapati
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Matthew I Feng
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Elyse H Chan
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Kyle O Lee
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Trishita Paul
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Ishaan Sehgal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jalen Patel
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Xiaochen Li
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Zeynep B Zengin
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Hedyeh Ebrahimi
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Ameish Govindarajan
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Luis Meza
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Benjamin D Mercier
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Neal S Chawla
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Nazli Dizman
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
- Yale University School of Medicine, New Haven, CT, USA
| | - Errol J Philip
- University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - JoAnn Hsu
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Cristiane D Bergerot
- Centro de Câncer de Brasília (CETTRO), Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | - Alex Chehrazi-Raffle
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Adam Rock
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sandy Liu
- Department of Medical Oncology, City of Hope Orange County Lennar Foundation Cancer Center, Irvine, CA, USA
| | - Abhishek Tripathi
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Tanya B Dorff
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Merluzzi TV, Salamanca-Balen N, Philip EJ, Salsman JM, Chirico A. Integration of Psychosocial Theory into Palliative Care: Implications for Care Planning and Early Palliative Care. Cancers (Basel) 2024; 16:342. [PMID: 38254831 PMCID: PMC10813714 DOI: 10.3390/cancers16020342] [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: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Palliative care improves patients' symptoms, quality of life and family satisfaction with caregiving, reduces hospital admissions and promotes alignment of medical care with the patient's needs and goals. This article proposes the utility of integrating three psychosocial theories into standard palliative care with implications for care planning, early palliative care and optimizing quality of life. First, Control Theory focuses on the complex juxtaposition of promoting agency/empowerment in patients and carers and coping with often highly uncertain outcomes. Second, Optimal Matching Theory accounts for the alignment of need and provision of care to potentiate the quality of life effects of supportive care in a complex social process involving health care providers, patients and carers. Third, Hope Theory represents a dynamic process, which is marked by variation in the qualities of hope as the patient and carer confront challenges during palliative care. Future work will be translational in nature to adapt both assessment and interventions based on this theoretically driven augmentation of palliative care as well as to evaluate whether it provides a conceptual framework that has incremental utility in palliative care planning.
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Affiliation(s)
- Thomas V. Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, USA;
| | | | - Errol J. Philip
- School of Medicine, University of California, Los Angeles, CA 90095, USA;
| | - John M. Salsman
- Department of Social Sciences and Health Policy, Atrium Health—Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA;
| | - Andrea Chirico
- Department of Social and Developmental Psychology, Sapienza University of Rome, 00185 Roma, Italy;
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Bergerot CD, Philip EJ, Govindarajan A, Castro D, Malhotra J, Bergerot P, Salgia S, Salgia M, Salgia N, Hsu J, Meza L, Zengin ZB, Liu S, Chehrazi-Raffle A, Tripathi A, Dorff T, Pal S. Changes in Perception of Cure Among Patients With Genitourinary Cancers Initiating Immune Checkpoint Inhibitors: A Longitudinal Study. Clin Genitourin Cancer 2023; 21:626-630.e3. [PMID: 37391301 DOI: 10.1016/j.clgc.2023.05.018] [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: 03/29/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND We explored changes in perceptions of cure among patients with genitourinary (GU) cancers starting Immune checkpoint inhibitors (ICIs) therapy. MATERIALS AND METHODS This longitudinal study assessed patients before starting therapy and 3-months later with a questionnaire that included patient perceptions of ICIs and the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety scale. General linear modeling was used to investigate changes in expectation of cure over time, and chi-square tests were used to determine the association between expectation of cure and perceptions of ICIs and anxiety. RESULTS A total of 45 patients were recruited (73% male, 84% diagnosed with renal cell carcinoma). The proportion of patients who possessed an accurate expectation of cure increased over time (55.6%-66.7%, P = .001). An accurate expectation of cure was associated with lower rates of anxiety over time. Patients with inaccurate expectation of cure reported more severe side effects and worse self-reported ECOG score at the follow-up assessment (P = .04). CONCLUSION We found that patients with GU metastatic cancer treated with ICI therapy have increasingly accurate expectations of cure over time. Accurate expectation of cure is associated with decreased anxiety. Further research is needed to fully explore this dynamic over time and help inform interventions that can help patients develop accurate expectations.
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Affiliation(s)
- Cristiane Decat Bergerot
- Centro de Cancer de Brasilia, Instituto Unity de Ensino e Pesquisa, Oncoclinicas, Brasília, DF, Brazil
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA
| | - Ameish Govindarajan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Daniela Castro
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Jasnoor Malhotra
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Paulo Bergerot
- Centro de Cancer de Brasilia, Instituto Unity de Ensino e Pesquisa, Oncoclinicas, Brasília, DF, Brazil
| | | | | | - Nicholas Salgia
- Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Luis Meza
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Zeynep B Zengin
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sandy Liu
- Department of Medical Oncology, City of Hope Orange County Medical Center, Irvine, CA
| | - Alex Chehrazi-Raffle
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Abhishek Tripathi
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Tanya Dorff
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Sumanta Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.
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Bergerot CD, Philip EJ, Bergerot PG, Razavi M, Lee D, Clark KL, Loscalzo M, Pal SK, Dale W. Anxiety, Depression, and Coping Strategies during Chemotherapy Treatment: A Comparison of Older and Younger Adults with Advanced Cancer in Brazil. Cancer Invest 2023; 41:781-788. [PMID: 37882784 DOI: 10.1080/07357907.2023.2274033] [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: 03/08/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
We sought to examine differences in anxiety, depression and coping strategies among younger (<64-year old) and older (≥65-year old) patients. Patients were assessed at baseline (T1), mid-point (T2) and on the last day of treatment (T3) using the Hospital Anxiety and Depression Scale and the Ways of Coping. A linear mixed modeling approach was used. The study included 200 patients (gender: 70% women; diagnosis: 30% breast, 22% hematological, 18% gastrointestinal; disease stage: 60% advanced). Older patients who used an emotion-focused coping strategy had a greater decrease in anxiety at T3 compared to those that used problem-focused coping (p = .002).
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Affiliation(s)
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | | | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - David Lee
- University of New Mexico, Albuquerque, New Mexico, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Bergerot CD, Philip EJ, Malhotra J, Bergerot PG, Castro DV, Govindarajan A, Salgia S, Salgia M, Salgia N, Hsu J, Meza L, Zengin ZB, Liu S, Chehrazi-Raffle A, Tripathi A, Dorff T, Pal S. Racial and ethnic differences in perceptions of germline or somatic DNA sequencing among patients with advanced prostate, urothelial, or kidney cancer. J Genet Couns 2023. [PMID: 37697864 DOI: 10.1002/jgc4.1786] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
We sought to determine racial and ethnic differences in perceptions (quality of communication, expectations, and concerns) of germline or somatic DNA sequencing (genomic profiling). Patients with prostate, urothelial, or kidney cancer were surveyed using a questionnaire that assessed previous experience, beliefs, expectations, and concerns regarding genomic profiling. Descriptive statistics and chi-square tests were used to identify factors associated with patients' perceptions of genomic profiling. A total of 150 consecutive patients were enrolled. The majority were male (74%) with a mean age of 68 years old. Most patients underwent somatic testing (54%), 24% undertook germline testing, and 21% undertook both tests. Significant differences were found across racial and/or ethnicity concerning factors that could have influenced patients' decision to pursue genomic profiling, including ability to guide the type of treatment (White: 54.1% vs. other ethnic groups: 43.9%, p = 0.04) and potential to improve treatment response (White: 10.1% vs. other ethnic groups: 22.0%, p = 0.04). Other ethnic group of patients were more concerned about learning that the cancer was less treatable or aggressive (43.8% vs. 27.7%, p = 0.01) and anxious about what would be learnt from genomic profiling (34.4% vs. 21.3, p = 0.01) as compared to White patients. Our findings reinforce the importance of developing culturally tailored education to help patients participate actively in decisions about genomic profiling.
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Affiliation(s)
| | - Errol J Philip
- University of California San Francisco, San Francisco, California, USA
| | - Jasnoor Malhotra
- Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | | | - Daniela V Castro
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Ameish Govindarajan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sabrina Salgia
- Western University of Health Sciences, Pomona, California, USA
| | - Meghan Salgia
- University of Miami School of Medicine, Miami, Florida, USA
| | - Nicholas Salgia
- Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Luis Meza
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Zeynep B Zengin
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sandy Liu
- Department of Medical Oncology, City of Hope Orange County Medical Center, Irvine, California, USA
| | - Alex Chehrazi-Raffle
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Abhishek Tripathi
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Tanya Dorff
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sumanta Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Bergerot CD, Bergerot PG, Razavi M, Philip EJ, Lakhdari S, França MVDS, Molina LNM, Freitas ANDS, Taveira MC, de Azeredo AC, Fuzita WH, Fernandes CM, Pio RB, de Araujo R, Couto MM, de Vasconcellos VF, Nonino MF, Lee D, de Matos Neto JN, Buso MM, Soto-Perez-de-Celis E, Dale W. Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil. Cancer 2023; 129:2095-2102. [PMID: 36964938 DOI: 10.1002/cncr.34759] [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: 12/05/2022] [Revised: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND This study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health-related quality of life (HR-QOL) outcomes 3 months after initiating treatment. METHODS This is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient-centered outcomes (HR-QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage. RESULTS Fifty-six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy - General FACT-G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, -0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found. CONCLUSION Remote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR-QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient-reported outcomes in low-resource environments.
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Affiliation(s)
- Cristiane Decat Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Paulo Gustavo Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- University of California San Francisco, San Francisco, California, USA
| | - Sabri Lakhdari
- Clínica Médica Cronos, Brasilia, Distrito Federal, Brazil
| | | | | | - Alici Natalia de Sousa Freitas
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Mariane Cunha Taveira
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | | | | | - Cristiano Menezes Fernandes
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Raquel Batista Pio
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Romildo de Araujo
- Centro Pernambucano de Oncologia, Grupo Oncoclinicas, Recife, Pernambuco, Brazil
| | - Milena Macedo Couto
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | | | - Maria Fernanda Nonino
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - David Lee
- University of New Mexico, Albuquerque, New Mexico, USA
| | - João Nunes de Matos Neto
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Marco Murilo Buso
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | | | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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8
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Bergerot CD, Malhotra J, Bergerot P, Philip EJ, Castro DV, Hsu J, Mota ACDA, Cardoso de Azeredo A, Neto JNDM, Hutson T, Grünwald V, Bex A, Psutka SP, Rini B, Plimack ER, Master V, Albiges L, Choueiri TK, Pal S, Powles T. Patients' Perceptions Regarding the Relevance of Items Contained in the Functional Assessment of Cancer Therapy Kidney Symptom Index-19. Oncologist 2023:7077455. [PMID: 36917626 DOI: 10.1093/oncolo/oyad028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/06/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND There is a lack of consensus regarding the optimal method of assessing health-related quality of life (HR-QOL) among patients with metastatic renal cell carcinoma (mRCC). This study explored the perceived relevance of items that make up the Functional Assessment of Cancer Therapy Kidney Symptom Index-19 (FKSI-19), as judged by patients with mRCC. METHODS This was a multinational cross-sectional survey. Eligible patients responded to a questionnaire composed of 18 items that assessed the perceived relevance of each item in the FKSI-19 questionnaire. Open-ended questions assessed additional issues deemed relevant by patients. Responses were grouped as relevant (scores 2-5) or nonrelevant (score 1). Descriptive statistics were collated, and open-ended questions were analyzed and categorized into descriptive categories. Spearman correlation statistics were used to test the association between relevance and clinical characteristics. RESULTS A total of 151 patients were included (gender: 78.1 M, 21.9F; median age: 64; treatment: 38.4 immunotherapy, 29.8 targeted therapy, 13.9 immuno-TKI combination therapy) in the study. The most relevant questions evaluated fatigue (77.5), lack of energy (72.2), and worry that their condition will get worse (71.5). Most patients rated blood in urine (15.2), fevers (16.6), and lack of appetite (23.2) as least relevant. Qualitative analysis of open-ended questions revealed several themes, including emotional and physical symptoms, ability to live independently, effectiveness of treatment, family, spirituality, and financial toxicity. CONCLUSION There is a need to refine widely used HR-QOL measures that are employed among patients diagnosed with mRCC treated with contemporary therapies. Guidance was provided for the inclusion of more relevant items to patients' cancer journey.
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Affiliation(s)
| | - Jasnoor Malhotra
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Paulo Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil
| | - Errol J Philip
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Daniela V Castro
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | | | | | - Thomas Hutson
- Urologic Oncology Program, Texas Oncology at Baylor Sammons Cancer Center, Dallas, TX, USA
| | - Viktor Grünwald
- Clinic for Medical Oncology, Clinic for Urology, University Hospital Essen, Essen, Alemanha, Germany
| | - Axel Bex
- UCL Division of Surgical and Interventional Science, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sarah P Psutka
- Urology Clinic, University of Washington, Seattle, WA, USA
| | - Brian Rini
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Elizabeth R Plimack
- Department of Hematology/Oncology and Chief, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Viraj Master
- Department of Urology, Emory University Hospital, Atlanta, GA, USA
| | - Laurence Albiges
- Department of Cancer Medicine, Gustave Roussy Institute, Paris, France
| | - Toni K Choueiri
- Lank Center for Genitourinary (GU) Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sumanta Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Thomas Powles
- Barts Cancer Centre, Barts Cancer Centre at St. Bartholomew's Hospital, London, UK
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9
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Bergerot CD, Bergerot PG, Molina LNM, Freitas ANDS, do Nascimento KL, Philip EJ, Lee D, Sacchi LL, Nazario JLF, Matos Neto JN, Buso MM, Soto-Perez-De-Celis E, Florez N. Impact of a Biopsychosocial Screening Program on Clinical and Hospital-Based Outcomes in Cancer. JCO Oncol Pract 2023:OP2200751. [PMID: 36753690 DOI: 10.1200/op.22.00751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND The integration of a biopsychosocial screening (BPS) program has been proposed by international agencies to better identify and effectively manage unmet needs among patients with cancer. We sought to evaluate the effect of a BPS program on hospital admissions and length of stay (LOS) among a diverse sample of patients with cancer and receiving treatment in Brazil. METHODS A retrospective analysis was performed from March 2020 to December 2021. Eligible patients were diagnosed with cancer and were receiving treatment at a private practice in Brazil. Clinical characteristics, participation in the BPS program, hospital admissions, reason, and LOS in hospital were evaluated. We compared the number of hospital admissions and LOS between groups (participation v no participation). T test and Chi-square test were used to test for differences between groups. RESULTS A total of 1,014 patients were included in the analysis. Baseline clinical characteristics were well balanced between groups (n = 459 patients who participated and n = 555 patients who did not). The median age of patients was 63 years. Breast and hematological cancers were the most common types of cancer; 60% were diagnosed at an advanced disease stage. A smaller proportion of patients who participated in the BPS program were hospitalized compared with patients who did not participate (8% v 32%, P = .001). Patients who participated in the program also spent less days in the hospital compared with patients who did not participate in the program (M = 4.2 days v 9.8 days, P = .001). CONCLUSION Engagement in a BPS program was associated with reduced hospital admissions and LOS. This study provides novel insight into the potential broader implications of BPS programs for clinical care systems. Future studies are needed to explore the mechanisms behind such associations.
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Affiliation(s)
- Cristiane Decat Bergerot
- Centro de Câncer de Brasília, Brasília, DF, Brazil.,Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | - Paulo Gustavo Bergerot
- Centro de Câncer de Brasília, Brasília, DF, Brazil.,Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | | | | | - Karla Lucia do Nascimento
- Centro de Câncer de Brasília, Brasília, DF, Brazil.,Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA
| | - David Lee
- University of New Mexico, Albuquerque, NM
| | | | | | - João Nunes Matos Neto
- Centro de Câncer de Brasília, Brasília, DF, Brazil.,Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | | | | | - Narjust Florez
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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10
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Bergerot CD, Ferreira LN, Molina LNM, Pagung LB, Pedersen BDS, de Andrade TG, Machado RHI, Freitas ANDS, Barreto LHCT, de Araujo LL, Tumeh IBRG, Vieira NBS, Lee D, Philip EJ, Neto JNM, Buso MM, Simard S, Ozakinci G, Humphris G, Bergerot PG, Smith AB. Fear of cancer recurrence among Brazilian patients with cancer: Translation and cultural adaptation of FCR4/7 and FCRI-SF measures. J Psychosom Res 2023; 165:111125. [PMID: 36610336 DOI: 10.1016/j.jpsychores.2022.111125] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Fear of cancer recurrence or progression (FCR) is considered one of the most common unmet needs among patients with cancer. This study sought to translate and evaluate the psychometric properties of the Fear of Cancer Recurrence scale (FCR4/7) and Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF). METHODS This study involved three phases: (1) translation and cultural adaptation of the FCR4/7 and FCRI-SF measures, (2) validity and reliability testing of the Portuguese version of these measures, and (3) examining patient's perceptions of these measures. Eligible patients were diagnosed with localized breast cancer, and patients with metastatic cancer. Descriptive analyses were collated, and psychometric analysis were conducted (confirmatory factor analysis). RESULTS A total of 200 patients were recruited (100 patients with localized and 100 patients with metastatic cancer). A significant proportion of patients reported moderate to severe FCR (FCR7: 32.0% and FCRI-SF: 43.0%). Female gender, younger age and metastatic cancer were associated with higher levels of FCR. Psychometric analyses suggested that the Portuguese versions of the FCR4/7 and FCRI-SF were valid, unidimensional in nature, with acceptable reliability coefficients across all scales. In a sub-sample qualitative analysis (n = 75), most patients were satisfied with the relevance of both measures. CONCLUSION Our findings suggest the Portuguese versions of the FCR4/7 and FCRI-SF are valid tools to assess FCR among patients with localized and metastatic cancer. Future research can now extend our understanding of FCR and assess this construct among Portuguese speaking patients, to guide the development of effective and targeted interventions for patients globally.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - David Lee
- University of New Mexico, Albuquerque, NM, USA
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA, USA
| | - João Nunes Matos Neto
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil
| | - Marco Murilo Buso
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil
| | - Sebastien Simard
- Health Science Department, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
| | - Gozde Ozakinci
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, United Kingdom
| | - Gerald Humphris
- Population and Behavioural Sciences, School of Medicine, University of St. Andrews, Scotland, United Kingdom
| | - Paulo Gustavo Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil.
| | - Allan Ben Smith
- Faculty of Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales (UNSW Sydney), Liverpool, Australia.
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11
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Zengin ZB, Govindarajan A, Salgia N, Sayegh N, Tripathi N, Muddasani R, Chehrazi-Raffle A, Feng M, Mercier BD, Ladbury C, Hao C, Salgia S, Chawla N, Meza L, Malhotra J, Dizman N, Hsu J, Castro DV, Barragan-Carrillo R, Ebrahimi H, Philip EJ, Chang M, Zhang J, Byron S, Lyou Y, Dorff T, Pal SK, Dandapani S. Genomic and Transcriptomic Predictors of Response from Stereotactic Body Radiation Therapy in Patients with Oligoprogressive Renal Cell Carcinoma. Eur Urol Oncol 2023:S2588-9311(22)00203-6. [PMID: 36609061 DOI: 10.1016/j.euo.2022.11.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/17/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023]
Abstract
Stereotactic body radiation therapy (SBRT) has been shown to be safe and effective for delaying systemic treatment change among patients with metastatic renal cell carcinoma (mRCC). In this study, we sought to assess the genomic signatures of patients with mRCC who underwent SBRT for oligoprogression. A total of 30 patients with oligoprogressive disease were identified, the majority of whom had clear cell renal cell carcinoma (83.3%) and were receiving first-line treatment (53.3%). Genomic and transcriptomic sequencing were available in 20 and 16 patients, respectively. Duration of systemic treatment (DOT) was categorized as that prior (DOT[P]) and subsequent (DOT[S]) to radiation treatment. The median DOT(P) and DOT(S) were 15.1 and 18.3 mo, respectively, with a median DOT(S)/DOT(P) ratio of 1.4. Patients who had a DOT(S)/DOT(P) ratio of ≥1 had increased expression in pathways related to cell proliferation and development. In contrast, among patients with a ratio of ≤1, the reactive oxygen species pathway was enriched. This study highlights the potential role of genomics and transcriptomics to refine radiation treatment selection in patients with mRCC. PATIENT SUMMARY: In this study, we looked at mutations and genomic expressions among kidney cancer patients who responded better to stereotactic body radiotherapy. We found that enriched expression of certain pathways might play a role in response to radiotherapy.
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Affiliation(s)
- Zeynep B Zengin
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Ameish Govindarajan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Nicholas Salgia
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Nicolas Sayegh
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Nishita Tripathi
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Ramya Muddasani
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Alex Chehrazi-Raffle
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Matthew Feng
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Benjamin D Mercier
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Colton Ladbury
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Claire Hao
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sabrina Salgia
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Neal Chawla
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Luis Meza
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jasnoor Malhotra
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Daniela V Castro
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | - Hedyeh Ebrahimi
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Errol J Philip
- University of California-San Francisco, San Francisco, CA, USA
| | - Mark Chang
- Kerk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
| | - Jiaming Zhang
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Sara Byron
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Yung Lyou
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Tanya Dorff
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sumanta K Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
| | - Savita Dandapani
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
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12
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Castro DV, Zengin ZB, Malhotra J, Bergerot CD, Meza L, Dizman N, Govindarajan A, Hsu J, Chehrazi-Raffle A, Chawla N, Mercier BD, Chen SW, Feng M, Prajapati S, Lee KO, Philip EJ, Dorff TB, Lyou Y, Pal SK. Perceptions of COVID-19 Vaccination in Patients with Genitourinary Cancers: A Survey Study. Cancer Invest 2023; 41:70-76. [PMID: 36239609 DOI: 10.1080/07357907.2022.2136683] [Citation(s) in RCA: 1] [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] [Indexed: 01/25/2023]
Abstract
Since the approval of the COVID-19 vaccines, their safety and efficacy has been widely demonstrated in patients with cancer. However, there remain patients with reservations regarding vaccination. We aimed to assess genitourinary cancer patients' perceptions of the vaccines as well as barriers and influencers of decision-making through the completion of a questionnaire. While vaccine-associated concerns were observed, most patients with genitourinary cancers were willing to receive the vaccine. Moving forward, differing strategies could be considered to enhance patient education on the utility of vaccination in the setting of cancer and beyond.
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Affiliation(s)
- Daniela V Castro
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Zeynep B Zengin
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Jasnoor Malhotra
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Cristiane D Bergerot
- Centro de Câncer de Brasília (CETTRO), Instituto Unity de Ensino e Pesquisa, Brasília, Brazil
| | - Luis Meza
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA.,Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ameish Govindarajan
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Alex Chehrazi-Raffle
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Neal Chawla
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Benjamin D Mercier
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sean W Chen
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Feng
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sweta Prajapati
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Kyle O Lee
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- University of California San Francisco (UCSF) School of Medicine, San Francisco, California, USA
| | - Tanya B Dorff
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Yung Lyou
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sumanta K Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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13
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Tumeh IBRG, Bergerot CD, Lee D, Philip EJ, Freitas-Júnior R. mHealth program for patients with advanced cancer receiving treatment in a public health hospital in Brazil. Psychooncology 2023; 32:125-132. [PMID: 36284459 DOI: 10.1002/pon.6059] [Citation(s) in RCA: 1] [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: 07/05/2022] [Revised: 09/06/2022] [Accepted: 09/25/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Previous studies have suggested the benefit of routine screening for biopsychosocial symptoms among patients with cancer. In recognition of the lack of data from low- and middle-income countries, this study sought to test and determine the effect of a mHealth program to screen biopsychological symptoms among patients with advanced breast or gynecological cancer. METHODS This was a quasi-experimental pre-post study conducted in a public hospital located in central western Brazil. Patients diagnosed with advanced breast of gynecological cancer who were about to initiate chemotherapy treatment at this institution and had access to Internet by smartphone, computer or tablet were invited to participate. Patients received training on using the app Comfort, a program developed to rate their physical and emotional symptoms during the 6-month of the proposed study. Patients were also asked to complete the EuroQOL 5D (EQ-5D-3L) every month. Mann-Whitney U test was used to determine differences among groups of patients (engaged and non-engaged). RM-ANOVA was used to determine the effect of time on mean visual analog scale (VAS) score. RESULTS A total of 125 patients were recruited (median age = 46.6 years old, 41.6% married). Mostly, patients possessed lower levels of education and had relatively low monthly incomes. Notably, 67.2% of patients engaged with the Comfort program, and few patients (4%) withdrew due to lack of engagement with the program or issues with internet connection. In general, patients who engaged with the program reported improvement in physical and emotional symptoms (p < 0.01), as well as in their overall quality of life (VAS; p = 0.009), compared with patients who did not engage with the program. CONCLUSIONS This is the first mHealth program developed in Brazil for patients in a low resource setting. Our findings suggest that Comfort could be an effective resource to assist patients and health care providers track symptoms and improve patients' quality of life.
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Affiliation(s)
| | | | - David Lee
- University of New Mexico, Albuquerque, New Mexico, USA
| | - Errol J Philip
- University of California San Francisco, San Francisco, California, USA
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14
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Razavi M, Bergerot CD, Philip EJ, Dale W. Association of time intervals in cancer screenings and older participants' characteristics, in a nationally representative sample. J Geriatr Oncol 2023; 14:101392. [PMID: 36344421 DOI: 10.1016/j.jgo.2022.10.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 08/16/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Health agencies and guidelines have proposed various recommendations regarding breast and prostate cancer screening intervals for older adults. However, there is limited data about factors that could impact older individuals' adherence to these guideline-based intervals. This study emphasized the differences in screening rates between men and women undergoing screening for breast (mammogram) and prostate (prostate-specific antigen [PSA] test) cancer. It also investigated the socio-demographic and emotional factors associated with screening time intervals. MATERIALS AND METHODS This cross-sectional design study used data from the National Social Life Health and Aging Project Wave 3 (NSHAP-W3, 2015). The outcome measures were screening time intervals (PSA test or mammogram). Individuals were asked, "About how long has it been since you last had a screening?" Response categories ranged from 1 = within the past year to 5 = never. Differences in screening time intervals were evaluated and displayed by age group (PSA vs. mammogram). The association between the outcome measures and participants' characteristics was evaluated via ordinal logistic regression. RESULTS There were 2320 participants included: 52% women and 48% men. They had a mean age of 66.9 years old, were mostly White (74%) and college graduates (68%). The average time interval between screenings was greater for PSA testing than mammography (mean [M] = 2.28 vs. M = 1.89, p < 0.001). The middle age groups (PSA: 60-79 and mammogram: 65-74), had significantly more frequent screenings compared to the youngest group (50-54). In contrast, older (80+) individuals did not display shorter screening time intervals compared to the youngest group. Furthermore, shorter time intervals between screenings were associated with higher household income (mammogram: odds ratio [OR] = 0.804; PSA: OR = 0.785, p < 0.05), African American descent (mammogram: OR = 0.458, p < 0.001), and higher frequency of physical activity (PSA: OR = 0.921, p = 0.030). Lastly, women who responded "yes" to skipping care due to lack of insurance reported longer periods between mammograms (OR = 1.784, p = 0.002). DISCUSSION Findings from this real-world US population representative database highlight the role of age, income, and insurance in the timing between screenings; participants aged between 60 and 79 years old, African American women, and physically active men are more likely to pursue earlier screening. These results emphasize the importance of socioeconomic and lifestyle factors when seeking to impact screening timing.
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Affiliation(s)
- Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | - Errol J Philip
- University of California San Francisco, San Francisco, CA, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
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15
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Merluzzi TV, Salamanca-Balen N, Philip EJ, Salsman JM. "Letting go" - Relinquishing control of illness outcomes to God and quality of life: Meaning/peace as a mediating mechanism in religious coping with cancer. Soc Sci Med 2023; 317:115597. [PMID: 36535230 PMCID: PMC9962851 DOI: 10.1016/j.socscimed.2022.115597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/26/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Relinquishing control (RC) of outcomes to God is a long-standing form of religious coping with serious illness. Placing cancer outcomes "in God's hands" has been positively related to coping and quality of life (QOL). However, the mechanisms involved in this relationship have not been established. A serial mediation model [i.e., RC (X)-Meaning/Peace (M1)-Coping Efficacy (M2)-Symptoms, Physical QOL, Functional QOL (Ys)] tested the hypothesis that Meaning/Peace alone and in conjunction with coping would mediate the RC-QOL relationship. METHOD 548 persons with a cancer diagnosis completed the Religious Problem-Solving Scale (RPSS), FACIT-Sp Meaning and Peace Scales, Cancer Behavior Inventory (coping efficacy), and measures of Physical Quality of Life (PQOL), Functional Quality of Life (FQOL) and Symptoms. RESULTS As hypothesized, the single mediation effects of Meaning/Peace were significant [Indirect Effects: PQOL: .23 (95% CI: 0.15, 0.34); FQOL: 0.46 (95% CI: 0.33, 0.61); Symptoms: -0.18 (95% CI: -0.27, -0.10)]. In addition, mediation was confirmed for the serial mediation model (i.e., Meaning/Peace - Coping Efficacy as serial mediators) with significant indirect effects [Indirect Effects: PQOL: 0.37 (95% CI: 0.27, 0.48); FQOL: 0.57 (95% CI: 0.42, 0.72); Symptoms: -0.25 (95% CI: -0.35, -0.17)]. CONCLUSIONS In the mediation models tested, the RC-QOL and RC-Symptoms relationships were mediated by the confluence of a sense of peace perhaps due to patients' feelings that outcomes were "in God's hands" and a sense of coherence between their current situation and a spiritually-based meaning system. Meaning/Peace was also related to coping efficacy, suggesting that these mediating constructs could be used to inform evidence-based interventions, such as Meaning-Centered therapies, that are sensitive to the belief systems of cancer patients and enhance QOL.
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Affiliation(s)
| | | | - Errol J Philip
- University of Notre Dame, Department of Psychology, United States
| | - John M Salsman
- Wake Forest University College of Medicine, Social Sciences and Health Policy, United States
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16
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Kenfield SA, Philip EJ, Phillips SM, Meyerhardt JA, Chan JM, Atreya CE, Kim MO, Harris Q, Steiding P, Macaire G, McCullough ML, Piawah S, Johnson WY, Kurttila FA, Lewis WL, Pesmen C, Watson Y, Van Blarigan EL. Optimizing intervention tools to improve nutrition and physical activity for colorectal cancer survivors (Tools To Be Fit): Study protocol of a randomized factorial experiment. Contemp Clin Trials 2022; 123:107009. [PMID: 36396066 PMCID: PMC10561599 DOI: 10.1016/j.cct.2022.107009] [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: 06/22/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is the 2nd leading cause of cancer death in the United States. The American Cancer Society (ACS) Nutrition and Physical Activity Guidelines are associated with longer survival among CRC survivors, but few report behaviors consistent with the guidelines. METHODS The Tools To Be Fit study, based on the Multiphase Optimization Strategy (MOST) framework, is a full factorial experimental to optimize a remotely delivered 48-week diet and physical activity intervention for non-metastatic CRC survivors. The intervention includes a core component (booklet and personal report). CRC survivors (N = 400) are additionally randomly assigned to one of 16 combinations of four candidate components, each with 2 options: 1) text messaging (on/off); 2) self-monitoring modality (digital/paper); 3) health coaching (on/off); and 4) support person coaching (on/off). OUTCOMES Our primary outcome is adherence to the ACS guidelines after 48 weeks using a score that includes physical activity from accelerometers, dietary intake from a food frequency questionnaire, and body mass index (BMI) measured by a technician. Secondary outcomes include the ACS score after 24 weeks and score components at 24 and 48 weeks. Exploratory outcomes include adherence and change in Social Cognitive Theory constructs. We will explore moderation by sociodemographic, clinical, and psychological/behavioral factors; and change in the ACS score in relation to change in levels of insulin, insulin sensitivity, inflammation, gut microbiome structure, fatigue, depression, and sleep disturbance. DISCUSSION The proposed study aims to inform a randomized controlled trial to determine whether an optimized intervention reduces risk of recurrence among CRC survivors.
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Affiliation(s)
- Stacey A Kenfield
- Department of Urology, University of California, San Francisco, CA, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America
| | - Errol J Philip
- UCSF School of Medicine, University of California, San Francisco, CA, United States of America
| | - Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | | | - June M Chan
- Department of Urology, University of California, San Francisco, CA, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America
| | - Chloe E Atreya
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America; Department of Medicine, University of California, San Francisco, CA, United States of America
| | - Mi-Ok Kim
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America
| | - Quincy Harris
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America
| | - Paige Steiding
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America
| | - Greta Macaire
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America
| | - Marjorie L McCullough
- Department of Population Science, American Cancer Society, Atlanta, GA, United States of America
| | - Sorbarikor Piawah
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States of America; Department of Medicine, University of California, San Francisco, CA, United States of America
| | - Wenora Y Johnson
- Fight Colorectal Cancer Research Advocate, Springfield, MO, United States of America
| | - Florence A Kurttila
- Fight Colorectal Cancer Research Advocate, Springfield, MO, United States of America
| | - Wendy L Lewis
- Fight Colorectal Cancer Research Advocate, Springfield, MO, United States of America
| | - Curtis Pesmen
- Fight Colorectal Cancer Research Advocate, Springfield, MO, United States of America
| | - Yasmeem Watson
- Fight Colorectal Cancer Research Advocate, Springfield, MO, United States of America
| | - Erin L Van Blarigan
- Department of Urology, University of California, San Francisco, CA, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America.
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17
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Mercier BD, Tizpa E, Philip EJ, Feng Q, Huang Z, Thomas RM, Pal SK, Dorff TB, Li YR. Dietary Interventions in Cancer Treatment and Response: A Comprehensive Review. Cancers (Basel) 2022; 14:cancers14205149. [PMID: 36291933 PMCID: PMC9600754 DOI: 10.3390/cancers14205149] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Chemotherapy and radiotherapy are essential components to the management of most solid malignancies. These modalities exert their effects primarily by mediating the DNA damage of malignant cells; however, healthy cells are also damaged by the same mechanisms and can incur acute and late side effects resulting in both morbidity and mortality. Dietary interventions have been shown to reduce cancer growth, progression, and metastasis in many different solid tumor models and they show promise for improving cancer outcomes in early phase clinical studies. Here, we review preclinical and clinical studies that examine how dietary interventions can impact cancer treatment toxicity and efficacy in patients who were undergoing chemotherapy and/or radiotherapy. This information can help clinicians tailor the dietary regimens to patients based on their treatment methods and promote larger clinical trials to test the dietary effects on cancer treatment safety and efficacy. Abstract Chemotherapy and radiotherapy are first-line treatments in the management of advanced solid tumors. Whereas these treatments are directed at eliminating cancer cells, they cause significant adverse effects that can be detrimental to a patient’s quality of life and even life-threatening. Diet is a modifiable risk factor that has been shown to affect cancer risk, recurrence, and treatment toxicity, but little information is known how diet interacts with cancer treatment modalities. Although dietary interventions, such as intermittent fasting and ketogenic diets, have shown promise in pre-clinical studies by reducing the toxicity and increasing the efficacy of chemotherapeutics, there remains a limited number of clinical studies in this space. This review surveys the impact of dietary interventions (caloric restriction, intermittent and short-term fasting, and ketogenic diet) on cancer treatment outcomes in both pre-clinical and clinical studies. Early studies support a complementary role for these dietary interventions in improving patient quality of life across multiple cancer types by reducing toxicity and perhaps a benefit in treatment efficacy. Larger, phase III, randomized clinical trials are ultimately necessary to evaluate the efficacy of these dietary interventions in improving oncologic or quality of life outcomes for patients that are undergoing chemotherapy or radiotherapy.
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Affiliation(s)
- Benjamin D. Mercier
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Eemon Tizpa
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Errol J. Philip
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Qianhua Feng
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Ziyi Huang
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Reeny M. Thomas
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Sumanta K. Pal
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Tanya B. Dorff
- Department of Medical Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Yun R. Li
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA
- Division of Quantitative Medicine & Systems Biology, Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ 85004, USA
- Correspondence:
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18
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Castro DV, Malhotra J, Meza L, Govindarajan A, Philip EJ, Pal SK. How to Treat Renal Cell Carcinoma. JACC CardioOncol 2022; 4:271-275. [PMID: 35818545 PMCID: PMC9270613 DOI: 10.1016/j.jaccao.2022.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 01/26/2022] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
With several newly approved regimens for RCC, cardiovascular risks must be considered during treatment selection. Although uncommon, toxicities associated with these systemic therapies can have shortterm and long-term implications. Although some toxicities may be lethal, others can be managed with early intervention. As further agents are developed, multidisciplinary expertise is needed to manage associated cardiovascular toxicities.
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Affiliation(s)
| | - Jasnoor Malhotra
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Luis Meza
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | | | - Errol J. Philip
- University of California-San Francisco, San Francisco, California, USA
| | - Sumanta K. Pal
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
- Address for correspondence: Dr Sumanta K. Pal, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, California 91010, USA. @montypal
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19
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Bergerot CD, Philip EJ, Bergerot PG, Siddiq N, Tinianov S, Lustberg M. Fear of Cancer Recurrence or Progression: What Is It and What Can We Do About It? Am Soc Clin Oncol Educ Book 2022; 42:1-10. [PMID: 35561298 DOI: 10.1200/edbk_100031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Patients with cancer face a trajectory marked by emotional and physical distress that can be associated with both diagnosis and treatment. Fear of cancer recurrence or progression has been considered one of the most common unmet needs reported by patients diagnosed with both localized and metastatic disease. Fear of cancer recurrence or progression has been defined as the "fear, worry, or concern relating to the possibility that cancer will come back or progress." Often overlooked by health care teams, fear of cancer recurrence or progression has been associated with impaired quality of life and psychosocial adjustment, elevated emotional distress, and a range of physical symptoms. Several interventions for fear of cancer recurrence or progression are currently under investigation. Early recognition, support, and validation of feelings associated with fear of cancer recurrence or progression, and appropriate referrals to psychosocial oncology, can be beneficial for many patients. Assessing patients early in their cancer trajectory, and at important milestones, including a change in therapies, at the end of active treatment, and during follow-up visits, can help identify individuals at risk and help individuals engage in supportive programs.
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Affiliation(s)
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA
| | - Paulo Gustavo Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil
| | - Namrah Siddiq
- Yale Cancer Center, Yale School of Medicine, New Haven, CT
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20
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Pham NB, Abraham N, Velankar KY, Schueller NR, Philip EJ, Jaber Y, Gawalt ES, Fan Y, Pal SK, Meng WS. Localized PD-1 Blockade in a Mouse Model of Renal Cell Carcinoma. Front Drug Deliv 2022; 2. [PMID: 36132332 PMCID: PMC9486680 DOI: 10.3389/fddev.2022.838458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Herein we report the impact of localized delivery of an anti-mouse PD-1-specific monoclonal antibody (aPD1) on Renca tumors in the resulting T cell responses and changes in broader immune gene expression profiles. Renca is a BALB/c mice syngeneic tumor that has been used to model human renal cell carcinoma In this study, T cell subsets were examined in tumors and draining lymph nodes of mice treated with localized PD-1 with and without the addition of adenosine deaminase (ADA), an enzyme that catabolizes adenosine (ADO), identified as an immune checkpoint in several types of human cancers. The biologics, aPD1, or aPD1 with adenosine deaminase (aPD1/ADA), were formulated with the self-assembling peptides Z15_EAK to enhance retention near the tumor inoculation site. We found that both aPD1 and aPD1/ADA skewed the local immune milieu towards an immune stimulatory phenotype by reducing Tregs, increasing CD8 T cell infiltration, and upregulating IFNɣ. Analysis of tumor specimens using bulk RNA-Seq confirmed the impact of the localized aPD1 treatment and revealed differential gene expressions elicited by the loco-regional treatment. The effects of ADA and Z15_EAK were limited to tumor growth delay and lymph node enlargement. These results support the notion of expanding the use of locoregional PD-1 blockade in solid tumors.
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Affiliation(s)
- Ngoc B. Pham
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Nevil Abraham
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Ketki Y. Velankar
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Nathan R. Schueller
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Errol J. Philip
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Yasmeen Jaber
- Department of Medical Oncology and Developmental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Ellen S. Gawalt
- Department of Chemistry and Biochemistry, Duquesne University, Pittsburgh, PA, United States
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yong Fan
- Institute of Cellular Therapeutics, Allegheny-Singer Research Institute, Pittsburgh, PA, United States
- Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Sumanta K. Pal
- Department of Medical Oncology and Developmental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Wilson S. Meng
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, United States
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Correspondence: Wilson S. Meng,
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21
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Decat Bergerot C, Costas-Muñiz R, Lee D, Philip EJ. Social support as a protective factor for patients with cancer during the pandemic. Cancer Invest 2022; 40:473-474. [PMID: 35510567 DOI: 10.1080/07357907.2022.2074410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Cristiane Decat Bergerot
- Instituto Unity de Ensino e Pesquisa. Centro de Câncer de Brasília (CETTRO), Brasília, DF, Brazil
| | | | - David Lee
- University of New Mexico, Albuquerque, NM, USA
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA, USA
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22
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Merluzzi TV, Zhang G, Philip EJ, Lee D, Salamanca-Balen N. Discerning critical stressors and resources in the lives of cancer patients: A multivariate analysis of targets of intervention for enhancing cancer care and quality of life. Psychooncology 2022; 31:1186-1195. [PMID: 35194880 DOI: 10.1002/pon.5906] [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: 11/21/2021] [Revised: 01/19/2022] [Accepted: 02/18/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study examined the relationship between a broad variety of stressors, resources, and outcomes to identify targets of intervention to enhance the quality of life of cancer patients and contribute to a comprehensive model of cancer care. METHODS Five hundred and sixty persons with a diagnosis of cancer completed measures of stressors (past negative life events, current problems, current symptoms, comorbidities), resources (coping self-efficacy, social support, satisfaction with care) and outcomes (emotional and functional well-being). RESULTS Multivariate canonical correlations between pairs of canonical variates (stressors-outcomes, Rc = 0.56; stressors-resources, Rc = 0.42, resources-outcomes Rc = 0.66) were significant (all ps < 0.0001), which confirmed the relationship between those components and supported proceeding to more granular levels of analysis. More refined analyses revealed that the most critical variables in relation to outcomes (i.e., emotional and functional well-being), were current problems and symptoms among the stressors and coping self-efficacy, social support and patient satisfaction among the resources. CONCLUSIONS This study provided an approach to the discernment of the most critical aspects of interventions that may improve supportive care and quality of life outcomes. Thus, efforts to address current problems (e.g., financial, home life, work), as well as effective management of symptoms (e.g., pain, fatigue, sleep), using the coordinated integration of medical care, support services and psycho-social interventions would provide the greatest impact on quality-of-life outcomes. Interventions that focus on problem solving and reinforce patient agency and activation may be most effective in sustaining quality of life outcomes into survivorship.
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Affiliation(s)
- Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Guangjian Zhang
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Errol J Philip
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Dayoung Lee
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
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23
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Dragomanovich HM, Dhruva A, Ekman E, Schoenbeck KL, Kubo A, Van Blarigan EL, Borno HT, Esquivel M, Chee B, Campanella M, Philip EJ, Rettger JP, Rosenthal B, Van Loon K, Venook AP, Boscardin C, Moran P, Hecht FM, Atreya CE. Being Present 2.0: Online Mindfulness-Based Program for Metastatic Gastrointestinal Cancer Patients and Caregivers. Glob Adv Health Med 2022; 10:21649561211044693. [PMID: 35174001 PMCID: PMC8842457 DOI: 10.1177/21649561211044693] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Indexed: 01/22/2023] Open
Abstract
Purpose A metastatic cancer diagnosis is associated with high levels of distress in patients and caregivers, which may be alleviated by mindfulness interventions. Research on scalable, tailored, online mindfulness training programs is needed. We sought to test the feasibility and acceptability of a remotely delivered 8-week mindfulness-based intervention, Being Present 2.0 (BP2.0). Methods We performed a single-arm feasibility study of BP2.0 among patients with any metastatic gastrointestinal cancer receiving chemotherapy, with or without an informal caregiver. Participants were instructed to practice mindfulness using pre-recorded guided meditations 5 times per week using a study-specific website and to attend a weekly live, interactive virtual meeting facilitated by a trained instructor. The web-based platform enabled direct measurement of adherence. Results The study enrolled 46 of 74 (62%) patients contacted, together with 23 caregivers (69 participants total), from May to October 2018. Median patient age was 52 (range 20-70 years), 39% were male, 67% non-Hispanic white, 65% had colorectal cancer, and 78% lived outside of San Francisco. The top reasons cited for participation were to reduce stress/anxiety and learn how to meditate. Mean baseline National Comprehensive Cancer Network Distress Thermometer (NCCN DT) scores were 4.7 (patients) and 5.8 (caregivers). The study discontinuation rate was 20% (eight patients and six caregivers). Among the remaining 55 participants, 43 (78%) listened to at least one audio recording and/or attended at least one virtual meeting, although adherence data was incomplete. The retention rate was 71%, with 39 participants completing at least one follow-up assessment. In post-intervention qualitative interviews, 88% of respondents reported a positive experience. Compared to baseline, participants reported significantly reduced post-intervention NCCN DT scores (mean 3.1; P = .012). Conclusion The BP2.0 online mindfulness-based program is feasible and acceptable for patients with metastatic gastrointestinal cancer and caregivers. These results will guide plans for a follow-up efficacy study. ClinicalTrials.gov Identifier: NCT03528863.
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Affiliation(s)
- Hannah M Dragomanovich
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA
| | - Anand Dhruva
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Osher Center for Integrative Medicine, CA, USA.,UCSF Department of Medicine, CA, USA
| | - Eve Ekman
- UCSF Osher Center for Integrative Medicine, CA, USA.,Greater Good Science Center, University of California Berkeley, Berkeley, CA, USA
| | - Kelly L Schoenbeck
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Department of Medicine, CA, USA
| | - Ai Kubo
- Kaiser Permanente Division of Research, CA, USA
| | | | - Hala T Borno
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Department of Medicine, CA, USA
| | - Mikaela Esquivel
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Bryant Chee
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA
| | - Matthew Campanella
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | | | - John P Rettger
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Blake Rosenthal
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Benioff Children's Hospital Oakland, CA, USA
| | - Katherine Van Loon
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Department of Medicine, CA, USA
| | - Alan P Venook
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Department of Medicine, CA, USA
| | | | - Patricia Moran
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Osher Center for Integrative Medicine, CA, USA
| | - Frederick M Hecht
- UCSF Osher Center for Integrative Medicine, CA, USA.,UCSF Department of Medicine, CA, USA
| | - Chloe E Atreya
- University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.,UCSF Osher Center for Integrative Medicine, CA, USA.,UCSF Department of Medicine, CA, USA
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24
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Merluzzi TV, Philip EJ, Gomer B, Heitzmann Ruhf CA, Kim D. Comorbidity, Functional Impairment, and Emotional Distress: A Coping Mediation Model for Persons With Cancer. Ann Behav Med 2021; 55:994-1004. [PMID: 33522569 DOI: 10.1093/abm/kaaa122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Comorbid disease in cancer patients can substantially impact medical care, emotional distress, and mortality. However, there is a paucity of research on how coping may affect the relationship between comorbidity and emotional distress. PURPOSE The current study investigated whether the relations between comorbidity and emotional distress and between functional impairment and emotional distress were mediated by three types of coping: action planning (AP), support/advice seeking (SAS), and disengagement (DD). METHODS Four hundred and eighty-three persons with cancer completed a measure of functional impairment (Sickness Impact Profile), the Checklist of Comorbid Conditions, the Brief COPE, the Hospital Anxiety and Depression Scale, the Quality of Life Assessment for Cancer Survivors (Negative Feelings Scale), and the Distress Screening Schedule (Emotional Distress Scale). The latter three measures were used to form a latent construct representing the outcome, emotional distress. RESULTS Model comparison analysis indicated that the model with DD as a mediator had a better fit than models containing AP and SAS. DD mediated the relationship between functional impairment and emotional distress, so that engaging in DD was associated with greater distress. In addition, comorbidity and functional impairment were directly and positively related to emotional distress, but the relation between comorbidity and distress was not mediated by coping type. CONCLUSIONS Both comorbidity and functional impairment may be associated with distress, but disengagement coping only mediated the relation involving functional impairment and was positively associated with distress. Future studies can investigate whether teaching active coping or adaptive coping (e.g., through mindfulness exercises) can decrease distress in cancer patients, despite functional impairments.
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Affiliation(s)
- Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Errol J Philip
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Brenna Gomer
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Carolyn A Heitzmann Ruhf
- Department of Psychiatry and Behavioral Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dahyeon Kim
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
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25
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Zengin ZB, Weipert C, Salgia NJ, Dizman N, Hsu J, Meza L, Chehrazi-Raffle A, Muddasani R, Salgia S, Malhotra J, Chawla N, Philip EJ, Kiedrowski L, Maughan BL, Rathi N, Goel D, Choueiri TK, Agarwal N, Pal SK. Complementary Role of Circulating Tumor DNA Assessment and Tissue Genomic Profiling in Metastatic Renal Cell Carcinoma. Clin Cancer Res 2021; 27:4807-4813. [PMID: 34130999 DOI: 10.1158/1078-0432.ccr-21-0572] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/30/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE The role of circulating cell-free tumor DNA (ctDNA) as an adjunct to tissue genomic profiling is poorly defined in metastatic renal cell carcinoma (mRCC). In this study, we aim to validate previous findings related to genomic alteration (GA) frequency in ctDNA and determine the concordance between ctDNA and tissue-based profiling in patients with mRCC. EXPERIMENTAL DESIGN Results of 839 patients with mRCC who had ctDNA assessment with a Clinical Laboratory Improvement Amendments (CLIA)-certified ctDNA assay between November 2016 and December 2019 were collected. Tissue-based genomic profiling was collected when available and concordance analysis between blood- and tissue-based testing was performed. RESULTS ctDNA was assessed in 839 patients (comprising 920 samples) with mRCC. GAs were detected in 661 samples (71.8%). Tissue-based GAs were assessed in 112 patients. Limiting our analyses to a common 73-/74-gene set and excluding samples with no ctDNA detected, a total of 228 mutations were found in tissue and blood. Mutations identified in tissue (34.7%; 42/121) were also identified via ctDNA, whereas 28.2% (42/149) of the mutations identified in liquid were also identified via tissue. Concordance between ctDNA and tissue-based profiling was inversely related to the time elapsed between these assays. CONCLUSIONS This study confirms the feasibility of ctDNA profiling in the largest mRCC cohort to date, with ctDNA identifying multiple actionable alterations. It also demonstrates that ctDNA and tissue-based genomic profiling are complementary, with both platforms identifying unique alterations, and confirms that the frequency of unique alterations increases with greater temporal separation between tests.
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Affiliation(s)
- Zeynep B Zengin
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | | | - Nicholas J Salgia
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Nazli Dizman
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Joann Hsu
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Luis Meza
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Alexander Chehrazi-Raffle
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Ramya Muddasani
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Sabrina Salgia
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Jasnoor Malhotra
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Neal Chawla
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Errol J Philip
- University of California San Francisco (UCSF) School of Medicine, San Francisco, California
| | | | - Benjamin L Maughan
- Department of Medical Oncology, Huntsman Cancer Center, University of Utah, Salt Lake City, Utah
| | - Nityam Rathi
- Department of Medical Oncology, Huntsman Cancer Center, University of Utah, Salt Lake City, Utah
| | - Divyam Goel
- Department of Medical Oncology, Huntsman Cancer Center, University of Utah, Salt Lake City, Utah
| | - Toni K Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Neeraj Agarwal
- Department of Medical Oncology, Huntsman Cancer Center, University of Utah, Salt Lake City, Utah.
| | - Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California.
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26
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de Kouchkovsky I, Zhang L, Philip EJ, Wright F, Kim DM, Natesan D, Kwon D, Ho H, Ho S, Chan E, Porten SP, Wong AC, Desai A, Huang FW, Chou J, Oh DY, Pruthi RS, Fong L, Small EJ, Friedlander TW, Koshkin VS. TERT promoter mutations and other prognostic factors in patients with advanced urothelial carcinoma treated with an immune checkpoint inhibitor. J Immunother Cancer 2021; 9:e002127. [PMID: 33980590 PMCID: PMC8118032 DOI: 10.1136/jitc-2020-002127] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) can achieve durable responses in a subset of patients with locally advanced or metastatic urothelial carcinoma (aUC). The use of tumor genomic profiling in clinical practice may help suggest biomarkers to identify patients most likely to benefit from ICI. METHODS We undertook a retrospective analysis of patients treated with an ICI for aUC at a large academic medical center. Patient clinical and histopathological variables were collected. Responses to treatment were assessed for all patients with at least one post-baseline scan or clear evidence of clinical progression following treatment start. Genomic profiling information was also collected for patients when available. Associations between patient clinical/genomic characteristics and objective response were assessed by logistic regression; associations between the characteristics and progression-free survival (PFS) and overall survival (OS) were examined by Cox regression. Multivariable analyses were performed to identify independent prognostic factors. RESULTS We identified 119 aUC patients treated with an ICI from December 2014 to January 2020. Genomic profiling was available for 78 patients. Overall response rate to ICI was 29%, and median OS (mOS) was 13.4 months. Favorable performance status at the start of therapy was associated with improved OS (HR 0.46, p=0.025) after accounting for other covariates. Similarly, the presence of a TERT promoter mutation was an independent predictor of improved PFS (HR 0.38, p=0.012) and OS (HR 0.32, p=0.037) among patients who had genomic profiling available. Patients with both a favorable performance status and a TERT promoter mutation had a particularly good prognosis with mOS of 21.1 months as compared with 7.5 months in all other patients (p=0.03). CONCLUSIONS The presence of a TERT promoter mutation was an independent predictor of improved OS in a cohort of aUC patients treated with an ICI who had genomic data available. Most of the clinical and laboratory variables previously shown to be prognostic in aUC patients treated with chemotherapy did not have prognostic value among patients treated with an ICI. Genomic profiling may provide important prognostic information and affect clinical decision making in this patient population. Validation of these findings in prospective patient cohorts is needed.
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Affiliation(s)
- Ivan de Kouchkovsky
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Li Zhang
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Errol J Philip
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Francis Wright
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Daniel M Kim
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Divya Natesan
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Daniel Kwon
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Hansen Ho
- University of California San Francisco School of Pharmacy, San Francisco, California, USA
| | - Son Ho
- University of California San Francisco School of Pharmacy, San Francisco, California, USA
| | - Emily Chan
- Pathology, University of California San Francisco, San Francisco, California, USA
| | - Sima P Porten
- Urology, University of California San Francisco, San Francisco, California, USA
| | - Anthony C Wong
- Radiation Oncology, University of California San Francisco, San Francisco, California, USA
| | - Arpita Desai
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Franklin W Huang
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jonathan Chou
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - David Y Oh
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Raj S Pruthi
- Urology, University of California San Francisco, San Francisco, California, USA
| | - Lawrence Fong
- Medicine, University of California San Francisco, San Francisco, California, USA
| | - Eric J Small
- Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Vadim S Koshkin
- Medicine, University of California San Francisco, San Francisco, California, USA
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Bergerot CD, Razavi M, Clark KL, Philip EJ, Pal SK, Loscalzo M, Dale W. Emotional problem-related distress screening and its prevalence by cancer type: Assessment by patients' characteristics and level of assistance requested. Psychooncology 2021; 30:1332-1338. [PMID: 33797817 DOI: 10.1002/pon.5685] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Emotional problem-related distress is a common issue faced by patients with cancer. However, patients suffering with this emotional burden do not typically seek assistance. This study sought to determine the prevalence of emotional problem-related distress by cancer type, and identify factors correlated with the level of assistance requested. METHODS Using the SupportScreen®, patients were screened for emotional problem-related distress at their first or second visit to an NCI designated Comprehensive Cancer Center. General Linear Model was used to test the association between emotional problem-related distress and type of cancer, and the relationship between level of assistance requested and patients' characteristics. RESULTS A total of 2,421 patients were included in this analysis. Patients were mostly female (62%), diagnosed with breast (24%), gynecological (16%) or gastrointestinal (15%) cancers. Highest levels of emotional problem-related distress were reported by patients diagnosed with lung, gynecological, breast and gastrointestinal cancers. Level of assistance requested were significantly associated with problem-related distress scores (p < 0.001), which were higher among patients with lower household incomes (p < 0.001) and Spanish as primary language (p = 0.001). CONCLUSION Our study found an association between Level of assistance requested and emotional problem-related distress, which were heightened by lower income and Spanish-speaking. Intervention strategies should be considered to increase access to psychosocial support services.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Philip EJ, Zhang S, Tahir P, Kim D, Wright F, Bell A, Borno HT. Cost-Effectiveness of Immunotherapy Treatments for Renal Cell Carcinoma: A Systematic Review. KCA 2021. [DOI: 10.3233/kca-200107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Kidney cancer exerts significant disease burden in the United States and possesses a rapidly evolving treatment landscape. The expansion of novel systemic treatment approaches and the use of immunotherapy has been accompanied by increased costs over time. However, the cost-effectiveness of immunotherapy in renal cell carcinoma (RCC) has not been fully assessed. The current study presents a systematic review of cost-effectiveness studies of immunotherapy-based treatment in the context of RCC. METHODS: A literature search utilizing PubMed, Embase, Web of Science, and the Cochrane Library was undertaken to find articles related to the cost-effectiveness of immunotherapy treatment in renal cell carcinoma (RCC). The inclusion criteria for articles were as follows: English, published between 1983 and 2020 and evaluated cost-effectiveness in any of the currently approved immunotherapies for RCC. Exclusion criteria included being a review article, commentary or editorial, as well as possessing no specific cost-effectiveness evaluation or analysis relevant to the current review. RESULTS: The current review identified 23 studies, published between 2008 and 2020, across 9 different countries. The studies identified tended to focus on patients with locally advanced or metastatic RCC and examined the cost-effectiveness of immunotherapy across various lines of treatment (first-line treatment (n = 13), second-line treatment (n = 8), and first-line and beyond (n = 2). Eight studies examined the use of interferon-alpha (IFN-alpha), with some reports supporting the cost-effectiveness of these agents and an equal number of studies demonstrating the opposite, with sunitinib often demonstrating superior cost bases. The majority, fourteen studies, included the use of novel immune checkpoint inhibitors (nivolumab, ipilimumab, pembrolizumab), half of which found that checkpoint inhibitors were more cost-effective when compared to oral systemic therapies (sunitinib, everolimus, axitinib, pazopanib, and cabozantinib). DISCUSSION: Novel immune checkpoint inhibitors constituted the most frequently examined agents and were likely to be deemed cost-effective as compared to other treatments; although this often required higher willingness-to-pay (WTP) thresholds or healthcare systems that possessed more cost-constraints. These observations have clinical and health system applicability, with the ability to potentially reduce the cost of treatment for locally advanced or metastatic RCC.
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Affiliation(s)
- Errol J. Philip
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Sylvia Zhang
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Peggy Tahir
- University of California San Francisco Library, San Francisco, CA, USA
| | - Daniel Kim
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Francis Wright
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Alexander Bell
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Hala T. Borno
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA, USA
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Bergerot CD, Philip EJ. Emotional Burden Associated with COVID-19: Trust and Communication in Cancer Care. Cancer Invest 2020; 39:1-2. [PMID: 33148064 DOI: 10.1080/07357907.2020.1847383] [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: 10/23/2022]
Affiliation(s)
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA, USA
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Bergerot CD, Philip EJ. Emotional Burden Associated with COVID-19: Trust and Communication in Cancer Care. Cancer Invest 2020:1-4. [PMID: 33148036 DOI: 10.1080/07357907.2020.1847290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Cristiane Decat Bergerot
- Instituto Unity de Ensino e Pesquisa, Centro de Câncer de Brasília (CETTRO), Brasília, DF, Brazil
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA
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Bergerot CD, Razavi M, Philip EJ, Bergerot PG, Buso MM, Clark KL, Loscalzo M, Pal SK, Dale W. Association between hospital anxiety and depression scale and problem-related distress in patients with cancer in a Brazilian private institution. Psychooncology 2020; 30:296-302. [PMID: 33044794 DOI: 10.1002/pon.5571] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/23/2020] [Accepted: 10/07/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Emotional symptoms are frequently reported among patients with cancer. We evaluated the association between emotional symptoms and problem-related distress in a sample of patients with cancer about to initiate chemotherapy within a private hospital in Brazil. METHODS Patients were assessed before initiating chemotherapy, treatment mid-point, and on the last day of treatment for anxiety and depression (Hospital Anxiety and Depression Scale [HADS]) and for problem-related distress (Distress Thermometer Problem List). Problem-related distress variable was computed as the sum of practical, physical, spiritual and familial problems. Mixed-model analysis was applied to determine the association between HADS and problem-related distress, adjusting for age and gender. RESULTS A total of 655 consecutive patients were enrolled. There was a significant main effect of time (F = 8.99, p = 0.0001), showing that emotional symptoms improve over time. A significant main effect was observed for problem-related distress (F = 371.56, p < 0.0001) revealing that patients with elevated problem-related distress at baseline tend to have higher HADS across the three time points, compared to patients with lower problem-related distress. There was an interaction effect between problem-related distress and time (F = 85.22, p < 0.0001), suggesting that HADS scores decreased differently over time, depending on patients' initial level of problem-related distress. CONCLUSION Overall, emotional symptoms, while decreasing over time, remained associated with problem-related distress after chemotherapy in Brazil. The potential benefit of implementing a psychosocial intervention remains high throughout cancer treatment.
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Affiliation(s)
- Cristiane D Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA.,Instituto Unity de Ensino e Pesquisa, Centro de Câncer de Brasília (CETTRO), Brasília, DF, Brazil
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope-National Medical Center, Duarte, California, USA
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | - Paulo G Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA.,Instituto Unity de Ensino e Pesquisa, Centro de Câncer de Brasília (CETTRO), Brasília, DF, Brazil
| | - Marco M Buso
- Department of Oncology, Centro de Câncer de Brasília (CETTRO), Brasília, DF, Brazil
| | - Karen L Clark
- Department of Supportive Care Medicine, City of Hope-National Medical Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope-National Medical Center, Duarte, California, USA
| | - Sumanta K Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope-National Medical Center, Duarte, California, USA
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Basu A, Philip EJ, Dewitt B, Hanmer J, Chattopadhyay A, Yau C, Melisko ME, Esserman LJ. The quality of life index: a pilot study integrating treatment efficacy and quality of life in oncology. NPJ Breast Cancer 2020; 6:52. [PMID: 33083531 PMCID: PMC7560724 DOI: 10.1038/s41523-020-00193-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/27/2020] [Indexed: 11/09/2022] Open
Abstract
The majority of women diagnosed with breast cancer will experience some form of drug-related toxicity and subsequent impairments in Health-related Quality of Life (HRQoL). Despite this, HRQoL is assessed inconsistently and there is no validated method to integrate HRQoL data into the assessment of therapeutic agents. This proof of concept study utilizes data from the neoadjuvant I-SPY 2 clinical trial to describe the development of the Quality of Life Index (QoLI) measure. The QoLI represents a single composite score that incorporates validated longitudinal measures of clinical efficacy and QoL and one that permits a more comprehensive, direct comparison of individual therapeutic agents. Preliminary data suggest the QoLI is able to distinguish between agents based on their efficacy and toxicity; with further validation, the QoLI has the potential to provide more patient-centered evaluations in clinical trials and help guide treatment decision making in breast cancer and other oncologic diseases.
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Affiliation(s)
- A Basu
- Department of Surgery, University of California San Francisco, San Francisco, CA 94115 USA
| | - E J Philip
- School of Medicine, University of California San Francisco, San Francisco, CA 94115 USA
| | - B Dewitt
- Department of Engineering & Public Policy, Carnegie Mellon University, Pittsburgh, PA USA
| | - J Hanmer
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA USA
| | - A Chattopadhyay
- School of Medicine, University of California San Francisco, San Francisco, CA 94115 USA
| | - C Yau
- Department of Surgery, University of California San Francisco, San Francisco, CA 94115 USA
| | - M E Melisko
- Department of Surgery, University of California San Francisco, San Francisco, CA 94115 USA
| | - L J Esserman
- Department of Surgery, University of California San Francisco, San Francisco, CA 94115 USA
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Bergerot CD, Philip EJ, Bergerot PG, Hsu J, Dizman N, Salgia M, Salgia N, Vaishampayan U, Battle D, Loscalzo M, Dale W, Pal SK. Discrepancies between genitourinary cancer patients' and clinicians' characterization of the Eastern Cooperative Oncology Group performance status. Cancer 2020; 127:354-358. [PMID: 33007114 DOI: 10.1002/cncr.33238] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 12/06/2019] [Revised: 01/28/2020] [Accepted: 03/04/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patient-reported outcomes have been used to assess treatment effectiveness and actively engage patients in their disease management. This study was designed to describe the patient-reported performance status (PS) and the provider-reported PS. METHODS Patients with metastatic genitourinary cancers were recruited from a single cancer center before the initiation of a new line of treatment. PS (Eastern Cooperative Oncology Group [ECOG]), quality of life (Functional Assessment of Chronic Illness Therapy-General), and distress (Patient-Reported Outcomes Measurement Information System Anxiety and Depression) were self-reported by patients. Clinical data (eg, age, sex, diagnosis, and physician-reported ECOG PS) were extracted from medical records. Multivariate analysis was used to determine the association between PS, quality of life, and psychological symptoms. RESULTS One hundred forty-five patients were enrolled (76.6% male, 70.3% White, 81.4% married, and 76.6% well educated). The median age was 67 years; 66.9% were diagnosed with renal cell carcinoma, 20.0% were diagnosed with urothelial carcinoma, and 13.1% were diagnosed with prostate cancer. Clinicians more frequently classified patients' ECOG PS as 0 in comparison with the patients themselves (92.4% vs 64.1%; P = .001). Higher clinician-reported ECOG PS was associated with poorer physical and functional well-being and higher rates of depression (P < .01), whereas higher patient-reported ECOG PS was associated with worse psychosocial outcomes (P < .01). CONCLUSIONS Discrepancies were noted between the patient- and provider-reported ECOG PS, with clinicians overestimating the ECOG PS in comparison with the patients themselves. This study's findings suggest that patients incorporate their social and emotional well-being into their PS score in addition to their physical well-being. This information is not immediately accessible to most clinicians from just a standard patient interview and likely accounts for the overestimation of the patients' ECOG PS by the clinicians.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Errol J Philip
- University of California San Francisco, San Francisco, California
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - JoAnn Hsu
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Nazli Dizman
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Megan Salgia
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Nicholas Salgia
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Ulka Vaishampayan
- Department of Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan
| | - Dena Battle
- Kidney Cancer Research Alliance, Alexandria, Virginia
| | - Matthew Loscalzo
- Department of Supportive Care, City of Hope Comprehensive Cancer Center, Duarte, California
| | - William Dale
- Department of Supportive Care, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Sumanta Kumar Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
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Bergerot CD, Battle D, Philip EJ, Bergerot PG, Msaouel P, Smith A'B, Bamgboje AE, Shuch B, Derweesh IH, Jonasch E, Stern AP, Pal SK, Staehler M. Fear of Cancer Recurrence in Patients With Localized Renal Cell Carcinoma. JCO Oncol Pract 2020; 16:e1264-e1271. [PMID: 32955409 DOI: 10.1200/op.20.00105] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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
PURPOSE Patients with cancer commonly report distress and fear of cancer recurrence (FCR) impacting quality of life and clinical outcomes. This study aims to test the association between emotional well-being and clinical characteristics of survivors with localized renal cell carcinoma (RCC). MATERIALS AND METHODS Survivors with localized RCC were invited to participate in this study through social media by the Kidney Cancer Research Alliance. Participants self-reported clinical characteristics, distress (Distress Thermometer), and FCR (Fear of Cancer Recurrence-7). Ordinal regression was used to test the association between emotional well-being and patient characteristics. RESULTS A total of 412 survivors were included in this analysis. Participants were mostly female (79.4%) and well educated (58.3%), with a median age of 54 years (range, 30-80 years) and median time since diagnosis of 17.5 months. More than one half were diagnosed with stage I disease (56.1%). Most patients (62.3%) had a clear understanding of their diagnosis. A high prevalence of moderate to severe distress (67.0%) and FCR (54.9%) was reported across all survivors of RCC. Higher FCR was associated with female gender, younger age, and lack of understanding of their diagnosis (P = .001), whereas more recent diagnosis was associated with higher distress levels (P = .01). CONCLUSION Our findings suggest that FCR is a common problem that is persistent after therapy and that certain individuals, including female and younger patients, may be at particular risk of experiencing clinically relevant FCR.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Dena Battle
- Kidney Cancer Research Alliance, Alexandria, VA
| | - Errol J Philip
- University of California, San Francisco, San Francisco, CA
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Pavlos Msaouel
- Division of Cancer Medicine, Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Allan 'Ben' Smith
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Adeola Esther Bamgboje
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Brian Shuch
- Ronald Reagan UCLA Medical Center, University of California Los Angeles Medical Center, Los Angeles, CA
| | | | - Eric Jonasch
- Division of Cancer Medicine, Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Michael Staehler
- Department of Urology, Ludwig-Maximilians University, Munich, Germany
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Bergerot PG, Bergerot CD, Philip EJ. Emotional Distress During the COVID-19 Pandemic: Psycho-Oncology Perspective. Oncology (Williston Park) 2020; 34:270-271. [PMID: 32674215] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Patients with cancer represent a vulnerable population and are at greater risk of developing serious complications as a result of a COVID-19 infection. In response, oncology societies around the world have proposed changes to their standards of care. These changes have helped guide health care providers in prioritizing clinical management of patients with cancer: identifying situations in which urgent intervention is needed and those that can be triaged until the risk of infection has lessened.
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Affiliation(s)
- Paulo Gustavo Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
- Centro de Câncer de Brasília, DF, Brazil
| | - Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
- Centro de Câncer de Brasília, DF, Brazil
| | - Errol J Philip
- University of California San Francisco School of Medicine, San Francisco, California
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Loo V, Salgia M, Bergerot P, Philip EJ, Pal SK. First-Line Systemic Therapy for Metastatic Clear-Cell Renal Cell Carcinoma: Critical Appraisal of Emerging Options. Target Oncol 2020; 14:639-645. [PMID: 31595385 DOI: 10.1007/s11523-019-00676-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Until recently, a dichotomy existed in the front-line approach of metastatic clear-cell renal cell carcinoma (mRCC). Specifically, patients received either targeted therapy or immunotherapy. Targeted therapy entailed use of agents blocking signaling through the vascular endothelial growth factor (VEGF) receptor, such as cabozantinib, sunitinib, or pazopanib. Immunotherapy entailed dual therapy with nivolumab and ipilimumab, both checkpoint inhibitors for intermediate/poor International Metastatic RCC Database Consortium (IMDC)-risk disease patients. Within the past year, two datasets have emerged that led to recent approvals of combined therapy with VEGF and checkpoint inhibitors. These regimens (axitinib with either avelumab or pembolizumab) are among several that have been or will be evaluated for patients with newly diagnosed mRCC. We aim to facilitate treatment decisions through this comprehensive and contextualized overview of recent datasets in this therapeutic space.
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Affiliation(s)
- Vivian Loo
- Department of Protocol Content Administration, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Meghan Salgia
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Paulo Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | | | - Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
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Basu A, Philip EJ, Dewitt B, Hanmer J, Chattopadhyay A, Yau C, Asare S, Digiorgio K, Singhrao R, Asare A, Perlmutter J, Melisko M, Esserman L. Abstract P2-12-06: The clinical benefit index: A pilot study integrating treatment efficacy and quality of life in oncology clinical trials. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-12-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer remains the most frequently diagnosed cancer among women worldwide, accounting for a quarter of all diagnoses. Despite advances in treatment and symptom management, the majority of women will experience some form of drug-related toxicity, psychosocial distress, and subsequent impairments in their quality of life (QoL). Distress and impairments in QoL can interfere with treatment adherence, while engagement in health promoting behaviors and effective management of symptoms has been associated with improved QoL, adherence and increased survival. The utilization of QoL or other Patient Reported Outcome (PRO) measures in clinical trials remains inconsistent, and no uniformly accepted measure exists to integrate QoL data into the assessment of therapeutic agents. There are two goals of the I-SPY 2 QoL Pilot Study: 1) To demonstrate the reporting of an integrated utility-based QOL score, the PROPr, within a novel longitudinal approach that provides a single numerical index of QoL; 2) Generate a Clinical Benefit Index (CBI), a single composite score that integrates the longitudinal PROPr score with a clinical efficacy score, RCB index, to provide a measure that could go beyond clinical efficacy in the evaluation of therapeutic agents in the I-SPY 2 TRIAL. Methods: Study participants were part of the I-SPY 2 TRIAL assessing novel neoadjuvant therapies added to standard chemotherapy in the treatment of Stage 2/3 breast cancer. Participants completed a validated QoL measure at three time points: baseline, prior to surgery, and 1-month post-surgery. QoL was assessed using the NIH PROMIS measure (physical function (four items), anxiety (eight items), depression (eight items), fatigue (eight items), applied cognition (eight items) and social roles (four items)) and results at each time point used to calculate the PROPr, a single utility-based index score to assess overall quality of life. PROPr index utility scores were used to generate a single longitudinal QoL score based on area under the curve modeling. Clinical efficacy was assessed based on the residual cancer burden (RCB) observed at the time of surgery. The CBI was generated by plotting RCB index against the longitudinal PROPr index for each participant and study arm. Results: Only a fraction (n=107) of all patients had complete data across study timepoints and were included in our analyses, and thus our data represent a proof of concept. Patients on the control arm were treated with Paclitaxel followed by anthracycline (AC). Patients in the pilot were assigned either the control arm or six experimental drug arms. The longitudinal PROPr utility index demonstrated a range of outcomes, with some arms more challenging to tolerate, and others much better, ranging from 0.67 to 1.16. The RCB index of the seven study arms ranged from 0.49 to 1.99. The CBI, an integration of the longitudinal PROPr and RCB indexes, also demonstrated a range from 0.43 to 1.60. Conclusion: We are reporting the development of a novel, valid and standardized QoL assessment that should be a routine part of clinical trials in oncology. This proof of concept study suggests that that calculation of the CBI is feasible and can reveal differences in the clinical profiles of therapeutic agents, both in terms of QoL and overall integration of clinical efficacy and QoL. The CBI represents a novel approach to providing summary data that can be easily interpreted as part of clinical trial outcome data. Ideally, these integrated assessments would provide a more comprehensive evaluation of investigational therapies, and ultimately help inform treatment decision discussions between patients and providers. Moving forward, electronic PRO data will be collected as part of routine care in the I-SPY 2 TRIAL, thus enabling the longitudinal PROPr and CBI scores to be generated for every agent evaluated.
Citation Format: Amrita Basu, Errol J. Philip, Barry Dewitt, Janel Hanmer, Aheli Chattopadhyay, Christina Yau, Smita Asare, Karyn Digiorgio, Ruby Singhrao, Adam Asare, Jane Perlmutter, I-SPY 2 Consortium, Michelle Melisko, Laura Esserman. The clinical benefit index: A pilot study integrating treatment efficacy and quality of life in oncology clinical trials [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-12-06.
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Affiliation(s)
- Amrita Basu
- 1University of California San Francisco, San Francisco, CA
| | | | | | - Janel Hanmer
- 3University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Christina Yau
- 1University of California San Francisco, San Francisco, CA
| | - Smita Asare
- 4Quantum Leap Healthcare Collaborative, San Francisco, CA
| | | | - Ruby Singhrao
- 1University of California San Francisco, San Francisco, CA
| | - Adam Asare
- 1University of California San Francisco, San Francisco, CA
| | | | | | - Laura Esserman
- 1University of California San Francisco, San Francisco, CA
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Gao Y, Kaushik S, Philip EJ, Li Z, Qin Y, Liu YP, Zhang WL, Su YL, Chen X, Weng H, Kharzeev DE, Liu MK, Qi J. Chiral terahertz wave emission from the Weyl semimetal TaAs. Nat Commun 2020; 11:720. [PMID: 32024831 PMCID: PMC7002692 DOI: 10.1038/s41467-020-14463-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [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: 06/19/2019] [Accepted: 01/08/2020] [Indexed: 11/23/2022] Open
Abstract
Weyl semimetals host chiral fermions with distinct chiralities and spin textures. Optical excitations involving those chiral fermions can induce exotic carrier responses, and in turn lead to novel optical phenomena. Here, we discover strong coherent terahertz emission from Weyl semimetal TaAs, which is demonstrated as a unique broadband source of the chiral terahertz wave. The polarization control of the THz emission is achieved by tuning photoexcitation of ultrafast photocurrents via the photogalvanic effect. In the near-infrared regime, the photon-energy dependent nonthermal current due to the predominant circular photogalvanic effect can be attributed to the radical change of the band velocities when the chiral Weyl fermions are excited during selective optical transitions between the tilted anisotropic Weyl cones and the massive bulk bands. Our findings provide a design concept for creating chiral photon sources using quantum materials and open up new opportunities for developing ultrafast opto-electronics using Weyl physics.
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Affiliation(s)
- Y Gao
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - S Kaushik
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY, 11794, USA
| | - E J Philip
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY, 11794, USA
| | - Z Li
- State Key Laboratory for Artificial Microstructure and Mesoscopic Physics, Beijing Key Laboratory of Quantum Devices, Peking University, Beijing, 100871, China
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing, 100190, China
| | - Y Qin
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 611731, China
- Institute of Electronic and Information Engineering, University of Electronic Science and Technology of China, Dongguan, 523808, China
| | - Y P Liu
- Institute of Modern Physics, Fudan University, Shanghai, 200433, China
| | - W L Zhang
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Y L Su
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - X Chen
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY, 11794, USA
| | - H Weng
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing, 100190, China
- Songshan Lake Materials Laboratory, Dongguan, 523808, China
| | - D E Kharzeev
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY, 11794, USA.
- Department of Physics, Brookhaven National Laboratory, Upton, NY, 11973-5000, USA.
- RIKEN-BNL Research Center, Brookhaven National Laboratory, Upton, NY, 11973-5000, USA.
| | - M K Liu
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - J Qi
- State Key Laboratory of Electronic Thin Films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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Philip EJ, Bergerot CD, Clark K, Bergerot P, Loscalzo M. Obesity and psychosocial well-being among cancer patients and survivors. Psychooncology 2019; 28:2141-2148. [PMID: 31486137 DOI: 10.1002/pon.5181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/19/2019] [Revised: 07/04/2019] [Accepted: 07/15/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE As the association between obesity and cancer receives increasing attention, studies have begun to examine the potential impact of excess weight on psychosocial domains during treatment and survivorship. The current study will examine the effect of weight status on psychosocial outcomes among patients diagnosed with breast cancer, prostate cancer, and colon cancer. METHODS This retrospective study included 4159 patients over the age of 55 who were diagnosed with postmenopausal breast (52.2%), prostate (38.7%), or colon cancer (9.1%). Prior to treatment, patients were screened for problem-related distress using a 33-item touch screen-based instrument. Descriptive statistics were generated for each cancer type and one-way analysis of covariance (ANCOVA) used to determine significant differences in distress by weight (nonobese: <30 kg/m2 vs obese: ≥30 kg/m2 ). RESULTS A higher prevalence of biopsychosocial problem-related distress was reported by patients with breast cancer (M = 4.3) compared with prostate (M = 2.8) and colon cancer (M = 3.8). Obese breast and prostate cancer patients reported higher levels of problem-related distress compared with nonobese patients (P < .05), whereas an opposite trend was noted for patients with colon cancer. CONCLUSION The current study found notable obesity-related differences among patients diagnosed with postmenopausal breast cancer or prostate cancer, with excess weight consistently associated with poorer psychosocial outcomes. These findings among a large cohort of patients provide insight into the impact of obesity during the cancer care trajectory and can provide guidance in the development and implementation of supportive care services for this "at-risk" population.
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Affiliation(s)
- Errol J Philip
- School of Medicine, University of California San Francisco, California
| | - Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Karen Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Paulo Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California
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Bergerot CD, Razavi M, Philip EJ, Bergerot PG, Soto-Perez-de-Celis E, De Domenico EBL, Clark KL, Loscalzo M, Pal SK, Dale W. Association between chemotherapy toxicity risk scores and physical symptoms among older Brazilian adults with cancer. J Geriatr Oncol 2019; 11:280-283. [PMID: 31401205 DOI: 10.1016/j.jgo.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/02/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Utilizing the Cancer and Aging Research Group (CARG) chemotherapy toxicity risk score before starting treatment in older adults with cancer is guideline-recommended. However, this has not been tested in most developing countries. We investigated the use of a Portuguese version of the CARG score, including the association between this score and physical symptoms, among older Brazilian adults with cancer. PATIENTS AND METHODS We enrolled patients aged ≥65 starting chemotherapy at a public Brazilian hospital. A Portuguese version of the CARG tool was created and linguistically validated. Patients were assessed for chemotherapy toxicity risk using the CARG score, and physical symptoms were evaluated using the Functional Assessment of Cancer Treatment-General (FACT-G) scale. Multivariable logistic regression was used to identify physical symptoms associated with high CARG scores, including pain, nausea, and fatigue. RESULTS Older patients (65+) with cancer were enrolled (n = 117). Patients were mostly female (57.3%), white (52.1%), married (52.1%), and had less than high school education (75.2%). Breast, gastrointestinal and lung cancers were the most common diagnosis, and 66.7% had metastatic disease. Elevated pain scores (P < .01) were associated with higher chemotherapy toxicity risk scores, even after adjusting for potential confounders. CONCLUSION We created and implemented a Portuguese language version of the CARG tool. We found that, although physical symptoms are not included in the CARG model, elevated pain was strongly associated with having a high CARG score. As a modifiable risk factor, pain should be addressed among older patients with cancer considering chemotherapy, to help mitigate their risks for toxicity.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America; Universidade Federal de Sao Paulo (2014-2017), Sao Paulo, SP, Brazil
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA, United States of America
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | | | | | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America.
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Bergerot CD, Bergerot PG, Philip EJ, Hsu JA, Dizman N, Vaishampayan U, Dorff T, Pal SK. Perception of cure among patients with metastatic genitourinary cancer initiating immunotherapy. J Immunother Cancer 2019; 7:71. [PMID: 30867071 PMCID: PMC6416952 DOI: 10.1186/s40425-019-0557-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/04/2019] [Indexed: 12/14/2022] Open
Abstract
Background Despite the advent of checkpoint inhibitors (CPIs) for advanced genitourinary (GU) cancers, existing studies suggest that durable complete responses are observed in fewer than 10% of patients. This study sought to evaluate the association between expectations of cure reported by patients with advanced GU cancers initiating immunotherapy and quality of life (QOL), anxiety and depression. Patient and methods A single-institution, cross-sectional survey study was conducted with patients preparing to receive CPIs for treatment of metastatic renal cell carcinoma (RCC), urothelial cancer (UC) and prostate cancer (PC). Patients were assessed prior to initiation of immunotherapy for expectations of cure (divided into four quartiles), quality of life (QOL; Functional Assessment of Chronic Illness Therapy-General [FACT-G]), and symptoms of anxiety and depression (PROMIS). Results Sixty patients were enrolled, with metastatic RCC, UC and PC comprising 63, 28 and 8% of the study population, respectively. Median age of the cohort was 65 (range, 31–91), and 68% were male; 33% received CPI in the first-line setting. Despite extensive counseling from oncologists regarding potential clinical outcomes with immunotherapy, a substantial proportion of patients (23%) harbored inaccurate expectations regarding the potential benefit of immunotherapy. Importantly, patients with accurate expectations of cure reported lower anxiety scores using the PROMIS-Anxiety inventory. No significant differences were found between expectations of cure and quality of life or depression, using the FACT-G and PROMIS-Depression inventories, respectively. Conclusion The current study found that a considerable proportion of patients with advanced GU cancers harbor inaccurate expectations concerning the potential benefit of immunotherapy. These results suggest that more effective counselling may mitigate patient anxiety, and potentially promote treatment satisfaction and adherence.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA, USA
| | - Jo Ann Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Ulka Vaishampayan
- Department of Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, MI, USA
| | - Tanya Dorff
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
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Philip EJ. Defeating cancer: Knowledge alone is not enough. Philip A.Salem, Quartet Books, ISBN-10: 0704374528. £15.00. Psychooncology 2019. [DOI: 10.1002/pon.4976] [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: 11/05/2022]
Affiliation(s)
- Errol J. Philip
- Laboratory for Psycho-oncology Research; University of Notre Dame; Notre Dame Indiana USA
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Bergerot PG, Bergerot CD, Philip EJ, Meza L, Dizman N, Hsu J, Pal SK. Targeted Therapy and Immunotherapy: Effect of Body Mass Index on Clinical Outcomes in Patients Diagnosed with Metastatic Renal Cell Carcinoma. KCA 2019. [DOI: 10.3233/kca-180047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | - Luis Meza
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - JoAnn Hsu
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Merluzzi TV, Chirico A, Serpentini S, Yang M, Philip EJ. The role of coping in the relationship between stressful life events and quality of life in persons with cancer. Psychol Health 2019; 34:497-513. [PMID: 30632798 DOI: 10.1080/08870446.2018.1545905] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Stressful life events (SLEs) impact the quality of life (QOL) of cancer patients. This study investigated the mediation of the relationship between SLEs and QOL (Model 1: Emotional-EQOL and Model 2: Physical/Functional-PFQOL by three types of coping: Action/Planning, Support/Advise-Seeking, and Disengagement/Denial). Design and Main Measures: 662 persons with cancer completed a Stressful Life Events Checklist, the Brief COPE scale, the FACT Emotional, Physical, and Functional Scales, and the Physical Impact Scale of the Sickness Impact Profile. RESULTS SLEs were positively associated with Action/Planning (Model 1: B = 0.195, 95% CI = [0.089, 0.304]; Model 2: B = 0.192, 95% CI = [0.086, 0.289]) and Disengagement/Denial (Model 1: B = 0.394, 95% CI = [0.281, 0.513]; Model 2: B = .392, 95% CI = [0.285, 0.508]) but not Support/Advice-Seeking; however, only Disengagement/Denial was related to Emotional-QOL (Model 1: B = -0.659, 95% CI = [-0.848, -0.498]) and Physical/Functional-QOL (Model 2: B = -1.460, 95% CI = [-1.856, -1.069]). Thus, only Disengagement/Denial mediated the relationship between SLEs and QOL. CONCLUSIONS The results indicated that SLEs represent a class of events for which there may be only one dominant coping response, disengagement. SLEs may not be controllable or predictable and reduce capacity for active coping with serious illness. However, SLEs may be detected at any point in the cancer trajectory so that supportive services might be provided.
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Affiliation(s)
- Thomas V Merluzzi
- a Department of Psychology , University of Notre Dame , Notre Dame , IN , USA
| | - Andrea Chirico
- b Department of Psychology of Developmental and Socialization Processes , 'Sapienza' University of Rome , Roma , Italy
| | | | - Miao Yang
- a Department of Psychology , University of Notre Dame , Notre Dame , IN , USA
| | - Errol J Philip
- d Laboratory for Psychooncology Research , University of Notre Dame , Notre Dame , IN , USA
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Merluzzi TV, Serpentini S, Philip EJ, Yang M, Salamanca-Balen N, Heitzmann Ruhf CA, Catarinella A. Social relationship coping efficacy: A new construct in understanding social support and close personal relationships in persons with cancer. Psychooncology 2018; 28:85-91. [PMID: 30303251 DOI: 10.1002/pon.4913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 06/26/2018] [Revised: 10/02/2018] [Accepted: 10/07/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Social relationship coping efficacy (SRCE) is the confidence to engage in behaviors that can maintain or enhance close social relationships in the context of illness. This study focused on psychometric analyses of the SRCE scale and its role in maintaining or enhancing personal relationships, social support, and quality of life (QOL). METHOD A mixed diagnosis sample (N = 151) of cancer patients completed a variety of measures: physical debilitation, received emotional and instrumental support, SRCE, and QOL. RESULTS The SRCE scale is a 10-item, one-factor, internally reliable (α = 0.965) measure with strong concurrent validity in relation to measures of social support. SRCE fully mediated the relationship between physical debilitation and both instrumental and emotional received support. SRCE also was directly related to both social/family well-being and psychological distress, and this relationship was also partially mediated by social support. CONCLUSIONS The results corroborated that SRCE might account for changes in both instrumental and emotional support. Also, the direct and indirect relationship (mediated by social support) of SRCE with both social/family well-being and distress indicated that interventions to increase SRCE with those at risk for social support loss may bolster social support in personal relationships as well as enhance emotional well-being and quality of life.
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Affiliation(s)
- Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Samantha Serpentini
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA.,Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Errol J Philip
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Miao Yang
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | | | - Carolyn A Heitzmann Ruhf
- Department of Psychiatry and Behavioral Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Bergerot CD, Bergerot PG, Philip EJ, De Domenico EBL, Manhaes MFM, Pedras RN, Salgia MM, Dizman N, Ashing KT, Li M, Dale W, Pal SK. Assessment of distress and quality of life in rare cancers. Psychooncology 2018; 27:2740-2746. [DOI: 10.1002/pon.4873] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
- Federal University of Sao Paulo; Sao Paulo Brazil
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
- Federal University of Sao Paulo; Sao Paulo Brazil
| | - Errol J. Philip
- The Notre Dame Laboratory for Psycho-Oncology Research; University of Notre Dame; Notre Dame IL USA
| | | | | | | | - Meghan M. Salgia
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Kimlin Tam Ashing
- Department of Population Sciences; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Min Li
- Department of Biostatistics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - William Dale
- Department of Supportive Care Medicine; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Sumanta K. Pal
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
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Philip EJ, Salamanca-Balen N, Lewis B, Merluzzi TV. Lifestyle behaviors and psychosocial outcomes among cancer survivors. Psychooncology 2018; 27:2877-2880. [PMID: 30189468 DOI: 10.1002/pon.4885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/23/2018] [Accepted: 09/02/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Errol J Philip
- Laboratory for Psycho-oncology Research, University of Notre Dame, Notre Dame, IN, USA
| | | | - Brian Lewis
- College of Natural Sciences and Mathematics, California State University, Fullerton, CA, USA
| | - Thomas V Merluzzi
- Laboratory for Psycho-oncology Research, University of Notre Dame, Notre Dame, IN, USA
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Bergerot CD, Clark KL, Obenchain R, Philip EJ, Loscalzo M. Breast and gynecological cancer patients' risk factors associated with biopsychosocial problem-related distress. Psychooncology 2017; 27:1013-1020. [PMID: 29226996 DOI: 10.1002/pon.4607] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 06/20/2017] [Revised: 11/09/2017] [Accepted: 11/30/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Inequalities exist between breast and gynecological cancer patients' experiences, leading to high levels of distress throughout the cancer journey. The present study aims to identify differences in source of biopsychosocial problem-related distress between women diagnosed with breast or gynecological cancers. METHODS From 2009 to 2016, women with breast (n = 2111) and gynecological (n = 641) cancers were screened using the core items of the instrument You, Your Family, and City of Hope are a Team. This is a touch screen-based instrument that assess problem-related distress due to physical, practical, functional, emotional, and other problems and identifies types of assistance requested. Data were analyzed using the linear regression model. RESULTS A significant difference in overall biopsychosocial problems rated as high distress was found between breast (M = 5.0) and gynecological (M = 6.2) cancer patients (P < .001). Gynecological cancer patients endorsed a greater number of problems to talk with a member of the team (alone or with written information), while both cancer groups requested written information equally. Gynecological cancer was associated with higher physical, functional, emotional, and total distress. Younger patients, non-Asian, and those with lower education and lower household income also reported greater distress. CONCLUSIONS Gynecological cancer patients represent a high-risk group, reporting greater problem-related distress and higher levels of requested assistance. Age, education, race/ethnicity, and income were found to be potential risk factors. Findings highlight the importance of considering characteristics and special needs related to specific types of cancer to assist in the effective treatment of distress throughout the continuum of care.
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Affiliation(s)
- Cristiane Decat Bergerot
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.,Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Karen Lynn Clark
- Department of Supportive Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Richard Obenchain
- Department of Supportive Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Errol J Philip
- The Notre Dame Laboratory for Psycho-Oncology Research, University of Notre Dame, Notre Dame, IN, USA
| | - Matthew Loscalzo
- Department of Supportive Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Merluzzi TV, Philip EJ. "Letting Go": From Ancient to Modern Perspectives on Relinquishing Personal Control-A Theoretical Perspective on Religion and Coping with Cancer. J Relig Health 2017; 56:2039-2052. [PMID: 28168581 DOI: 10.1007/s10943-017-0366-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The concept of "letting go" or relinquishing control has a long intellectual history, including the earliest Taoist writings, long-standing religious traditions, modern conceptualizations of religious coping, and current psychological control theory. This paper briefly traces the ancient roots of "letting go," with an emphasis on Stoic philosophers, and plants it firmly in current control theory and religious coping research, with a focus on its more modern conceptualization, that of secondary control. Presenting the theoretical perspective, which is grounded in religious conceptions of control of outcomes integrated with modern control theory in psychology, is the main goal of this paper. However, the theoretical integration is bolstered by some initial descriptive findings based on cancer patients and survivors. This integration of religious coping and psychological theory has important implications for testing the utility of personal control and God-referenced control as ways to cope with the uncertainties of a serious illness such as cancer. Finally, the theory and descriptive findings lay the groundwork for future empirical studies and the development of counseling interventions.
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Affiliation(s)
- Thomas V Merluzzi
- Department of Psychology, 121 Haggar Hall, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Errol J Philip
- Department of Psychology, 121 Haggar Hall, University of Notre Dame, Notre Dame, IN, 46556, USA
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