Effect Of Chemotherapy In Patients Research Articles

Effect of Personalized Nutrition Combined with Acceptance and Commitment Therapy on Psychological Resilience, Quality of Life and Side Effects of Chemotherapy in Patients with Advanced Gastric Cancer.

Aims/Background Gastric cancer is a common and life-threatening cancer, which predisposes patients to certain psychological problems. Implementation of both personalized nutrition and acceptance and commitment therapy (ACT) have shown unique advantages in the treatment of cancer patients. This study aims to evaluate the effects of this comprehensive therapy on psychological resilience, quality of life and side effects of chemotherapy in patients with advanced gastric cancer (AGC), yielding findings that can inform the development of holistic and effective treatment methods. Methods The clinical data of 240 AGC patients who underwent chemotherapy in the Fourth Hospital of Hebei Medical University from February 2021 to February 2023 were retrospectively analyzed. After excluding 15 patients who did not meet the inclusion criteria, 225 patients were included in the study. According to the management methods, the patients were divided into three groups: group A receiving routine management (n = 76), group B receiving routine management plus personalized nutrition (n = 75), and group C receiving routine management, personalized nutrition and ACT (n = 74). The psychological resilience, quality of life and side effects of chemotherapy were evaluated in the three groups. Results There was no difference in the Connor-Davidson resilience scale (CD-RISC) scores and quality of life questionnaire-core 30 (QLQ-C30) scores among the three groups at admission (p > 0.05). After chemotherapy, compared with the group C, the CD-RISC scores of group A and group B were significantly lower (p < 0.001), and the scores of physical function, cancer-related symptoms and overall health in group A and group B were significantly lower (p < 0.001). The incidence of side effects of chemotherapy in group C was 25.68%, which was significantly lower than that in group A and group B (p < 0.05); there was no statistical difference in this regard between group A and group B (p > 0.05), and the same parameter was significantly different between group A and group C (p < 0.05). Conclusion Personalized nutrition management plus ACT has a significant favorable effect on improving psychological resilience, alleviating the side effects of chemotherapy, and enhancing the quality of life in patients with AGC undergoing chemotherapy.

Identifying pre-habilitation targets for the mitigation of long-term side effects of chemotherapy in patients with early breast cancer.

Pre-treatment characteristics of women with early breast cancer that are associated with persistent fatigue or suboptimal health-related quality of life (HRQOL) post-chemotherapy need to be identified as potential targets for pre-habilitation. Ancillary analysis of previously collected data from patients with newly diagnosed Stage I-III breast cancer scheduled to receive chemotherapy. The objective was to identify baseline (pre-chemotherapy) variables associated with meaningful deteriorations in fatigue and other measures of HRQOL from pre-treatment to 6months after chemotherapy completion. Percentages are reported along with unadjusted and adjusted relative risks. In a sample of 249 women post-chemotherapy, 32% reported worsening fatigue (FACIT-F), 35% worsening Physical Well-Being (PWB), 16% worsening Functional Well-Being (FWB), 8% worsening Emotional Well-Being (EWB), and 30% worsening Social Well-Being (SWB). In multivariable (MV) analysis, variables that were significant in univariate analysis - Black race, high BMI, and baseline poorer EWB - remained significant for worsening post-chemotherapy fatigue (FACIT-F). In MV analysis that included race, education, falls, and baseline EWB, Black race and a positive falls history remained significant for worsening PWB. In MV analysis inclusive of race, Short Physical Performance Battery (SPPB) and FWB, lower SPPB and FWB remained significant predictors of worsening FWB. In MV analysis that included baseline Mental Health Index-Anxiety, EWB and SWB, a higher SWB and lower EWB remained significant for worsening SWB. Pre-chemotherapy characteristics in women with early-stage breast cancer that are associated with increased fatigue and reduced HRQOL post-treatment could be used to identify patients who may benefit from pre-habilitation interventions.

Efficacy and Safety of Chemotherapy after Immunotherapy in Patients with Advanced Non-Small-Cell Lung Cancer.

Background: There are currently few data about the safety and effectiveness of chemotherapy for patients with metastatic non-small-cell lung cancer (NSCLC) who have progressed from prior immunotherapy. Methods: Data from patients with consecutive stage IIIB-IV, ECOG performance status (PS) 0-2, non-small-cell lung cancer (NSCLC) treated with combination or single-agent chemotherapy following progression on an earlier immunotherapy regimen were retrospectively gathered. Recorded were baseline attributes, outcome metrics, and toxicities. The neutrophil/lymphocyte (N/L) ratio's predictive usefulness was examined through an exploratory analysis. Results: The analysis comprised one hundred subjects. The adeno/squamous carcinoma ratio was 77%/23%, the M/F ratio was 66%/34%, the ECOG PS was 0/1/≥2 47%/51%/2%, and the median PD-L1 expression was 50% (range 0-100). The median age was 67 (range 39-81) years. Prior immunotherapy included a single-agent treatment in 83% of cases, with pembrolizumab use being prevalent, and a median N/L ratio of four prior to chemotherapy. The overall median time-to-progression on previous immunotherapy was 6 months. After immunotherapy, just 33% of subjects underwent chemotherapy. A median of 4 (range 1-16) cycles of chemotherapy were administered; platinum doublets (primarily carboplatin) were delivered in only 31% of cases, vinorelbine accounted for 25%, taxanes for 25%, and gemcitabine for 8%. The median clinical benefit was 55%, while the overall response rate was 21%. The median overall survival was 5 months (range 1-22) and the median time to progression was 4 months (range 1-17). Subgroups with low and high N/L ratios were compared, but there was no discernible difference in survival. Conclusions: After immunotherapy, a small percentage of patients with advanced NSCLC had chemotherapy. Following immunotherapy advancement, chemotherapy demonstrated a moderate level of therapeutic effectiveness; no adverse concerns were noted. The effectiveness of chemotherapy following immunotherapy was not predicted by the baseline N/L ratio.

Interaction of &lt;i&gt;CYP3A4, CYP3A5, CYP1A1 and CYP2B6&lt;/i&gt; genes in the development of organotoxic effects of chemotherapy in patients with Hodgkin's lymphoma

Interaction of &lt;i&gt;CYP3A4, CYP3A5, CYP1A1 and CYP2B6&lt;/i&gt; genes in the development of organotoxic effects of chemotherapy in patients with Hodgkin's lymphoma

Prospect of immunotherapy alone in patients with advanced NSCLC with high btmb: a review and a meta-analysis

Lung cancer is the most prevalent cancer in the world, and the main treatment for advanced non-small cell lung cancer is immunotherapy combined with chemotherapy. In recent years, bTMB has received increasing attention as an emerging metric for monitoring the efficacy of tumour immunotherapy in terms of its operability, accessibility and real-time nature. We envisaged whether immunotherapy alone could be used to reduce the side effects of chemotherapy in patients with high bTMB lung cancer. We thus did a meta-analysis in order to show that immunotherapy alone is feasible in patients with high bTMB NSCLC.Methods This study aims to compare the efficacy of PD- 1/PD-L1 inhibitors (namely, atezolizumab, pembrolizumab, nivolumab, or tislelizumab) versus chemotherapy in NSCLC patients. The search for relevant studies was conducted in three major databases (i.e., PubMed, Embase, and Medline) up until January 2023. Specifically, we identified studies that reported risk ratios (HRs) for reporting progression-free survival (PFS) or overall survival (OS), or objective remission rates (ORs) for immunotherapy alone versus chemotherapy in high bTMB and low bTMB patient groups. Given that NSCLC represents the predominant type of lung cancer, we exclusively focused on this subtype. Our analysis encompassed a meta-analysis of the identified literature, incorporating heterogeneity analysis and sensitivity analysis. The quality of the evidence is evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to ascertain the reliability and robustness of the findings.Result-We conducted a meta-analysis of seven randomised controlled trials including 4,755 patients with advanced non-small cell lung cancer (NSCLC) evaluated the efficacy of PD- 1 or PD-L1 monotherapy compared to chemotherapy alone. All patients were randomized to receive either PD- 1/PD-L1 treatment alone or chemotherapy alone as a control. In the high bTMB patient group, PD- 1/PD-L1 monotherapy resulted in significant improvements in overall survival (HR = 0.55, 95% CI 0.49–0.61, p = 0.77) and progression-free survival (HR = 0.74, 95% CI 0.68–0.81, p = 0.78) compared to chemotherapy alone. Conversely, in the low bTMB patient group, PD- 1 monotherapy or PD-L1 monotherapy failed to demonstrate significant improvements in overall survival (HR = 0.82, 95% CI 0.73–0.92, p = 0. 13) and progression-free survival (HR = 1.22, 95% CI 1.22- 1.45, p = 0.003) in advanced NSCLC. Conclusion Our analysis suggests that monotherapy with immunotherapy is a feasible option for patients with advanced NSCLC and high bTMB. However, the results have to be construed with caution because of the small sample size and the potential bias in the studies included. Therefore, further research with larger sample sizes and rigorous study designs is necessary to confirm the observed benefits of immunotherapy in this patient population.

Long-term effects of chemotherapy in patients with acute leukemia in childhood

An increase in the survival rate of patients who had cancer in childhood determines the need to study the long-term consequences of the treatment. Long-term complications may develop from various organs and systems: active studies of the toxicity of chemotherapy are carried out in the field of pharmacogenetics, respiratory, cardiovascular, sensorineural and endocrine systems, as well as skin, central nervous system, immune system and others. The treatment of acute leukemia carried out in childhood can significantly reduce the quality of life, cause cognitive and psychoemotional disorders. Experts in the field of pediatric hematology-oncology proposed to create an indicator called «survival without pronounced toxicity». A group of scientists initiated an international project to study the outcomes of childhood malignant tumors. Among the long-term consequences, it is planned to assess the quality of life and the development of complications. The study of long-term complications of leukemia treatment will allow us to develop algorithms for the prevention and follow-up of these patients.

Predictive miRNAs Patterns in Blood of Breast Cancer Patients Demonstrating Resistance Towards Neoadjuvant Chemotherapy.

The effect of chemotherapy in patients with breast cancer (BC) is uncertain. This study attempted to analyze serum microRNAs (miRNAs) in NAC resistant and sensitive BC patients and develop a miRNA-based nomogram model. To further help clinicians make treatment decisions for hormone receptor-positive patients. A total of 110 BC patients with NAC were recruited and assigned in sensitive and resistant group, and 4 sensitive patients and 3 resistant patients were subjected to high-throughput sequencing. The functions of their target genes were analyzed by GO and KEGG. Five BC-related reported miRNAs were selected for expression pattern measurement by RT-qPCR and multivariate logistic analysis. The nomogram model was developed using R 4.0.1, and its predictive efficacy, consistency and clinical application value in development and validation groups were evaluated using ROC, calibration and decision curves. There were 44 differentially-expressed miRNAs in resistant BC patients. miR-3646, miR-4741, miR-6730-3p, miR-6831-5p and miR-8485 were candidate for resistance diagnosis in BC. Logistic multiple regression analysis showed that miR-4741 (or = 0.30, 95% CI = 0.08-0.63, P = 0.02) and miR-6831-5p (or = 0.48, 95% CI = 0.24-0.78, P = 0.01) were protective factors of BC resistance. The ROC curves showed a sensitivity of 0.884 and 0.750 for miR-4741 and miR-6831-5P as markers of resistance, suggesting that they can be used as independent risk factors for BC resistance. The other 3 miRNAs can be used as calibration factors to establish the risk prediction model of resistance in BC. In risk model, the prediction accuracy of resistance of BC is about 78%. 5-miRNA signature diagnostic models can help clinicians provide personalized treatment for NAC resistance BC patients to improve patient survival. MiR-4741 and miR-6831-5p are independent risk factors for breast cancer resistance. This study constructed a nomogram model of NAC resistance in BC based on 5 differentially-expressed serum miRNAs.

Assessment of chemotherapy-induced nausea and vomiting in pediatrics: Adequacy of control and adherence to guidelines

BackgroundChemotherapy-induced nausea and vomiting (CINV) is one of the most common side effects of chemotherapy in patients. Although sufficient evidence regarding its assessment and treatment in adults exists, CINV is more complicated in children. There are established guidelines for its prevention and treatment endorsed by several reputable organizations; however, their adherence varies between institutions. Therefore, this study aimed to assess the incidence and severity of CINV in pediatric patients receiving any form of chemotherapy in the acute and delayed phases and evaluated our institution's adherence to published guidelines by the Pediatric Oncology Group of Ontario. Material and methodThis was a prospective longitudinal single-center study. A structured assessment was administered twice to patients or their caregivers during the acute and delayed phases. Baxter Animated Retching Faces scale was used. ResultsA total of 186 patients completed 236 surveys, including those for acute and delayed phases. Incidence of nausea was reported in 33% patients in both phases, while vomiting was observed in 20.3% and 18.8% of the acute and delayed phases, respectively. A total of 31% patients met the criteria for proper adherence in case of prescribed appropriate antiemetic agent(s)/class irrespective of the dose. ConclusionCINV is a major adverse effect among children who receive high and moderate emetogenic chemotherapy compared to those receiving minimal and low emetogenic regimens. Despite the low rate of adherence to the guidelines, the incidence and severity of CINV reported in our study were consistent with previous studies. Further research should seek strategies to better implement and standardize the guidelines.

Comparative evaluation of the effectiveness of chemotherapy in patients with high-grade IIIC-IVB stage serous ovarian carcinoma depending on the mutation in the BRCA1/2 gene

Comparative evaluation of the effectiveness of chemotherapy in patients with high-grade IIIC-IVB stage serous ovarian carcinoma depending on the mutation in the BRCA1/2 gene

Treatment of Liver Metastases With Focused Ultrasound and Microbubbles in Patients With Colorectal Cancer Receiving Chemotherapy

Pre-clinical trials have obtained promising results that focused ultrasound (FUS) combined with microbubbles (MBs) increases tumor uptake and the therapeutic effect of drugs. The aims of the study described here were to investigate whether FUS and MBs could improve the effect of chemotherapy in patients with liver metastases from colorectal cancer and to investigate the safety and feasibility of using FUS+MBs. We included 17 patients with liver metastases from colorectal cancer, selected two lesions in each patient's liver and randomized the lesions for, respectively, treatment with FUS+MBs or control. After chemotherapy (FOLFIRI or FOLFOXIRI), the lesions were treated with FUS (frequency=1.67 MHz, mechanical index=0.5, pulse repetition frequency=0.33 Hz, 33 oscillations, duty cycle=0.2%-0.4% and MBs (SonoVue) for 35 min). Nine boluses of MBs were injected intravenously at 3.5 min intervals. Patients were scheduled for four cycles of treatment. Changes in the size of metastases were determined from computed tomography images. Treatment with FUS+MBs is safe at the settings used. There was considerable variation in treatment response between lesions and mixed response between lesions receiving only chemotherapy. There is a tendency toward larger-volume reduction in lesions treated with FUS+MBs compared with control lesions, but a mixed response to chemotherapy and lesion heterogeneity make it difficult to interpret the results. The combination of FUS and MBs is a safe, feasible and available strategy for improving the effect of chemotherapy in cancer patients. Therapeutic effect was not demonstrated in this trial. Multicenter trials with standardized protocols should be performed.

Selective protection of normal cells from chemotherapy, while killing drug-resistant cancer cells

Cancer therapy is limited by toxicity in normal cells and drug-resistance in cancer cells. Paradoxically, cancer resistance to certain therapies can be exploited for protection of normal cells, simultaneously enabling the selective killing of resistant cancer cells by using antagonistic drug combinations, which include cytotoxic and protective drugs. Depending on the mechanisms of drug-resistance in cancer cells, the protection of normal cells can be achieved with inhibitors of CDK4/6, caspases, Mdm2, mTOR, and mitogenic kinases. When normal cells are protected, the selectivity and potency of multi-drug combinations can be further enhanced by adding synergistic drugs, in theory, eliminating the deadliest cancer clones with minimal side effects. I also discuss how the recent success of Trilaciclib may foster similar approaches into clinical practice, how to mitigate systemic side effects of chemotherapy in patients with brain tumors and how to ensure that protective drugs would only protect normal cells (not cancer cells) in a particular patient.

Effects of Chemotherapy on Aortic 18-Fluorodeoxyglucose Uptake in Patients With Hodgkin and Non-Hodgkin Lymphoma

BackgroundDespite advances in the treatment of oncology patients, therapy-related side effects may lead to premature morbidity. Inflammatory activation that has been linked to cardiovascular disease is crucial for the pathogenesis of both Hodgkin (HL) and non-Hodgkin lymphoma (NHL). ObjectivesThe purpose of this study was to assess the vascular effects of chemotherapy in patients with HL and NHL by positron emission tomography/computed tomography with 18-fluorodeoxyglucose (18-FDG PET/CT) and to investigate interactions with systemic inflammation as assessed by circulating inflammatory markers. MethodsBetween July 2015 and July 2019, 65 consecutive patients (mean age 56 ± 17.78 years) with confirmed diagnosis of either HL (n = 33) or NHL (n = 32) were prospectively studied. PET/CT imaging was performed at baseline, at an interim phase, and after first-line treatment. Aortic FDG uptake was assessed by measuring global aortic target-to-background ratio (GLA-TBR). Serum biomarkers interleukin (IL)-6 and IL-1b were measured at each phase. ResultsPatients with HL demonstrated significant reduction in aortic TBR after first-line treatment (median GLA-TBR baseline: 1.98, median GLA-TBR third scan: 1.75, median difference = −0.20, 95% CI: −0.07 to −0.33, P = 0.006), which remained significant after adjustment for confounders (adj. R2 of model = 0.53). In contrast, patients with NHL did not demonstrate a significant aortic inflammation response (P = 0.306). Furthermore, patients with HL demonstrated a significant reduction in IL-6 (P = 0.048) and IL-1b (P = 0.045), whereas patients with NHL did not demonstrate significant reduction in IL-6 (P = 0.085) and IL-1b levels (P = 0.476). ConclusionsAortic inflammation, as assessed by 18-FDG PET/CT, is reduced in HL patients after first-line treatment but not in NHL patients. These findings imply that different pathophysiological pathways and different therapies might affect the arterial bed in different ways for patients with lymphoma.

The Influence of Fish Oil Supplementation on the Adverse Effects of Chemotherapy in Patients with Hepatocellular Carcinoma

The Influence of Fish Oil Supplementation on the Adverse Effects of Chemotherapy in Patients with Hepatocellular Carcinoma

Acupuncture in chemotherapy-induced dysgeusia (AcuDysg): study protocol of a randomised controlled trial

IntroductionDysgeusia is a common side effect of chemotherapy in patients with cancer, but to date, there is no effective treatment. Many patients with cancer request complementary medicine treatment in addition...

Associations of Molecular-Genetic Bioenergetics and Chemotherapy-Induced Fatigue Symptoms in Patients with Breast Cancer: A proposal development

Introduction: Cancer-related fatigue (CRF) occurs in 82%-96% of cancer patients receiving chemotherapy (CT). CT-induced CRF is a distressing, persistent sense of exhaustion related to the disease or its treatment, and negatively impacts health outcomes. CRF is one of the most prevalent side effects of CT in patients with breast cancer. Despite various attempts to investigate the etiology of CRF, the biochemical mechanisms remain elusive. Objectives: The study aims to explore the molecular-genetic pathway of mitochondrial bioenergetics and its association with CT-induced CRF. We hypothesized that the chemotherapeutic agent containing anthracycline targets cell cycle progression, which triggers genetic and cellular instability, altering expression of mitochondrial genes and proteins, inducing reduced electron transport chain enzymatic activity and impaired oxidative phosphorylation, resulting in adenosine triphosphate (ATP) depletion and excessive reactive oxygen species (ROS) generation, leading to the development and intensification of CRF. Methods: This is a prospective, hypothesis-testing, and longitudinal study design. A total of 60 patients with breast cancer undergoing CT will be enrolled. Validated instruments will be used to measure CRF, depression, sleep disturbance, and physical activity. Whole blood sample will be collected before, during, and at the completion of CT to determine profiles of mitochondrial bioenergetics. A linear mixed model repeated measures analysis will be used to examine associations between changes in study variables. Anticipated Results: Increased scores of CRF will be associated with altered mitochondria-related genes and mitochondrial bioenergetics (e.g., ↓oxidative phosphorylation, ↓electron transport chain complexes activity, ↓ATP content, and ↑ROS production) in patients receiving CT-containing anthracyclines. Conclusion: The results will enable us to discover biomarkers, support the design of nonpharmacological interventions, and initiate precision symptom management to improve CRF.

Molecular tumor markers for predictive diagnosis and monitoring of lung cancer

Lung cancer is the leading cause of cancer deaths in many developed countries. One of the reasons lung cancer is at the top of the list is that it is often not diagnosed until the cancer reaches advanced stages. Current diagnosis of lung cancer includes various types of imaging supplemented by pathological evaluation of biopsies, but these methods are insufficient to detect lung cancer in the early stages. In recent years, the study of various molecular markers in biological fluids of the human body has become a relevant area for improving the quality of methods for early diagnosis and monitoring of cancer. In particular, saliva, sputum, blood and urine, as informative samples, have several advantages for use in diagnostic studies due to their easy bioavailability. Most published biomarkers are detected using PCR, metabolomics or other molecular biology methods, which provide a rapid diagnosis to initiate timely therapy. This literature review is devoted to the advantages and disadvantages of modern methods used in the diagnosis of lung cancer, as well as the analysis of a potential panel of tumor markers that can be used as predictors of the development and progression of this pathology. A detailed analysis of the results of numerous studies suggests that molecules such as CYFRA 21-1, GRP, SCCA, NSE, CEA and CA 72-4 individually do not have sufficient sensitivity and specificity to be used as independent biomarkers for the diagnosis of specific cancers diseases. Despite this, their application can be quite useful for predicting relapses and the dynamics of metastases, as well as for monitoring the effectiveness of chemotherapy in patients with already progressing cancer.

Neuropathic pain caused by the toxic effect of chemotherapy in patients with malignant neoplasms

This article discusses chemotherapy-induced peripheral neuropathic pain (CIPNP) and its associated neuropathic pain syndrome that occurs in patients with malignant neoplasms (MN) during cytostatic therapy. The overall prevalence of CIPNP in patients with malignant neoplasms associated with chemotherapy with neurotoxic drugs is estimated, according to various sources, to be about 70%. The pathophysiological mechanisms of CIPNP have not been fully studied, but it is known that they are based on: impaired axonal transport, oxidative stress, induction of apoptosis, DNA damage, dysfunction of voltage-gated ion channels, and central mechanisms. It is important to recognize CIPNP in the clinical symptoms of patients with cancer treated with cytostatics, since these disorders can lead to serious restrictions in the motor, sensory and autonomic functions of the upper and lower extremities, as well as reduce the quality of life and daily functioning of such patients, forcing them to adjust the dose of chemotherapy drugs, transfer the next cycles and even interrupt the treatment of cancer carried out according to vital needs. In addition to the clinical examination, scales and questionnaires have been developed to identify symptoms of CIPNP, but it is most important for neurological and oncological specialists to know and be able to recognize such symptoms in patients. The mandatory research methods for identifying the symptoms of polyneuropathy include electroneuromyography (ENMG), which allows you to assess muscle activity, functional characteristics and the state of the function of peripheral nerves. The methods used to reduce symptoms are screening patients for the development of CIPNP and identifying patients at high risk of CIPNP and, if necessary, reducing the dose or changing cytostatics. Methods for correcting this disorder using different classes of drugs require more detailed study and further research.

The effect of chemotherapy in patients with stage I mucinous ovarian cancer undergoing fertility-sparing surgery.

To determine the effect of adjuvant chemotherapy in patients with stage I mucinous ovarian cancer (MOC) undergoing fertility-preserving surgery. The clinicopathological characteristics and survival information of young women with stage I MOC from SEER databases between 2004 and 2019 were collected. The relationship between chemotherapy and the characteristics was examined by univariate and multivariate logistic regression analyses. Univariable and multivariate Cox proportional hazards survival analysis were employed for cancer-specific survival. Cox analysis was performed to build a nomogram model. All 901 eligible patients with stage I MOC were screened from the SEER database. There were 321(35.6%) patients aged 9-30 years, 580(64.4%) aged 31-45 years, 645 (71.6%) patients with stage IA/IB, 256 (28.4%) with stage IC disease, 411(45.6%) who underwent fertility-sparing surgery, and276(30.6%) who received postoperative adjuvant chemotherapy. Multivariate logistic regression analyses showed that postoperative chemotherapy was often used in patients aged 31-45 relative to aged 9-30 (HR: 2.215, 95%CI 1.443-3.401, P < 0.001) or with grade 3 compared to grade 1 tumors (HR: 7.382, 95%CI 4.054-13.443, P < 0.001) or with stage IC compared to stage IA/IB (HR: 6.436, 95%CI 4.515-9.175, P < 0.001) or with non-fertility sparing surgery relative to fertility-sparing (HR:2.226, 95%CI 1.490-3.327, P < 0.001). Multivariate analysis for the special population with fertility preservation indicated that patients with chemotherapy (HR: 2.905, 95% CI: 0.938-6.030, P=0.068) or with grade 3 (HR: 4.750, 95% CI: 1.419-15.896, P=0.011) had a greater risk of mortality. Significant CSS differences were observed between the non-chemotherapy and chemotherapy groups in MOC when patients were stage IA/IB-grade 2 (P=0.004) (10-year CSS rates of chemotherapy=84%, non-chemotherapy = 100%), but not when they were stage IA/IB-grade 1, stage IA/IB-grade 3 or stage IC (both P>0.05). A prognostic prediction nomogram model was built for stage I MOC patient who underwent fertility-sparing and the C-index was 0.709. The patients aged 31-45 years, with grade 3, stage IC, and non-fertility-sparing surgery were more likely to receive adjuvant chemotherapy in the real world. For stage I MOC patient who underwent fertility-sparing surgery, the choice of chemotherapy may increase the risk of death, and it should be carefully selected in clinical practice.

A preliminary, prospective study of peripheral neuropathy and cognitive function in patients with breast cancer during taxane therapy.

Dramatic improvements in cancer survival have occurred in the last decade, but the quality of life for many survivors is compromised due to severe, long-lasting, and often irreversible side effects of chemotherapy. The neurological side effects, chemotherapy induced peripheral neuropathy (CIPN) and cancer related/induced cognitive impairment (CRCI/CICI), are under-recognized and can occur after chemotherapy, immunotherapy, or radiation. The cellular mechanisms underlying these neurological side effects are poorly understood and there are no effective treatments or preventions, other than reduction or termination of cancer therapy. In our preliminary prospective, non-interventional study to examine the side effects of chemotherapy in patients with breast cancer (NCT03872141), patients with breast cancer who received standard of care single agent weekly taxane-based chemotherapy were assessed at baseline, midpoint, and end of treatment for neurological and cognitive changes and for blood levels of potential protein biomarkers (n = 13). CIPN and CRCI both showed an increase in severity with accumulating taxane and these changes were compared to protein alternations over the course of treatment. Using peripheral blood collected from patients (n = 10) during chemotherapy and tested with an antibody array curated by the MD Anderson RPPA Core), we found that 19 proteins were increased, and 12 proteins decreased over 12 weeks of treatment. Among those downregulate were proteins known to be critical for neuronal viability and function including GRB2 (growth factor receptor-bound protein 2) and NCS1 (neuronal calcium sensor 1). Concurrently, proteins associated with apoptosis, including BAK1 (Bcl-1 homologous antagonist/killer), were upregulated. These results support the proposal that CIPN and CRCI increase with increasing taxane exposure, and identified several proteins that are altered with taxane exposure that could be implicated in their pathogenesis. In conclusion, our study provides evidence for progressive neurological changes and the rationale to investigate the molecular basis for these changes with the goal of target identification for mitigation of these neurological side effects.

Effect of 1st line treatment on aortic inflammation as assessed by 18 FDG PET/CT in patients with Hodgkin and non-Hodgkin lymphoma

Abstract Background Despite advances in the treatment of oncology patients, therapy-related side effects may lead to premature morbidity among cancer survivors. Inflammatory activation that has been linked to cardiovascular disease is particularly crucial for the pathogenesis of both Hodgkin (HL) and non-Hodgkin lymphoma (NHL). Objectives To assess the vascular effects of chemotherapy in patients with HL and NHL by 18-Fluorodeoxyglucose (FDG PET/CT) and to investigate possible interactions with systemic inflammation as assessed by circulating inflammatory markers. Methods Between July 2015 and July 2019, sixty-five consecutive patients (37 males, mean age 56±17.8 years) with histologically confirmed new diagnosis of either HL (n=33) or NHL (n=32), were prospectively studied. PET/CT imaging was performed at baseline, at an interim phase and after 1st line treatment. Aortic FDG uptake was assessed by measuring global aortic TBR. Serum interleukin-6 (IL6) and interleukin-1b (IL1b) were measured at each phase for all patients and served as circulating inflammatory markers. Results Patients with HL demonstrated significant reduction in aortic TBR after 1st line treatment (aortic TBRbaseline=1.98, aorticTBR3rdscan=1.75, p=0.001, F=8.335), which remained significant after adjustment for 10-year cardiovascular risk (Framingham risk score), dyslipidemia, hypertension and diabetes (p=0.002, F=7.664). In contrast, patients with NHL did not demonstrate a significant aortic inflammation response (aortic TBRbaseline = 2.13, aorticTBR3rd scan=2.015, p=0.596, F=0.527), Figure 1. Regarding inflammatory markers, after 1st line treatment IL6 levels were reduced significantly in both HL and NHL groups (IL6baseline HL=3.25, IL6 post 1st line treatment HL=0.448, p=0.00; IL6baseline NHL=0.475, IL6 post 1st line treatment NHL=0.144, p=0.001); IL1b levels did not change significantly in either group, Table 1. Conclusions We demonstrate for the first time that aortic inflammation as assessed by 18-FDG PET-CT is reduced in HL patients after 1st line treatment but not in NHL patients. These findings imply that different pathophysiological pathways and different therapies might affect the arterial bed in different ways in lymphoma patients. Further, a strong potential role of molecular imaging in cardio-oncology emerges, offering valuable information on disease prognosis and progression with a single examination. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Hellenic Society of Hypertension