Side Effects Of Cancer Therapy Research Articles

Exploring the Molecular Basis of Anticancer Activity in Various Moss Species Against Colorectal Cancer Cells

Background: Mushrooms are shown to protect against the side effects of cancer. Therefore, mushrooms with proven anticancer properties and active ingredients are fascinating in the search for new cancer drugs. Objective: In this study, the effects of extracts from Hericium coralloides (M1), Lactarius deliciosus (M2), Lepista nuda (M3), Pleurotus ostreatus (M4), and Suillus collitinus (M5) together on HCT116 were investigated. Mesenchymal stem cells (MSCs) were used to study the effect on healthy cells. Methods: MTT was used to determine cell viability. Dose-response curves were generated, the IC50 values of the compounds were calculated, and the effect of the extracts was compared using it. The FTIR was used to analyze the quantitative changes of the cellular components. Results and Discussion: The evaluation of the IC50 values of all fungal species showed that they reduced the cell viability of HCT116 cells. In contrast, no significant reduction in cell viability was observed in MSCs. Changes in the ratio of cell membrane lipids, proteins, and cell nucleic acids between control and fungal-treated HCT116 cells were detected by FTIR. Many of the chemotherapeutic agents are of plant origin, and many resources should still be explored to inhibit the side effects of cancer therapy. Conclusion: The data obtained through this experiment will serve as a reference for studies to be a new source of anticancer drugs in modern pharmacology.

Utilizing machine learning and molecular dynamics for enhanced drug delivery in nanoparticle systems

Materials data science and machine learning (ML) are pivotal in advancing cancer treatment strategies beyond traditional methods like chemotherapy. Nanotherapeutics, which merge nanotechnology with targeted drug delivery, exemplify this advancement by offering improved precision and reduced side effects in cancer therapy. The development of these nanotherapeutic agents depends critically on understanding nanoparticle (NP) properties and their biological interactions, often analyzed through molecular dynamics (MD) simulations. This study enhances these analyses by integrating ML with MD simulations, significantly improving both prediction accuracy and computational efficiency. We introduce a comprehensive three-stage methodology for predicting the solvent-accessible surface area (SASA) of NPs, which is crucial for their therapeutic efficacy. The process involves training an ML model to forecast the many-body tensor representation (MBTR) for future time steps, applying data augmentation to increase dataset realism, and refining the SASA predictor with both augmented and original data. Results demonstrate that our methodology can predict SASA values 299 time steps ahead with a 40-fold speed improvement and a 25% accuracy increase over existing methods. Importantly, it provides a 300-fold increase in computational speed compared to traditional simulation techniques, offering substantial cost and time savings for nanotherapeutic research and development.

Carbon quantum dots in breast cancer modulate cellular migration via cytoskeletal and nuclear structure

Carbon nanomaterials have been widely applied for cutting edge therapeutic applications as they offer tunable physio-chemical properties with economic scale-up options. Nuclear delivery of cancer drugs has been of prime focus since it controls important cellular signaling functions leading to greater anti-cancer drug efficacies. Better cellular drug uptake per unit drug injection drastically reduces severe side-effects of cancer therapies. Similarly, carbon dots (CDs) uptaken by the nucleus can also be used to set-up cutting edge nano delivery systems. In an earlier paper, we showed the cellular uptake and plasma membrane impact of combustion generated yellow luminescing CDs produced by our group from fuel rich combustion reactors in a one-step tunable production. In this paper, we aim to specifically study the nucleus by establishing the uptake kinetics of these combustion-generated yellow luminescing CDs. At sub-lethal doses, after crossing the plasma membrane, they impact the actin and microtubule mesh, affecting cell adhesion and migration; enter nucleus by diffusion processes; modify the overall appearance of the nucleus in terms of morphology; and alter chromatin condensation. We thus establish how this one-step produced, cost and bulk production friendly carbon dots from fuel rich combustion flames can be innovatively repurposed as potential nano delivery agents in cancer cells.

Ligand-Based targeting in drug delivery system

Targeted drug delivery system has come up as a new approach that increase the effectiveness of the drug while reducing the side effects of cancer therapy. This review focuses on the application of ligand-based drug targeting, especially antibodies-drug conjugates in the case of ovarian cancer and folate-receptor targeting in the case for tumor cells. This review will provide analytical insights about the effectiveness of two approaches on improving bioavailability, targeting specific tumor cells, and enhancing drug carrying capacity. The findings show that folate receptor targeting does has significant potential in enhancing curcumin’s anticancer activity. However, there are still challenges such as rapid decomposition of curcumin. This review also highlights the need for future experiments and research to consolidate the effectiveness of the drug delivery system and explore their potential in broader clinical environment.

The CTOX-Score, a clinical risk prediction tool for cardiovascular toxicity secondary to cancer therapies

Abstract Introduction Cardiovascular toxicity (cardiotoxicity) is recognized as a major side-effect of cancer therapies. As early diagnosis and management is crucial in clinical practice1,2, knowledge about risk factors and risk scores is scarce3,4. Purpose The aim of this study is to develop a clinical prediction score to identify patients at high/very high risk of cardiotoxicity. Methods The CARDIOTOX registry5,6 included patients receiving cancer therapies related to moderate/high risk for cardiotoxicity (2012-2017). Clinical, laboratory and echo parameters were collected at baseline and at 3 weeks, 3 and 6 months, 1, 1.5 and 2 years after initiation of cancer therapy. Patients were classified according to current cardioncology guidelines2 and divided in two groups: no or mild cardiotoxicity vs moderate or high cardiotoxicity. Difference between groups were tested with t-student or U Mann-Withney for continuous variables and Fisher’s exact test for categorical data. Variables with p<0.05 were included in a multivariate binary logistic regression model to find independent predictors of cardiotoxicity and construct a clinical risk score, CTOX-Score. The calibration was evaluated by Hosmer-Lemeshow goodness-of-fit test and discrimination using ROC curves. Results From the 1324 individuals included in the registry we discarded all those with pre-existing symptomatic heart failure or LVEF<40% at baseline and those with incomplete baseline data. We considered 998 patients, aged 54.62±14.15 years, 176 men (17.6%), of which 53 (5.3%) developed moderate or severe cardiotoxicity. These patients had lower baseline LVEF (59.91±7.50% vs 64.20±5.88%), higher creatinine levels (0.90 (0.76, 1.10) mg/dl vs 0.74 (0.62, 0.90) mg/dl) and higher NT-ProBNP (177 (58, 476) pg/ml vs 66 (38, 133) pg/ml) compared with patients with no or mild cardiotoxicity (p<0.001). We found previous radiotherapy (OR=4.66, CI:1.24-17.52), acute myeloid leukemia (OR=6.85; CI:1.16-40.50), monoclonal antibodies (OR=3.27; CI:1.35-7.89), LVEF (OR=0.96; CI:0.84-0.98) and serum creatinine (OR=5.43; CI:1.63-18.14) as independent predictors of cardiotoxicity (p<0.05). A clinical risk score was developed based in beta coefficient of variables (Table 1). The model has good calibration according to Hosmer-Lemeshow goodness-of-fit (χ2=2.800, p=0.424) and good discrimination power (AUC:0.780, CI:0.69-0.87; p<0.001). The best cut-off value of CTOX-Score is ≥3 points (Sensitivity:70.00%, Specificity:72.25%, NPV:98.11%). Patients were classified in four risk categories: low (0-1 points); moderate (2); high (3-4); very high (≥5) (Figure 1). The model has good accuracy to identify very high-risk patients (Specificity 98.80%). Conclusion The CTOX-Score is a clinical risk prediction model to identify patients at high/very high-risk of cardiotoxicity and could allow for more personalized monitoring of patients. Additional studies are needed to externally validate the model prior to implementation in clinical practice.Multivariate binary logistic regressionCTOX-Score values among population

Crofelemer Reduces Diarrhea in Humans and Dogs Being Treated for Cancer, Recent Studies Show

Diarrhea is an often-overlooked side effect of cancer therapy that can significantly impact patient outcomes and quality of life. In a study of patient-reported chemotherapy side effects, diarrhea was the second most common side effect reported after fatigue.In response to a patient’s diarrhea, a treating physician may reduce a therapeutic dose or discontinue the cancer therapy altogether, potentially worsening patient outcomes. Specifically, patients with cancer and diarrhea are 40% more likely to discontinue their cancer therapy Furthermore, the cost of care for patients with cancer and diarrhea is estimated to be nearly 2.9 times higher than for patients with cancer without diarrhea.

Cancer research in Lebanon: Scope of the most recent publications of an academic institution (Review).

Cancer may be considered one of the most interesting areas of study, and although oncology research has grown markedly over the last decade, there is as yet no known cure for cancer. The objective of the present review is to examine various approaches to cancer research from a single institution, summarize their key conclusions and offer recommendations for future evaluations. The review examined 72 cancer-associated studies that were published within six years from 2017 to 2022. Published works in the subject fields of 'cancer' or 'oncology' and 'research' that were indexed in Scopus and Web of Science were retrieved and sorted according to article title, author names, author count, citation count and key words. After screening, a total of 28 in vitro/animal studies and 46 patient-associated published studies were obtained. A large proportion of these studies comprised literature reviews (20/72), while 20 studies were observational in nature. The 72 publications included 23 in which various types of cancer were examined, while the remaining studies focused on specific types of cancer, including lung, breast, colon and brain cancer. These studies aimed to investigate the incidence, prevalence, treatment and prevention mechanisms associated with cancer. Despite the existence of extensive cancer research, scientists seldom contemplate an ultimate cure for cancer. However, it is crucial to continuously pursue research on cancer prevention and treatment in order to enhance the effectiveness and minimize potential side effects of cancer therapy.

Aesthetics treatment with injectable fillers in patients with cancer: Safety and quality of life during active antineoplastic therapy.

e23245 Background: Patients treated with antineoplastic treatment,commonly experience physical changes,secondary to the disease,weight loss,stress,and cancer therapy side-effects.Injectable fillers,offer effective and safe soft-tissue manipulations improving patients’ positive body image.While FDA-approved fillers are used in various medical settings,data on the safety and implications on quality of life(QOL)in oncology patients during active cancer therapy are limited.The study aimed to assess oncology patients' safety,QOL and both physician and patients’ perceived skin changes when fillers are used during active cancer therapies. Methods: The study was conducted at the Women's Cancer Center and Dermatology Department between 2021-2023.Female oncology patients treated with antineoplastic therapies completed a validated QOL questionnaire,dermatologist and patient self-evaluation,prior and following aesthetic intervention.Patients were randomly assigned to receive aesthetic treatments. Results: 127 female patients diagnosed with cancer,and treated at a single cancer center were included in the study.Patient mean age was 57 years.Patient diagnoses included breast,ovarian,uterine,cervical,and other cancers(58%, 22%,7%,5%,8%,respectively).31 (24%) patients were randomized to receive filler treatment.106(83%)patients were not treated with fillers,patients were either not randomized to filler treatments,or attributing their abstention to their cancer diagnosis,potential risks shared by other patients,or their treating oncologist.Patients receiving fillers were treated with chemotherapy,chemotherapy and biological agents,biological agents,hormonal therapies,immunotherapy,biological and hormonal therapy(39%,23%,10%,19%,6%,3%,respectively).3 independent dermatologists assessed improved aesthetic parameters following filler treatment,patients appeared less ill,sad,distracted.6-8 weeks post filler injections,there was a markedly improved QOL score,and noticeable positive skin changes by dermatologists and patients evaluation.Patients appeared less tired,angry,worried(45%,38%,35%,respectively).Most patients were satisfied following injections(81%) and planned future aesthetic treatments.More than half of the patients(55%)had no adverse events.Thirteen patients experienced minor dermal side effects (grade 1,42%).While 1 patient developed delayed inflammatory reaction 6-months post injection(grade 2,3%). Conclusions: Aesthetic treatment with filler injections while on anti-cancer treatment,with minimal side effects,statistically improved patient QOL and dermatological measures,enhanced dermatologist and patient sense of positive body image,demonstrating that injectable fillers can be safely recommended to patients receiving anti-neoplastic therapies.

Bone age and dental late effects in childhood cancer survivors: Radiographic findings in a Brazilian sample.

Changes in bone age and tooth development are late side effects of cancer therapy and can be identified by imaging examination. To evaluate the late effects of antineoplastic treatment on bone age and dental development in childhood cancer survivors. This is a retrospective case-control study on paediatric cancer survivors of both sexes who underwent antineoplastic treatment with 5-15 years of survival. Carpal radiographs were assessed for bone age and growth curve, and panoramic radiographs were used to evaluate dental development and alterations. Carpal radiographs were analyzed using the Greulich and Pyle inspection method, and the Martins and Sakima method was used to analyze the growth curve. All tests were applied with a confidence level of 95%. The study and control groups comprised 28 and 56 patients, respectively. There was no significant difference in bone age and growth curve between the study and control groups. Nonetheless, when sex was compared to chronological and bone ages, there was a significant difference in bone age (p = 0.019) and an underestimation in both groups and sexes in the Greulich and Pyle method. As to late dental effects, dental agenesia, microdontia, gyroversion, and unerupted teeth were found. Dental shape alterations mainly involve the root region. Close multidisciplinary collaboration is necessary during the follow-up period of young patients who have survived cancer.

Abstract PS02-02: Patient-reported outcomes from the Phase 3 CAPItello-291 trial investigating capivasertib and fulvestrant for patients with aromatase inhibitor-resistant HR-positive/HER2-negative advanced breast cancer

Abstract Background: In the Phase 3 CAPItello-291 trial, adding capivasertib (C), a pan-AKT inhibitor, to fulvestrant (F) in patients (pts) with aromatase inhibitor-resistant, HR+/HER2− (HER2− defined as IHC 0, or 1+ or IHC2+/ISH–) advanced breast cancer significantly improved PFS vs placebo (P) + F in the overall (HR 0.60, 95% CI 0.51, 0.71, p< 0.001) and AKT pathway-altered populations (HR 0.50, 95% CI 0.38, 0.65, p< 0.001). The safety profile of C-F was manageable; diarrhea (mostly grade 1) was the most frequent adverse event. Global health status (GHS)/health-related quality of life (HRQoL) was maintained from baseline in both arms; time to deterioration (TTD) favored C-F. We report results from additional patient-reported outcomes (PRO). Methods: Pts were randomized 1:1 to receive F (500 mg IM on days 1 and 15 of cycle 1 and day 1 of each subsequent 28-day cycle) with either P or C (400 mg BID; 4 days on, 3 days off). PRO measures assessed HRQoL, disease-related symptoms, functioning, and patient-reported treatment tolerability using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), EORTC QLQ Breast Cancer 23 items (EORTC QLQ-BR23), PRO version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), and Patient Global Impression of Treatment Tolerability (PGI-TT). PROs were assessed at pre-specified timepoints. Change from baseline was assessed using Mixed Model Repeat Measures (on-treatment scores) for EORTC QLQ-C30 and summarized for EORTC QLQ-BR23; TTD was assessed using the stratified log-rank test for both. Results: Overall, 708 pts were randomized to C-F (n=355) or P-F (n=353). Overall compliance rates with EORTC QLQ-C30 and PGI-TT were 84.5% and 80.6% with C-F and 81.8% and 81.7% with P-F, respectively. Baseline compliance rates with the EORTC QLQ-C30 and PGI-TT were 88.2% and 82.8% with C-F and 87.3% and 83.1% with P-F, respectively. Mean changes from baseline in EORTC QLQ-C30 functional and symptom domain scores were maintained with C-F and P-F, except for diarrhea in the C-F arm, where scores worsened by >10 points (table). TTD analysis showed that HRs favored C-F vs P-F for all functional and symptom domains, except diarrhea (HR 2.75; 95% CI 2.01, 3.81), which favored P-F (table). Median TTD of diarrhea was shorter with C-F vs P-F in line with the C-F safety profile. Diarrhea with C-F was generally manageable, and discontinuations due to diarrhea were low (2.0%; n=7/355). For PGI-TT, most pts reported that they were ‘not at all’ or ‘a little bit’ bothered by the side effects of cancer therapy. Over the first 6 months, the proportion of pts reporting to be ‘somewhat’, ‘quite a bit’, or ‘very much’ bothered by side effects was higher for C-F vs P-F, with between-arm differences being highest in the first 2 cycles. Results from EORTC QLQ-BR23 domains will be presented at the meeting. Conclusions: Pts treated with C-F maintained HRQoL for longer than pts treated with P-F on all EORTC QLQ-C30 functional and symptom domain scores, except diarrhea. Worsening of diarrhea was observed with C-F, consistent with the safety profile of C, but events appeared tolerable and did not negatively impact GHS/HRQoL. Together with the clinical efficacy and manageable safety profile of C-F, the PRO results from the CAPItello-291 trial further support a positive benefit–risk profile of the combination in this population. https://clinicaltrials.gov/: NCT04305496. Funding: CAPItello-291 is sponsored by AstraZeneca. Editorial acknowledgment: AstraZeneca-funded medical writing support was provided by Suzanne Patel, Ph.D., from BOLDSCIENCE Inc. Capivasertib was discovered by AstraZeneca subsequent to a collaboration with Astex Therapeutics (and its collaboration with the Institute of Cancer Research and Cancer Research Technology Limited). Citation Format: Hope Rugo, Mafalda Oliveira, Sacha Howell, Florence Dalenc, Javier Cortés, Henry Gómez, Xichun Hu, Komal Jhaveri, Petr Krivorotko, Sibylle Loibl, Serafin Morales Murillo, Meena Okera, Yeon Park, Joo Hyuk Sohn, Eriko Tokunaga, Masakazu Toi, Samih Yousef, Lyudmila Zhukova, Marta Fulford, Haylee Andrews, Ian Wadsworth, Celina D’Cruz, Nicholas Turner. Patient-reported outcomes from the Phase 3 CAPItello-291 trial investigating capivasertib and fulvestrant for patients with aromatase inhibitor-resistant HR-positive/HER2-negative advanced breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS02-02.

Modulating DNA damage response in uveal melanoma through embryonic stem cell microenvironment

BackgroundUveal melanoma (UVM) is the most common primary intraocular tumor in adults, with a median survival of 4–5 months following metastasis. DNA damage response (DDR) upregulation in UVM, which could be linked to its frequent activation of the PI3K/AKT pathway, contributes to its treatment resistance. We have reported that embryonic stem cell microenvironments (ESCMe) can revert cancer cells to less aggressive states through downregulation of the PI3K signaling, showing promise in modulating the DDR of UVM.MethodsSince nonhomologous end joining (NHEJ) is the main DNA repair mechanism in UVM, this study utilized gene expression analysis and survival prognosis analysis to investigate the role of NHEJ-related genes in UVM based on public databases. Xenograft mouse models were established to assess the therapeutic potential of ESC transplantation and exposure to ESC-conditioned medium (ESC-CM) on key DNA repair pathways in UVM. Quantitative PCR and immunohistochemistry were used to analyze NHEJ pathway-related gene expression in UVM and surrounding normal tissues. Apoptosis in UVM tissues was evaluated using the TUNEL assay.ResultsPRKDC, KU70, XRCC5, LIG4 and PARP1 showed significant correlations with UM progression. High expression of PRKDC and XRCC5 predicted poorer overall survival, while low PARP1 and XRCC6 expression predicted better disease-free survival in UVM patients. ESCMe treatment significantly inhibited the NHEJ pathway transcriptionally and translationally and promoted apoptosis in tumor tissues in mice bearing UVM. Furthermore, ESC transplantation enhanced DDR activities in surrounding normal cells, potentially mitigating the side effects of cancer therapy. Notably, direct cell-to-cell contact with ESCs was more effective than their secreted factors in regulating the NHEJ pathway.ConclusionsOur results suggest that NHEJ-related genes might serve as prognostic markers and therapeutic targets in UVM. These findings support the therapeutic potential of ESC-based therapy in enhancing UVM sensitivity to radiochemotherapy and improving treatment outcomes while minimizing damage to healthy cells.

Nutrition therapy in colorectal cancer patient with severe malnutrition: A case report

Background: Malnutrition in cancer patients generally, and in gastrointestinal cancer specifically, is common, that could be from the cancer itself or the treatment. Thus, it is necessary to follow special nutrition rules in patients with colorectal cancer. This study aims to see the progress of the nutritional status of cancer patients treated with special nutrition rules. Case Description: A 72-year-old man was brought to the ER with the chief complaint of weakness, felt since 1 week ago. Other complaints are loss of appetite and liquid stool. History of weight loss is 12 kg in the last 6 months. He was diagnosed with colorectal cancer 6 months ago. The patient looks pale, with conjunctiva pallor, loss of subcutaneous fat in arms, trunk, and feet, and loss of muscle in the face, ribs, and shoulder. He was then admitted to the ward with a diagnosis of colorectal cancer with severe malnutrition. Nutrition therapy has been given since the beginning. The total energy was 2,100 kkal, with 80gr protein, 280gr carbohydrate, and 70gr fat. The patient was treated for 10 days. Clinically improved: the conjunctiva was no more pallor, arm circumference increased to 19cm, he had gained his appetite, was no longer dripping with norepinephrine, and no longer needed O2 supplementation (SaO2 in room air: 98%). Conclusion: Cancer treatment causes side effects on nutrition status. It is essential to give special nutrition rules to patients with colorectal cancer. Cancer patients also suffer from inadequate food intake, reduced ability to digest food, and disturbed body homeostasis. Malnutrition, especially in cancer patients, could result in general weakening, lower immunity, prolonged recovery period, and lower tolerance to the side effects of cancer therapy. Early nutrition therapy has a good impact on the nutritional status of the cancer patient.

Feasibility of a novel exercise program for patients with breast cancer offering different modalities and based on patient preference

PurposeExercise improves quality of life and reduces the side effects of cancer therapies. Nevertheless, attendance to exercise programs remains a challenge for patients. This study explored the feasibility of an exercise program in which women with breast cancer may be allowed to choose among three exercise delivery modalities. MethodsForty-seven patients with breast cancer (stage I-IV) participated in a 12-week combined aerobic and resistance training program. The exercise modality was chosen by patients according to their preferences and needs among three options: the personal training program, the home-based program, or the group-based program. Exercise prescription was similar between the three modalities. Whereas the primary endpoint was feasibility, assessed through recruitment rate, attendance, adherence, dropout rate, tolerability, and safety, secondary endpoints included health-related skills and quality of life. ResultsOut of 47 recruited patients, 24 chose the home-based program, 19 the personal training program, and four the group-based program. Six dropouts (13%) were registered, and no severe adverse events were recorded. The median program attendance was 98% for personal training programs, 96% for home-based programs, and 100% for group-based programs, whereas compliance resulted in more than 90% in each modality. At postintervention, a significant increase in cardiorespiratory fitness, lower body flexibility, and body weight was observed. Different quality-of-life domains were improved following the intervention, including physical and social functioning, fatigue, and appetite loss. No significant changes in other parameters were detected. ConclusionsAn exercise prescription based on a patient-preferred delivery modality showed high feasibility in women with breast cancer.

CARDIO-ONCOLOGY: A COMPREHENSIVE OVERVIEW AND INNOVATİVE APPROACHES

Cardio-oncology is a rapidly evolving field that focuses on the management of cardiovascular complications in cancer patients and survivors. As advances in cancer treatment continue to extend the lives of cancer patients, there is a growing need to address the cardiovascular consequences of cancer therapy. This essay provides a comprehensive overview of cardio-oncology, highlighting the challenges and innovative methods in the field. It discusses the impact of cancer treatment on the cardiovascular system, strategies for risk assessment and prevention, and the emerging techniques and technologies that are transforming the practice of cardio-oncology. Cancer and cardiovascular diseases are two of the leading causes of death worldwide. While advances in cancer treatment have significantly improved cancer survival rates, some of these treatments can lead to cardiovascular complications. Cardio-oncology is an interdisciplinary field that seeks to address the complex relationship between cancer and cardiovascular health. This field is essential in ensuring that cancer patients receive optimal care while minimizing the potential cardiovascular side effects of cancer therapies. This essay provides an in-depth exploration of cardio-oncology, beginning with an overview of the impact of cancer treatment on the cardiovascular system. It then discusses strategies for risk assessment and prevention before delving into the innovative methods and technologies that are revolutionizing the practice of cardio-oncology. Keywords: cardio-oncology, cancer therapy, cardiovascular system.

Impact of exercise on cancer: mechanistic perspectives and new insights.

This review critically evaluates the substantial role of exercise in enhancing cancer prevention, treatment, and patient quality of life. It conclusively demonstrates that regular physical activity not only reduces cancer risk but also significantly mitigates side effects of cancer therapies. The key findings include notable improvements in fatigue management, reduction of cachexia symptoms, and enhancement of cognitive functions. Importantly, the review elucidates the profound impact of exercise on tumor behavior, modulation of immune responses, and optimization of metabolic pathways, advocating for the integration of exercise into standard oncological care protocols. This refined abstract encourages further exploration and application of exercise as a pivotal element of cancer management.

PENGARUH ACUPRESSURE TITIK HT7 SHENMEN TERHADAP LATENSI DAN DURASI TIDUR PASIEN KANKER PASCA TERAPI

Abstract: Disruption of sleep latency and duration of cancer patients occurs due to multifactorial causes, one of which is a side effect of cancer therapy. The aim of this study was to analyze the effect of acupressure at the Shenmen HT7 point on sleep latency and duration of post-therapy cancer patients. The design uses a pre-experimental one-group pretest-posttest design approach. The population is 50 cancer patients at the Pucang Sewu Health Center and the Rangkah Health Center, Surabaya. A sample of 25 respondents was taken by purposive sampling according to the researcher's criteria. The instrument used was the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The results of the pre-test mean latency and sleep duration scores respectively were 1.96 + 0.61 and 1.08 + 0.86, while in the post-test conditions it was 1.12 + 0.72 and 0.56 + 0.71. The results of the Wilcoxon Signed Rank Test statistical test found that the p-value on the latency and sleep duration variables was 0.000 and 0.001, respectively, which means that there was a significant effect of giving the HT7 Shenmen point acupressure on the latency and sleep duration of post-therapy cancer patients. HT7 Shenmen stimulates the release of endorphins which cause relaxation, a feeling of calm, comfort, thereby helping to improve sleep latency and duration.

Pilot Study of Longitudinal Geriatric Assessment and Neurocognitive Evaluation in CAR T-Cell Therapy for Older Patients with Relapsed Refractory, Large B-Cell Lymphoma

Introduction: Chimeric antigen receptor T-cell (CAR T) therapy is increasingly utilized for older patients with relapsed refractory, large b-cell lymphoma (LBCL) with promising efficacy. However, the feasibility of conducting serial geriatric assessments with appropriate management has not been examined in this vulnerable population of patients. Moreover, the short-term and long-term impact of CAR T-cell therapy on the older patient's overall physical and neurocognitive functioning remains unknown. Methods: In this prospective pilot study (NCT04300998), we enrolled older patients with LBCL receiving commercial CAR T and conducted serial geriatric assessments (GA), formal neurocognitive testing in domains sensitive to cancer therapy side effects including attention, memory, and executive functions, and quality-of-life surveys prior to and following CAR T treatment at 3, 6, and 12 months among patients who remained in remission. CAR T manufacturing, treatment, and follow-ups followed national and institutional guidelines. Cytokine release syndrome (CRS) and Immune effector cell-associated neurologic syndromes (ICANS) were graded according to the ASTCT criteria. Standard statistical analysis was performed for CAR T treatment outcomes. GA impairment in each domain (binary outcome) was tabulated as percentages. For neurocognitive testing, means across timepoints were estimated for each test score using a linear mixed model predicting the score by timepoint. A random intercept was included to account for multiple assessments per patient. Results: Between April 2020 to March 2022, 18 patients were enrolled. The median age was 69.8 years (range 63.7 to 85.0) and 8 of 18 patients, 44%, were female. Eight patients received Axicabtagene ciloleucel while 6 and 4 patients received Tisagenlecleucel and Lisocabtagene maraleucel, respectively. Fourteen out of 18 patients, 78% (95% confidence interval [CI] 52 - 94), completed all required GA visits (baseline and all follow-up timepoints while in remission), meeting the prespecified feasibility endpoint of 75%. Geriatric vulnerabilities detected by GA were highly prevalent at the baseline including functional impairment by instrumental activities of daily living (44%), mobility impairment (24%), multimorbidity (61%), polypharmacy (44%), poor psychosocial support (39%), and depression (28%). Moreover, on a panel of 7 neurocognitive tests, 52.9% of patients had at least one and 29.4% had 2 or more impairments at baseline. With a median follow-up of 24 months (95% 23 - not reached), the 2-year overall and progression-free survival was 70% (95% CI 51 - 96) and 42% (95% CI 24 - 74), respectively. Ten patients had relapsed/progressed and among them 5 had died. Thirteen patients, 72%, experienced CRS with the majority grade 1-2 and only 2 patients (11%) had grade 3 CRS. Four patients, 22%, experienced ICANS (three grade 1 and one grade 2). The most common high-grade toxicities within 100 days of CAR T treatment were infections (n=4); cardiac complications (n=2); and thrombotic complications (n=2). There was no treatment-related death. Finally, longitudinal GA post-CAR T revealed the stability of geriatric impairment overtime among patients remaining in remission (Figure 1 left). Moreover, detailed neurocognitive testing revealed global stability of cognitive performance with improvements in 3 cognitive tests overtime, HVLT, ZBTA, and ZBF (Figure 1 right HVLT test). These findings support the notion among patients who achieve remission. Conclusions: In this prospective pilot study, we showed that longitudinal GA was feasible to perform in older, vulnerable lymphoma patients receiving CAR T therapy. Despite advanced age and high prevalence of baseline geriatric and cognitive deficits, CAR T treatment was well tolerated without excessive or unexpected toxicities. Stable GA deficits and improvement in some areas of cognitive performance were observed descriptively among patients in ongoing remission, supporting that CAR T treatment in older patients is safe without detrimental, long-term cognitive and functional impacts. Although the small sample size and incomplete data limited study interpretation and generalization, GA and geriatric management may provide valuable, actionable information to optimize older lymphoma patients for CAR T-cell therapy.

Exercise-based interventions for preventing and treating cancer therapy-related cardiovascular toxicity: a systematic review and meta-analysis

Abstract Background Cardiovascular toxicity is one of the most common side effects of cancer therapies. Physical exercise is regarded as a promising non-pharmacological therapy to prevent and mitigate cancer therapy-related cardiovascular toxicity (CTR-CVT) for cancer patients. Nevertheless, research evidence on its effects and optimal design remains unclear. Purpose This review aims to synthesize available data to evaluate the effects of exercise-based interventions on CTR-CVT in cancer patients and identify the potentially effective characteristics of exercise prescriptions. Methods Four databases (MEDLINE, Embase, Web of Science, and CENTRAL) were searched from the inception to October 2022 to identify eligible studies. Randomized controlled trials (RCTs) examining the effects of exercise-based interventions on CTR-CVT in cancer patients published in English were included. Risk of bias of included studies were assessed using the revised Cochrane "Risk of bias" tool for randomized trials (RoB 2.0). The meta-analysis was performed using statistical software R. Results Twenty studies with 1705 cancer patients were included. Our findings revealed that the VO2peak was significantly improved in the exercise-based intervention groups compared to the controls (standardized mean difference: 0.24, 95% confidence interval: 0.09 to 0.40). Evidence on other study outcomes remains unclear. The optimal characteristics of exercise programs could not be determined. Conclusion This review suggests that exercise-based interventions have the potential effects to prevent and treat CTR-CVT among cancer patients. Future well-designed RCTs are required to evaluate the impact of exercises on comprehensive CTR-CVT indicators.

Discussing long-term side effects of cancer therapy

Discussing long-term side effects of cancer therapy

Supporting gut health with medicinal cannabis in people with advanced cancer: potential benefits and challenges.

The side effects of cancer therapy continue to cause significant health and cost burden to the patient, their friends and family, and governments. A major barrier in the way in which these side effects are managed is the highly siloed mentality that results in a fragmented approach to symptom control. Increasingly, it is appreciated that many symptoms are manifestations of common underlying pathobiology, with changes in the gastrointestinal environment a key driver for many symptom sequelae. Breakdown of the mucosal barrier (mucositis) is a common and early side effect of many anti-cancer agents, known to contribute (in part) to a range of highly burdensome symptoms such as diarrhoea, nausea, vomiting, infection, malnutrition, fatigue, depression, and insomnia. Here, we outline a rationale for how, based on its already documented effects on the gastrointestinal microenvironment, medicinal cannabis could be used to control mucositis and prevent the constellation of symptoms with which it is associated. We will provide a brief update on the current state of evidence on medicinal cannabis in cancer care and outline the potential benefits (and challenges) of using medicinal cannabis during active cancer therapy.