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  • 1
    Online Resource
    Online Resource
    Anamorelin combined with physical activity, and nutritional counseling for cancer-related fatigue: a preliminary study
    Springer Science and Business Media LLC ; 2022
    In:  Supportive Care in Cancer Vol. 30, No. 1 ( 2022-01), p. 497-509
    Details
    In: Supportive Care in Cancer, Springer Science and Business Media LLC, Vol. 30, No. 1 ( 2022-01), p. 497-509
    Type of Medium: Online Resource
    ISSN: 0941-4355 , 1433-7339
    URL: Article
    DOI: 10.1007/s00520-021-06463-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463166-0
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  • 2
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    Integrative Oncology Consultations Delivered via Telehealth in 2020 and In-Person in 2019: Paradigm Shift During the COVID-19 World Pandemic
    SAGE Publications ; 2021
    In:  Integrative Cancer Therapies Vol. 20 ( 2021-01), p. 153473542199910-
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 20 ( 2021-01), p. 153473542199910-
    Abstract: The COVID-19 pandemic has catalyzed the use of mobile technologies to deliver health care. This new medical model has benefited integrative oncology (IO) consultations, where cancer patients are counseled about healthy lifestyle, non-pharmacological approaches for symptom management, and addressing questions around natural products and other integrative modalities. Here we report the feasibility of conducting IO physician consultations via telehealth in 2020 and compare patient characteristics to prior in-person consultations conducted in 2019. Methods: An integrated EHR-telemedicine platform was used for IO physician consultations. As in the prior in-person visits, patients completed pre-visit patient-reported outcome (PRO) assessments about common cancer symptoms [modified Edmonton Symptom Assessment Scale, (ESAS)], Measure Yourself Concerns and Wellbeing (MYCaW), and the PROMIS-10 to assess quality of life (QOL). Patient demographics, clinical characteristics, and PROs for new telehealth consultation in 2020 were compared to new in-person consultations in 2019 using t-tests, chi-squared tests, and -Wilcoxon rank-sum test. Results: We provided telehealth IO consultations to 509 new patients from April 21, 2020, to October 21, 2020, versus 842 new patients in-person during the same period in 2019. Most were female (77 % vs 73%); median age (56 vs 58), and the most frequent cancer type was breast (48% vs 39%). More patients were seeking counseling on herbs and supplements (12.9 vs 6.8%) and lifestyle (diet 22.7 vs 16.9% and exercise 5.2 vs 1.8%) in the 2020 cohort than 2019, respectively. The 2020 telehealth cohort had lower symptom management concerns compared to the 2019 in-person cohort (19.5 vs 33.1%). Conclusions: Delivering IO consultations using telehealth is feasible and meets patients’ needs. Compared to patients seen in-person during 2019, patients having telehealth IO consultations in 2020 reported lower symptom burden and more concerns about lifestyle and herbs and supplements. Additional research is warranted to explore the satisfaction and challenges among patients receiving telehealth IO care.
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/1534735421999101
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2101248-9
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  • 3
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    Online Resource
    PD25-12 PREDICTING RISK OF BCG RELATED SIDE EFFECTS USING URINARY CYTOKINES COMBINED WITH PRE-EXISTING URINARY SYMPTOMS
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Journal of Urology Vol. 193, No. 4S ( 2015-04)
    Details
    In: Journal of Urology, Ovid Technologies (Wolters Kluwer Health), Vol. 193, No. 4S ( 2015-04)
    Type of Medium: Online Resource
    ISSN: 0022-5347 , 1527-3792
    URL: Article
    DOI: 10.1016/j.juro.2015.02.1661
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 4
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    Online Resource
    Frequency of vaccine hesitancy among patients with advanced cancer
    Cambridge University Press (CUP) ; 2023
    In:  Palliative and Supportive Care
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP)
    Abstract: Vaccine hesitancy has become prevalent in society. Vulnerable populations, such as those with cancer, are susceptible to increased morbidity and mortality from diseases that may have been prevented through vaccination. Objectives Our objective was to determine patient perception of vaccine efficacy and safety and sources of information that influence decisions. Methods This study was a prospective cross-sectional survey trial conducted from March 10, 2022, to November 1, 2022, at a Supportive Care Clinic. Patients completed the survey with a research assistant or from a survey link. Vaccine hesitancy was defined as a response of 2 or more on the Parent Attitudes About Childhood Vaccines (PACV-4). Perception on vaccine safety and efficacy along with the importance of sources of information were determined by a questionnaire. Results Of the 72 patients who completed the PACV-4, 30 were considered vaccine-hesitant (42%). Of those who completed the survey alone (35), 23 (66%) were vaccine-hesitant; and of those who completed the survey with the help of a study coordinator (37), 7 (19%) were vaccine-hesitant. The most important source for decision-making was their doctor (82%, 95% CI 73–89), followed by family (42%, 95% CI 32–52), news/media (31%, 95% CI 22–41), and social media (9%, 95% CI 4–16). Clinical and demographic factors including age, gender, race/ethnicity, education level, and location of residence were not associated with vaccine hesitancy. Significance of results Vaccine hesitancy is present among patients with advanced cancer. The high value given to the doctor’s recommendation suggests that universal precautions regarding vaccine recommendation may be an effective intervention.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S147895152300113X
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2121158-9
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  • 5
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    Online Resource
    Complementary and Alternative Medicine Use in Minority and Medically Underserved Oncology Patients: Assessment and Implications
    SAGE Publications ; 2018
    In:  Integrative Cancer Therapies Vol. 17, No. 2 ( 2018-06), p. 371-379
    Details
    In: Integrative Cancer Therapies, SAGE Publications, Vol. 17, No. 2 ( 2018-06), p. 371-379
    Abstract: Introduction: Complementary and alternative medicine (CAM) use in minority and medically underserved oncology patients is not well documented. We assessed knowledge and utilization of CAM in a sample of these patients receiving treatment at an urban community hospital. Methods: Patients with cancer were interviewed using an electronic application that depicted specific CAM therapies. Patients were questioned on their knowledge and utilization of therapies, deterrents to use, and interest in using these therapies if they were made available. Results: Patients (n = 165) reported a high awareness and use of CAM therapies. CAM use was highest for prayer (85%), relaxation (54%), special diet (29%), meditation (19%), and massage (18%). Patients’ interest in using CAM was high for nearly all therapies. Lack of adequate knowledge and cost of use were reported as deterrents to use. Female patients reported higher use of aromatherapy relative to males (37.1% vs 19.4%, P = .02); those with higher education reported greater use of relaxation (60.8% vs 28.6%, P = .02); non-Hispanics reported higher use of relaxation relative to Hispanics (63.5% vs 44.2%, P = .03), and African American patients reported higher use of relaxation relative to White patients (69.2% vs 50%, P = .03). Conclusions: CAM use in minority and medically underserved cancer patients is common, but not professionally guided; thus, concerns remain regarding its safe use. Our data underscore the importance of patient-physician dialogue regarding CAM use in this patient population, and interest in access to the medically guided integration of evidence-based CAM therapies.
    Type of Medium: Online Resource
    ISSN: 1534-7354 , 1552-695X
    URL: Article
    DOI: 10.1177/1534735417735892
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2101248-9
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  • 6
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    Online Resource
    Recovery of chemotherapy-induced left ventricular dysfunction in cancer survivors.
    American Society of Clinical Oncology (ASCO) ; 2016
    In:  Journal of Clinical Oncology Vol. 34, No. 3_suppl ( 2016-01-20), p. 136-136
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 34, No. 3_suppl ( 2016-01-20), p. 136-136
    Abstract: 136 Background: Chemotherapy-induced left ventricular dysfunction (CILVD) leading to heart failure (HF) is a clinical problem of emerging importance particularly with the 14.5 million cancer survivors who are alive in the United States today, and projected to increase to almost 19 million in 2024. Many of these survivors have received cardiotoxic anticancer agents such as anthracycline and trastuzumab. Research showed that those exposed to anthracyclines are expected to have some degree of cardiac dysfunction 10 to 20 years after treatment and 5% of those patients will develop overt HF. This pilot study investigated whether cancer survivors with CILVD who achieved recovery of cardiac function will maintain their left ventricular ejection fraction (LVEF) if HF medications were discontinued. Methods: We conducted a prospective pilot study on 20 cancer survivors with history of CILVD with recovered cardiac function. HF medications were weaned off in a stepwise process per protocol. Cardiac function was monitored with LVEF measurement per echocardiography and cardiac biomarkers performed at baseline, 2, 4 and 6 months. Patients monitor their heart rate, blood pressure, and symptoms and reported changes based on set parameters. Results: Cancer survivors who maintained their LVEF after discontinuation of HF medications were younger (mean age 47.9 years SD+12.0), 65% female, 55% breast cancer survivors, with no history ofischemic heart disease, hypertension, diabetes mellitus and cardiac dysrhythmias. Chemotherapeutic agents (mean dose) used in the treatment of these patients include doxorubicin (363 mg/m 2 ), epirubicin (527mg /m 2 ), cyclophosphamide (5062 mg), and trastuzumab (6317 mg). There was no significant change from baseline measurements of LVEF and global longitudinal strain (GLS) of 55.1% (± 3.7) GLS of -18.3% (± 2.7) prior to weaning the HF medication to 56% (± 1.6) GLS of -18.2% (± 2.3). after complete withdrawal of HF medications. Conclusions: With the increasing number of young cancer survivors, CILVD may become a frequent clinical issue. Clearly, there is a need to examine the safety of withdrawing HF medications in cancer survivors with CILVD and if lifelong therapy with HF medications is necessary.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2016.34.3_suppl.136
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2016
    detail.hit.zdb_id: 2005181-5
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  • 7
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    Online Resource
    Integrative oncology consultation and symptom palliation: Analysis of patient-reported outcomes at a comprehensive cancer center.
    American Society of Clinical Oncology (ASCO) ; 2016
    In:  Journal of Clinical Oncology Vol. 34, No. 26_suppl ( 2016-10-09), p. 84-84
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 34, No. 26_suppl ( 2016-10-09), p. 84-84
    Abstract: 84 Background: Patients (pts) receiving cancer care are increasingly interested in complementary health approaches to improve symptoms and quality of life. We report on demographics and patient reported outcomes in an integrative oncology (IO) clinic. Methods: Pts presenting for IO consultation or follow-up completed: Measure Yourself Concerns and Wellbeing (MYCaW), Edmonton Symptom Assessment Scale (ESAS), Short Form 12 (SF-12) quality of life (QOL) scale, and an overall satisfaction questionnaire. Consultations were provided by medical oncologists. Results: 2,474 consultations were conducted from 9/2009 to 12/2013; 26.0% (n = 643) had ≥ 1 follow-up visit (mean 3.2; SD1.8). Most were female (69%) and white (75%); most frequent cancer types was breast (29%); 29% of pts had advanced disease. At baseline, ESAS scores were highest for Sleep (4.2; SD 2.8), Fatigue (4.0; SD 2.8), Well-Being (3.8 SD 2.6) and Anxiety (3.1; SD 2.9). Those with advanced disease had significantly higher baseline ESAS scores for pain, nausea, shortness of breath, and appetite; higher ESAS subscale scores for physical and global distress; lower SF-12 physical health scores; and were more interested in developing an integrative/holistic approach and appetite. Those with loco-regional disease were more interested in overall health, hot flashes, and dry mouth. For ESAS baseline scores ≥ 4 and follow up within 30 days of the initial consult, we observed overall improvement in ESAS symptoms (38-60% of pts with ESAS decrease ≥ 1). Overall satisfaction was high at both initial encounter (9.4; SD 1.3) and first follow up (9.5; SD 1.2). Patients were satisfied to very satisfied with how well MYCaW concern 1 and 2 were addressed: 8.0 (SD 2.2) and 9.1 (SD 1.8). No difference in overall satisfaction was observed comparing those with advanced vs loco-regional disease. Conclusions: Most pts presenting for integrative oncology consultation have early stage disease, relatively low symptom burden, and are most interested in support for overall health. Patients were overall very satisfied with how well their top concerns were addressed, with significant improvements in symptom distress.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2016.34.26_suppl.84
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2016
    detail.hit.zdb_id: 2005181-5
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  • 8
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    Online Resource
    Recurrence and survival outcomes following adjuvant therapy for early-stage uterine serous carcinoma (USC).
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. e16556-e16556
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. e16556-e16556
    Abstract: e16556 Background: The choice of adjuvant therapy for early-stage USC remains controversial. The objective of this study was to estimate the recurrence rates of patients with surgically resected early-stage USC stratified by observation alone or adjuvant therapy. Methods: A retrospective review of women with surgically-staged stage IA-II USC followed at M.D. Anderson Cancer Center between January 2000 and December 2011. Descriptive statistics were used to summarize the demographic and clinical characteristics of patients. We estimated the cumulative incidence of disease recurrence, overall survival (OS), and recurrence-free survival (RFS) as a function of adjuvant therapy received. Adjuvant therapy groups listed in the Table. Results: 80 patients included in study. 58 patients had stage IA, 14 had stage IB, and 8 had stage II disease. Mean age was 66.4 years. Median follow-up for all patients was 4.83 years (range: 0.02 – 18.16). Cumulative incidence of recurrence for the whole group was 0.18 (95% CI: 0.10 – 0.28) which was reached at 3.96 years and remained at this rate until rising to 0.23 (95% CI: 0.12 – 0.36) at 11.12 years. Adjuvant treatment was not significantly associated with decreased risk of recurrence (Table). RFS at 5 years for the whole population was 0.71 (95% CI: 0.59 – 0.80) and OS at 5 years was 0.76 (95% CI: 0.63 – 0.85). Adjuvant treatment was not significantly associated with RFS or OS. In a subset of stage IA patients, 4 of 27 patients in the observation or cuff alone group recurred compared with 1 of 16 patients in the chemotherapy +/- cuff group (HR 0.48, CI: 0.05 – 4.27, p=0.511). Conclusions: In this study, there were no observed differences between observation and adjuvant treatment modalities in recurrence rates or survival outcomes for patients with early-stage USC. The addition of adjuvant chemotherapy may reduce risk for recurrence in stage IA patients, but further study is needed. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2013.31.15_suppl.e16556
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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  • 9
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    Online Resource
    Correlation of HRD status with clinical and survival outcomes in patients with advanced-stage ovarian cancer.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 15_suppl ( 2021-05-20), p. 5568-5568
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 15_suppl ( 2021-05-20), p. 5568-5568
    Abstract: 5568 Background: Nearly 50% of patients with high grade ovarian cancer (HGOC) harbor a germline or somatic mutation in BRCA1/BRCA2 or have tumors characterized by homologous recombination deficiency (HRD). HRD is associated with response to poly(ADP-ribose) polymerase inhibitors (PARPi) in HGOC. Although PARPi show great promise, there is interest in investigating how HRD status affects outcomes and can be used to objectively tailor other treatment strategies. We aimed to compare clinical and survival outcomes in HGOC stratified by HRD status. Methods: We performed a retrospective analysis of all advanced HGOC from April 2013 to June 2019. Patients were included if germline BRCA and HRD status was known. Clinical outcomes were analyzed and stratified by (1) germline BRCA+ (2) germline BRCA - and somatic BRCA/HRD+, or (3) BRCA-/HRD-. Progression free (PFS) and overall survival (OS) were estimated using Kaplan-Meier methods stratified by HRD status and modeled via Cox proportional hazards regression. Results: 1271 patients with advanced HGOC presented during the study period of which 187 met inclusion criteria. 106 patients had germline BRCA mutation, 26 somatic BRCA/HRD+, and 55 BRCA/HRD-. Patients who had HRD- tumor had older median age at diagnosis (63 vs. 54 and 60 years, p 〈 0.001), white race (89% vs. 74% and 68%), non-serous histology (20% vs. 6% and 0%, p=0.04), required more NACT chemotherapy cycles (4 vs. 3 and 3 cycles, p=0.03), and less complete gross resection (R0) at tumor reductive surgery (TRS) (60% vs. 83% and 77%, p=0.02). Patients who had BRCA/HRD- tumor had worse PFS (14.9 months) compared to germline BRCA+ (23.5 months) or somatic BRCA/HRD+ (20.2 months, p 〈 0.001). Patients with BRCA/HRD- disease also had worse OS (42.3 months) compared to germline BRCA+ (68.8 months) or somatic BRCA/HRD+ (69.2 months). Multivariate analysis for PFS revealed that age (HR 1.02, 95% CI 1.00-1.04), p=0.01), stage (HR 5.7, 95% CI 1.39-23.4, p=0.02), R0 resection at TRS (HR 0.41, 95% CI 0.21-0.83, p=0.01), and BRCA/HRD- status (HR 1.63, 95% CI 1.07-2.48, p=0.02) were significant factors impacting PFS. Multivariate analysis for OS revealed that age (HR 1.07, 95% CI 1.03-1.10, p 〈 0.001) and R0 resection at TRS (HR 0.19, 95% CI 0.08-0.44, p 〈 0.001) were significant factors impacting OS. Conclusions: Germline BRCA-mutant, somatic BRCA/HRD+ HGOC was associated with improved PFS and OS regardless of primary TRS or NACT. BRCA-/HRD- was a negative prognostic factor for survival in HGOC.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.15_suppl.5568
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
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  • 10
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    Online Resource
    Phase I clinical trials in oncology: A review of the old and a look at the new.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 15_suppl ( 2017-05-20), p. e14030-e14030
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e14030-e14030
    Abstract: e14030 Background: In Phase I oncology trials the primary goal is to assess dose limiting toxicities (DLT) and estimate the maximum tolerated dose (MTD). The classical 3+3 design is still used in greater than 90% of studies. We review the classical 3+3 design and two new model-based designs: Bayesian Optimal Interval (BOIN) design and the recently updated modified toxicity probability interval (mTPI-2) design. These designs are easy to implement like the 3+3 using a simple table to guide dose escalation/de-escalation. As opposed to the 3+3 design, these designs can target a DLT rate well above or below the standard 33% target. In general, an expansion cohort is added to 3+3 designs to verify safety and get an early efficacy signal. In the 3+3 expansion cohort it is unclear how to proceed if excessive toxicity is observed; whereas, with BOIN and mTPI-2, expansion can be built in with toxicity monitoring and MTD updating. Methods: We carefully explain how computer simulations can be used to evaluate phase I designs and present results from simulations comparing the designs under several true dose toxicity curves. Results: We show that BOIN and mTPI-2 have better performance than the 3+3. These new designs select the true MTD at a much higher rate and treat a higher percentage of patients at the MTD. The new designs generally tend to allocate fewer patients to high toxicity doses and fewer patients to low toxicity doses, thus ensuring high ethical standards. Unlike older Bayesian designs (e.g., modified continual reassessment method), the newer designs do not require a statistician to update the model during the course of the trial. Readily available, free software make these designs simple to implement. Conclusions: We recommend the use of the new model-based designs over the classical 3+3 design.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.15_suppl.e14030
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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