ORCID Profile
0000-0002-9561-6144
Current Organisation
Dana Farber Cancer Institute
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Publisher: Elsevier BV
Date: 03-2023
DOI: 10.1016/J.JPAINSYMMAN.2022.11.010
Abstract: Shortness of breath is a distressing symptom that occurs in 10% to 70% of oncology patients. Despite this broad range in its occurrence, little is known about inter-in idual variability in shortness of breath and associated risk factors among patients receiving chemotherapy. Identify subgroups of patients with distinct shortness of breath profiles evaluate for differences among these subgroups in demographic and clinical characteristics evaluate for differences among symptom dimensions of shortness of breath, and evaluate for differences in quality of life outcomes. Outpatients (n=1338) completed questionnaires six times over two chemotherapy cycles. Occurrence of shortness of breath was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath profiles. Four distinct shortness of breath profiles were identified (None [70.5%], Decreasing [8.2%], Increasing [7.8%], High [13.5%]). Risk factors for membership in High class included: history of smoking, self-reported diagnosis of lung disease, having lung cancer, and receipt of a higher number of cancer treatments. Compared to the None class, High class reported poorer physical, psychological, and social functioning. Almost 14% of patients with heterogeneous types of cancer receiving chemotherapy had persistently high occurrence rates of shortness of breath for almost two months. In addition, compared to the Decreasing and Increasing classes, the High class' episodes of shortness of breath were more frequent and more severe. Clinicians need to assess all oncology patients for shortness of breath and provide targeted interventions.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.CYTO.2021.155653
Abstract: Cancer-related cognitive impairment (CRCI) is a significant problem for patients receiving chemotherapy. While a growing amount of pre-clinical and clinical evidence suggests that inflammatory mechanisms underlie CRCI, no clinical studies have evaluated for associations between CRCI and changes in gene expression. Therefore, the purpose of this study was to evaluate for differentially expressed genes and perturbed inflammatory pathways across two independent s les of patients with cancer who did and did not report CRCI. The Attentional Function Index (AFI) was the self-report measure used to assess CRCI. AFI scores of 7.5 indicate low versus high levels of cognitive function, respectively. Of the 185 patients in S le 1, 49.2% had an AFI score of 7.5. Of the 158 patients in S le 2, 50.6% had an AFI score of 7.5. Data from 182 patients in S le 1 were analyzed using RNA-seq. Data from 158 patients in S le 2 were analyzed using microarray. Twelve KEGG signaling pathways were significantly perturbed between the AFI groups, five of which were signaling pathways related to inflammatory mechanisms (e.g., cytokine-cytokine receptor interaction, tumor necrosis factor signaling). This study is the first to describe perturbations in inflammatory pathways associated with CRCI. Findings highlight the role of cytokines both in terms of cytokine-specific pathways, as well as pathways involved in cytokine production and cytokine activation. These findings have the potential to identify new targets for therapeutics and lead to the development of interventions to improve cognition in patients with cancer.
Location: United States of America
No related grants have been discovered for Marilyn Hammer.