A Data-Driven Epigenetic Characterization of Morning Fatigue Severity in Oncology Patients Receiving Chemotherapy: Associations With Epigenetic Age Acceleration, Blood Cell Types, and Expression-Associated Methylation.

Background: Moderate-to-severe fatigue commonly occurs in patients with cancer. Given the numerous roles that epigenetic processes may play in the development and severity of fatigue, the purposes of this study were to (1) use a data-driven discovery approach to evaluate for mechanisms underlying morning fatigue in a group of oncology patients receiving chemotherapy and (2) identify common biological mechanisms associated with morning fatigue severity across these independent epigenetic evaluations.

Methods: Patients completed questionnaires during the week prior to their chemotherapy treatment.

R-DA-EPOCH Versus DA-EPOCH-R: Impact of Chemoimmunotherapy Sequencing on Treatment Outcomes in Patients With Diffuse Large B-Cell Lymphoma.

Background: Chemoimmunotherapy with rituximab (R) added to dose-adjusted (DA)-EPOCH (continuous infusion of etoposide, vincristine, and doxorubicin with cyclophosphamide and prednisone) has become a standard treatment approach for high-risk diffuse large B-cell lymphoma (DLBCL) patients. In contrast to pivotal trials that sequenced rituximab with the initiation of each chemoimmunotherapy cycle, our institution adopted delaying rituximab following discharge after EPOCH completion in patients requiring inpatient chemotherapy (DA-EPOCH-R). Herein, we evaluate the efficacy and safety of rituximab sequencing with EPOCH initiation and after EPOCH administration.

Brain-derived neurotrophic factor and cytokines as predictors of cognitive impairment in adolescent and young adult cancer patients receiving chemotherapy: a longitudinal study.

Background: Inflammatory signaling is linked with cancer-related cognitive impairment (CRCI), potentially through modulation of brain-derived neurotrophic factor (BDNF) expression. Here, we evaluate associations between plasma cytokines and BDNF and their relationship with cognition in a longitudinal study of adolescent and young adult cancer patients (AYAC) receiving chemotherapy and non-cancer controls (NC) (Clinicaltrials.gov: NCT03476070).

A Breast cAncer Survivorship Inter-Professional Community (BASIC) Shared Care Model to Promote Healthy Behaviors in Singapore: A Pilot Randomized Controlled Trial.

Background: This pilot study assessed the feasibility and acceptability of a randomized controlled trial (RCT) to evaluate a shared care model combining oncologists' and primary care providers' expertise to help cancer survivors manage their health and adopt healthier behaviors.

Method: This open-label RCT recruited 70 breast cancer survivors from the National Cancer Centre Singapore between 03/2021-07/2022. Eligible participants (≥ 21 years, ≥ 3 years post-treatment, ECOG status 0-2, deemed low risk by oncologists), were randomized (1:1) to receive shared care or usual care with 1-year follow-up.

Incidence and predictors of immune checkpoint inhibitor treatment-related cognitive impairment in a racial and ethnic diverse population.

Introduction: Immune checkpoint inhibitors (ICI) have revolutionized cancer therapy in recent years. In addition to rejuvenating anti-cancer immunity, ICI may cause immune dysregulation, impacting homeostasis, including brain functions. Thus, the association of ICI with cognitive function needs further investigation.

Pharmacist-led interventions associated with symptoms identified by electronic patient-reported outcome battery: A descriptive study.

IntroductionAt the University of California Irvine (UCI) in Orange County California, we published an implementation study to evaluate the use of an electronic patient-reported outcome (ePRO) tool to guide pharmacist-led chemotherapy education in newly diagnosed cancer patients. The goal of this secondary analysis was to describe the types of pharmacist-led interventions performed in the implementation study.MethodsUsing a pre-configured ePRO battery, patients' symptoms were assessed in seven domains (cognitive impairment, physical impairment, pain, depression, anxiety, fatigue, nausea/vomiting) at each infusion visit.

Psychosocial challenges among Asian adolescents and young adults with cancer: a scoping review.

Background: Most of the landmark cohorts and reviews that assessed the psychosocial outcomes among adolescent and young adult (AYA) cancer survivors have focused on Western populations. This scoping review summarizes the existing evidence on psychosocial challenges experienced by AYAs with cancer in Asia, specifically work- and school-related outcomes, financial distress, social relationships, and concerns with infertility.

Methods: A literature search was conducted on Embase and Medline for studies that (1) were published in English between 2000 and 2023, (2) recruited AYAs diagnosed with cancer between the age of 15 and 39 years, (3) were conducted in Asia, and (4) assessed outcomes related to (i) work or/and school performance, (ii) financial distress, (iii) romantic relationship or/and relationship with family and peers, and (iii) concerns with childbirth and infertility.

Describing the Core Attributes and Impact of Comprehensive Cancer Centers Internationally: A Chronological Scoping Review.

: Comprehensive cancer centers (CCCs) remain at the forefront of cancer control efforts. Limited clarity and variation exist around the models, scope, characteristics, and impacts of CCCs around the globe. This scoping review systematically searched and synthesized the international literature, describing core attributes and anticipated and realized impacts of CCCs, detailing changes over time.

Genotyping for Optimization of Tamoxifen Therapy in Indonesian Women with ER+ Breast Cancer.

Certain genotypes are linked to a lower efficacy of tamoxifen therapy. This study aimed to observe polymorphisms and examine the impact of genotyping among tamoxifen-treated breast cancer patients in Indonesia. 150 breast cancer participants were recruited.

A feasibility study on implementing pre-emptive pharmacogenomics testing in outpatient clinics in Singapore (IMPT study).

In view of the limited data related to preemptive pharmacogenomics (PGx) testing in the primary care setting, we designed a study to assess the feasibility of implementing preemptive PGx services at outpatient clinics, with the aim to assess the practicality and challenges of implementing preemptive PGx testing within primary care, and its impact on clinical workflows and patient care. This prospective study was conducted between October 2022 and August 2023 at five outpatient clinics located in Singapore. Patients aged 21 to 65 with a reported history or risk of developing any of the target chronic conditions or any patients receiving one of the 29 PGx-associated medications were recruited.

Accounting for unmet needs resulting from cancer-related cognitive impairment.

Purpose: Cancer-related cognitive impairment (CRCI) causes a wide range of unmet needs for cancer survivors. It is unknown which clinical, demographic, cognitive, and psychological factors underpin and account for these various unmet needs. This study aimed to (a) identify factors associated with CRCI-related unmet needs, and (b) establish the most pertinent factors that account for CRCI-related unmet needs.

Perturbations in the neuroactive ligand-receptor interaction and renin angiotensin system pathways are associated with cancer-related cognitive impairment.

Purpose: This study reports on the results from our data-driven approach that identified perturbations in neuroactive ligand-receptor interaction and renin-angiotensin system (RAS) pathways in oncology patients with and without self-reported cancer-related cognitive impairment (CRCI).

Methods: In a sample of oncology patients receiving chemotherapy (n = 1343), the Attentional Function Index (AFI) was used to assess CRCI. Patients were grouped into low (AFI score of < 5) versus high (AFI score of > 7.

Implementing a nurse-enabled, integrated, shared-care model involving specialists and general practitioners in early breast cancer post-treatment follow-up (EMINENT): a single-centre, open-label, phase 2, parallel-group, pilot, randomised, controlled trial.

Background: Current models of post-treatment cancer care rely heavily on hospital-based, medical specialists and do not sufficiently leverage primary care. Many breast cancer survivors face ongoing unmet needs that may benefit from a multidisciplinary, shared-care approach. We aimed to evaluate the feasibility and preliminary effectiveness of implementing nurse-enabled, shared-follow-up care between the acute and primary care setting for early-stage breast cancer.

Experiences and preferences about information on treatment-related side effects among patients with early breast cancer.

Background: Treatment-related side effects are common among women treated for early breast cancer and their effective management is essential to maintain quality of life, ensure treatment adherence, and optimise survival outcomes. This study aimed to investigate patient-reported experiences and preferences about information regarding side effects received during breast cancer care.

Methods: An international multi-stakeholder expert group conducted an online patient survey assessing comprehensiveness, timing, and delivery modality of information regarding treatment-related side effects among patients undergoing primary therapy (surgery, radiation, and [neo]adjuvant chemotherapy) and endocrine therapy for early breast cancer.

The effect of non-pharmacological interventions on cognitive function in cancer: an overview of systematic reviews.

Purpose: A significant number of cancer survivors experience cancer-related cognitive impairment (CRCI), which can impact their ability to think, reason, make decisions, and perform daily actions. In recent years, non-pharmacological interventions for CRCI have gained significant attention. These interventions include exercise, cognitive behavioural therapy, cognitive training/remediation, dietary, mind-body, and multi-modal/complex interventions.

Patient-reported strategies for prevention and treatment of chemotherapy-induced peripheral neuropathy.

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating toxicity of many drugs used in cancer treatment. There are numerous available strategies for preventing or treating CIPN, but few are guideline-recommended, due to limited evidence of their effectiveness. The primary objective of this survey was to understand what strategies patients used to prevent or treat CIPN, and to understand their perceptions around CIPN prevention and treatment.

The MASCC COG-IMPACT: An unmet needs assessment for cancer-related cognitive impairment impact developed by the Multinational Association of Supportive Care in Cancer.

Purpose: Cancer-related cognitive impairment (CRCI) can have a profound impact on the lives of cancer survivors. A multitude of subjective and objective assessment tools exist to assess the presence and severity of CRCI. However, no purpose-built tool exists to assess the unmet needs of cancer survivors directly relating to CRCI.

HEalth-Related Quality of Life-Intervention in Survivors of Breast and Other Cancers Experiencing Cancer-Related Fatigue and Associated Cognitive Symptoms Using TraditionAL Chinese Medicine: The 'HERBAL' Trial.

Introduction: As pharmacological strategies remain limited for relieving fatigue and associated cognitive symptoms, integrative modalities such as traditional Chinese medicine (TCM) could be explored as therapeutic strategies in cancer survivors. Here, we evaluate and report the efficacy and safety of a TCM concoction, modified Xiang Bei Yang Rong Tang (XBYRT), on quality of life (QOL), cancer-related fatigue (CRF), and cognitive symptoms, compared to placebo.

Methods: In a single-centered, randomized, double-blinded, placebo-controlled pilot trial conducted from 2019 to 2022, fatigued cancer survivors ≥21 years old were recruited to receive the XBYRT intervention or placebo (5% diluted) once daily for the duration of 8 weeks.

Addressing Financial Toxicity From a Global Perspective: How to Advance Shared-Learning to Facilitate Change?

Financial Toxicity is a global issue requiring international efforts, but importantly, where to next?

BDNF augmentation reverses cranial radiation therapy-induced cognitive decline and neurodegenerative consequences.

Cranial radiation therapy (RT) for brain cancers is often associated with the development of radiation-induced cognitive dysfunction (RICD). RICD significantly impacts the quality of life for cancer survivors, highlighting an unmet medical need. Previous human studies revealed a marked reduction in plasma brain-derived neurotrophic factor (BDNF) post-chronic chemotherapy, linking this decline to a substantial cognitive dysfunction among cancer survivors.

Cancer care for transgender and gender-diverse people: Practical, literature-driven recommendations from the Multinational Association of Supportive Care in Cancer.

In the United States, over 2 million individuals openly identify with a gender that differs from their sex assigned at birth. A cancer diagnosis is physically and psychologically taxing-and, in some, traumatic. However, for transgender and gender-diverse (TGD) people, many of whom have experienced discrimination in myriad health care settings, the challenges may be even greater.

Impact of COVID-19 Pandemic on Emergency Department Visits for Opioid Use Disorder Across University of California Health Centers.

Introduction: Coronavirus 2019 (COVID-19) has had a devastating impact on mental health and access to addiction treatment in the United States, including in California, which resulted in the highest rates of emergency department visits (ED) for opioid poisoning in 2020. As California slowly returns to pre-pandemic normalcy, it remains uncertain whether the rates of opioid-related events have slowed down over time. We hypothesized that the number of opioid-related ED visits were exacerbated after the period of the COVID-19 pandemic and continue at a high rate in the present.

Perceptions of Implementing Real-Time Electronic Patient-Reported Outcomes and Digital Analytics in a Majority-Minority Cancer Center.

Purpose: Electronic patient-reported outcome (ePRO) tools are increasingly used to provide first-hand information on patient's symptoms and quality of life. This study explored how patients and health care providers (HCPs) perceive the use of a digital real-time ePRO tool, coupled with digital analytics at a cancer center located in a majority-minority county. Furthermore, we described the implementation barriers and facilitators identified from the participants' perspectives.

A systematic review and meta-analysis of patient-relevant outcomes in comprehensive cancer centers versus noncomprehensive cancer centers.

This systematic review describes difference in patient-relevant outcomes between comprehensive cancers (CCCs) versus non-CCCs. Studies were identified in PubMed, Cochrane CENTRAL, Epistemonikos, and gray literature from January 2002 to May 2024. Data were extracted and appraised by two authors.