scholarly journals Associating sleep problems with advanced cancer diagnosis, and immune checkpoint treatment outcomes: a pilot study

2022 ◽  
Author(s):  
Arthur Sillah ◽  
Ulrike Peters ◽  
Nathaniel F. Watson ◽  
Scott S. Tykodi ◽  
Evan T. Hall ◽  
...  
Keyword(s):  
Pilot Study ◽  
Treatment Outcomes ◽  
Advanced Cancer ◽  
Cancer Diagnosis ◽  
Immune Checkpoint ◽  
Sleep Problems

scholarly journals Associating Sleep Problems With Advanced Cancer Diagnosis, and Immune Checkpoint Treatment Outcomes: a Pilot Study

2021 ◽  
Author(s):  
Arthur Sillah ◽  
Ulrike Peters ◽  
Nathaniel F. Watson ◽  
Scott S. Tykodi ◽  
Evan T. Hall ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
High Risk ◽  
Advanced Cancer ◽  
Immune Checkpoint ◽  
Sleep Problems ◽  
Checkpoint Inhibitors ◽  
Metastatic Cancer ◽  
Sleep Patterns ◽  
Logistic Regression Models ◽  
Clinically Significant

Abstract Background: Sleep problems (SP) are common in cancer patients but have not been previously assessed in patients receiving immune checkpoint inhibitors (ICI).Methods: We collected questionnaire data on sleep apnea risk, insomnia and general sleep patterns. We used an adjusted multivariate Poisson regression to calculate prevalence ratios (PRs) and associated 95% confidence intervals (CIs) for associations between these SP and metastatic versus localized cancer stage (M1 vs M0), and adjusted logistic regression models to calculate ORs for associations between SP with the number of ICI infusions completed (6+ vs. <6).Results: Among 32 patients who received ICI treatment, the prevalence of low, intermediate, and high-risk OSA risk was 36%, 42%, and 21%, respectively. Overall, 58% of participants reported clinically significant insomnia. We did not find a significant association between intermediate or high risk OSA (vs. low risk) and metastatic cancer status [PR=1.01 (95% CI: 0.28, 3.67)]. Patients in the cohort who reported taking >15 minutes to fall asleep were 3.6 times more likely to be diagnosed with metastatic cancer compared to those reporting shorter sleep latency [95% CI (1.74, 7.35)]. We did not find a significant association between SP and number of ICI infusions completed.Conclusion: Our data associating sleep apnea risk, insomnia and sleep patterns with more advanced cancer encourages further exploration in larger-scale observational studies and suggests interventional clinical trials focused on sleep quality improvement could result in better outcomes for these patients.

scholarly journals Treatment with therapeutic anticoagulation is not associated with immunotherapy response in advanced cancer patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Johannet ◽  
Amelia Sawyers ◽  
Nicholas Gulati ◽  
Douglas Donnelly ◽  
Samuel Kozloff ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Objective Response ◽  
Progression Free Survival ◽  
Immune Checkpoint Blockade ◽  
Coagulation Cascade ◽  
Advanced Cancer Patients ◽  
Clinical Endpoints

Abstract Background Recent preclinical data suggest that there may be therapeutic synergy between immune checkpoint blockade and inhibition of the coagulation cascade. Here, we investigate whether patients who received immune checkpoint inhibitors (ICI) and were on concomitant anticoagulation (AC) experienced better treatment outcomes than individuals not on AC.Affiliation: Kindly confirm if corresponding authors affiliation is identified correctly.The corresponding author's affiliation is correct. Methods We studied a cohort of 728 advanced cancer patients who received 948 lines of ICI at NYU (2010–2020). Patients were classified based on whether they did (n = 120) or did not (n = 828) receive therapeutic AC at any point during their treatment with ICI. We investigated the relationship between AC status and multiple clinical endpoints including best overall response (BOR), objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), overall survival (OS), and the incidence of bleeding complications.Affiliations: Journal instruction requires a country for affiliations; however, this is missing in affiliations 1 to 5. Please verify if the provided country is correct and amend if necessary.The country is correct for all affiliations (1 - 5). Results Treatment with AC was not associated with significantly different BOR (P = 0.80), ORR (P =0.60), DCR (P =0.77), PFS (P = 0.59), or OS (P =0.64). Patients who received AC were significantly more likely to suffer a major or clinically relevant minor bleed (P = 0.05). Conclusion AC does not appear to impact the activity or efficacy of ICI in advanced cancer patients. On the basis of our findings, we caution that there is insufficient evidence to support prospectively evaluating the combination of AC and immunotherapy.

scholarly journals Effects of concomitant proton pump inhibitor use on immune checkpoint inhibitor efficacy among patients with advanced cancer

2021 ◽  
Vol 10 (1) ◽  
pp. 1929727
Author(s):  
Bao-Dong Qin ◽  
Xiao-Dong Jiao ◽  
Xin-Cheng Zhou ◽  
Bin Shi ◽  
Jian Wang ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Advanced Cancer ◽  
Proton Pump ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor

Patients’ Awareness of Advanced Disease Status, Psychological Distress and Quality of Life Among Patients With Advanced Cancer: Results From the APPROACH Study, India

2021 ◽  
pp. 104990912110428
Author(s):  
Aanchal Satija ◽  
Sushma Bhatnagar ◽  
Semra Ozdemir ◽  
Eric Finkelstein ◽  
Chetna Maholtra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Advanced Cancer ◽  
Cancer Diagnosis ◽  
Advanced Disease ◽  
Disease Status ◽  
Educational Background ◽  
Solid Cancer ◽  
Cross Sectional

Background: Prognostic disclosure to patients with advanced cancer facilitates treatment decisions and goals of care discussions. However, the perspectives of patients, families and physicians differ in this regard across different cultures. Non-disclosure of cancer diagnosis or prognosis is commonly observed in family-centric cultures such as India. Aim: To assess the prevalence of and factors associated with cancer patients’ awareness of advanced disease status; and its with quality of life and psychological distress. Methods: Patients for this cross-sectional questionnaire-based survey were recruited from oncology and palliative medicine clinics at a tertiary cancer hospital in India from January 2017 to June 2018. Patients aged ≥ 21 years, aware of cancer diagnosis and receiving oncology treatment for Stage IV solid cancer were included in the study after obtaining written informed consent. Results: Two hundred patients were enrolled, of which 146 (73%) were not aware of the stage of their malignancy and 9 (4.5%) believed that their disease was at stage I, II or III. Those who were aware of their advanced cancer stage had more years of education (9.9 years vs 8.1 years, p = .05) and had poorer spiritual wellbeing in the faith domain (adjusted difference −1.6, 95% confidence interval −3.1 to −0.1, p = .03) compared to those who were unaware. Conclusion: It is recommended that future studies may explore prognostic understanding in Indian patients according to their socio-cultural, spiritual and educational background.

Age affects the efficacy of immune checkpoint inhibitors in patients with advanced cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 2638-2638
Author(s):  
Yongjie Wang ◽  
Ronghua Yang ◽  
Dong Wang ◽  
Donghua Zhao ◽  
Peng Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Advanced Cancer ◽  
Immune Checkpoint ◽  
Older Patients ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Sign Test ◽  
Patients With Cancer ◽  
The Impact ◽  
Effect Of Age

2638 Background: Immune checkpoint inhibitors (ICIs), such as programmed death(ligand)1 (PD-(L)1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, have dramatic effects on treatment in patients with various malignancies. High tumor mutation burden (TMB) is predictive of clinical response to ICI in multiple cancer types. Although age-related immune dysfunction might induce difference on the efficacy of ICIs between younger and older patients, the potential effect of age on the efficacy of ICIs remains little known and controversial. Herein, we aimed to analysis the association between age and the efficacy of ICIs based on MSKCC cohort. Methods: We screened out 1661 patients having complete information with advanced cancer, whose tumors underwent next-generation sequencing (NGS) detection and who were treated with at least one dose of ICI in MSKCC cohort. All patients were divided into two groups according to age, the younger group (age ≤50-year old) and the older group (age > 50-year old). We further analyzed the differences in overall survival (OS) and TMB between the two groups. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated via Cox regression model for OS and P-values were calculated via the Wilcoxon sign test for TMB. We analyzed the effect of age on ICI in lung cancer using the same way. Results: In 1661 patients with cancer in our study, 312 (19%) younger and 1349 (81%) older patients were found. The pooled HRs for OS was 1.28 (95% CI: 1.09-1.52) in younger group compared with older group. In 1661 patients with cancer, there was 350 (21%) patients with lung cancer, including 30 (9%) younger and 320 (91%) older patients. The pooled HRs for OS was 1.45 (95% CI: 0.95-2.23) in younger group compared with older group in lung cancer. In addition, TMB in older group was higher than in younger group and significant difference of TMB was found via the Wilcoxon sign test (p = 2.6e-10) between the two groups, especially in lung cancer (p = 1e-4). Conclusions: Our study assessed the impact of age on the efficacy of ICIs using the threshold of 50 years old for the first time and we founded that patients in older group had higher TMB and longer OS than younger group.

scholarly journals Sleep Quality and Levodopa Intestinal Gel Infusion in Parkinson’s Disease: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Oriol De Fabregues ◽  
Alex Ferré ◽  
Odile Romero ◽  
Manuel Quintana ◽  
José Álvarez-Sabin
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Sleep Quality ◽  
Rem Sleep ◽  
Rating Scale ◽  
Sleep Problems ◽  
Periodic Leg Movements ◽  
Before And After ◽  
Hamilton Anxiety Rating Scale

Background. Sleep problems in patients with advanced Parkinson’s disease (PD) have a deleterious impact on quality of life. Objective. To assess the effect of levodopa-carbidopa intestinal gel (LCIG) infusion on sleep quality in advanced PD patients. Methods. Seven patients participated in a prospective pilot study. Before and after 6 months of LCIG infusion, an overnight polysomnography was performed and the Epworth Sleepiness Scale, fatigue scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and the Hamilton Anxiety Rating Scale were administered. Results. PSG showed low sleep efficiency. REM sleep without atony was found in 5 patients. After 6 months of LCIG infusion, the percentage of REM sleep decreased as well as the number of arousals especially due to reduction of spontaneous arousals and periodic leg movements during REM sleep, but differences were not statistically significant. Also, scores of all study questionnaires showed a tendency to improve. Conclusion. The results show a trend toward an improvement of sleep quality after 6 months of LCIG infusion, although differences as compared to pretreatment values were not statistically significant. The sleep architecture was not modified by LCIG. Further studies with larger study samples are needed to confirm these preliminary findings.

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