scholarly journals Cannabinoids is a “No-Go” While a Cancer Patient is on Immunotherapy; but is It Safe to Use Psychedelics During Cancer Immunotherapy?

2021 ◽  
Author(s):  
E. Amit Romach ◽  
M. Nachliely ◽  
O. Moran ◽  
M. Brami ◽  
I. Lamensdorf
Keyword(s):  
Cancer Patients ◽  
Negative Impact ◽  
Checkpoint Inhibitors ◽  
Anxiety And Depression ◽  
Therapeutic Approaches ◽  
Immunomodulatory Effects ◽  
Negative Effects ◽  
Patients With Cancer ◽  
The Past ◽  
Therapeutic Benefits

AbstractThe use of Psychedelics by patients with cancer to relieve anxiety and depression has increased in the past few years. Since Psychedelics have immunomodulatory effects, their consumption among cancer patients should be carefully considered due to their potential negative effects on the tumor immune stroma, especially in view of the increase in the utilization of therapeutic approaches that are based on immune activation such as treatment with immune checkpoint inhibitors (ICIs). Preclinical data provided in this report indicate a potentially negative impact on tumor growth as a result of Psychedelics consumption during treatment with ICIs. Furthermore, our research suggests that the use of psychedelic agents (Lysergic acid diethylamide [LSD] or Psylocibin) might diminish the beneficial therapeutic benefits of ICIs.It might be necessary to expend this line of research in order to validate these findings, in view of the increase use of cannabinoids and psychedelics among cancer patients, some of them being treated with immune-based modalities.

scholarly journals Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1458 ◽  
Author(s):  
Fausto Petrelli ◽  
Alessandro Iaculli ◽  
Diego Signorelli ◽  
Antonio Ghidini ◽  
Lorenzo Dottorini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Free Survival ◽  
Patients With Cancer ◽  
Hazard Ratios ◽  
The Cochrane Library ◽  
Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumours treated with ICIs. PubMed, the Cochrane Library and Embase were searched from inception until September 2019 for observational or prospective studies reporting the prognoses of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI) and an HR > 1 associated with a worse outcome in ABs users compared to AB non-users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51–2.84; p < 0.01). Similarly, PFS was inferior in AB users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22–1.93; p < 0.01). In cancer patients treated with ICIs, AB use significantly reduced OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

scholarly journals Antiphospholipid Antibody Syndrome and Infertility

2019 ◽  
Vol 41 (10) ◽  
pp. 621-627
Author(s):  
Vivian de Oliveira Rodrigues ◽  
Adriana de Góes e Silva Soligo ◽  
Gabriel Duque Pannain
Keyword(s):  
Antiphospholipid Antibodies ◽  
Fetal Loss ◽  
Female Infertility ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Therapeutic Approaches ◽  
Negative Effects ◽  
The Past ◽  
New Therapeutic Approaches ◽  
Abortion Complications

AbstractAntiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 years was performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation and inflammatory signaling pathways, to provide important advances in its treatment.

Differences in practice and preferences associated with truth-telling to cancer patients

2020 ◽  
pp. 096973302094575
Author(s):  
Jing Wu ◽  
Yan Wang ◽  
Xiaodong Jiao ◽  
Jingting Wang ◽  
Xuchun Ye ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Medical Staff ◽  
Family Members ◽  
Mainland China ◽  
Disease Diagnosis ◽  
Negative Effects ◽  
Truth Telling ◽  
Chi Square ◽  
Patients With Cancer ◽  
Significant Difference

Background: Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China. Objective: The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling. Research design: A quantitative survey with three closed-ended questionnaires was conducted. Participants: In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure. Ethical considerations: This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement. Findings: A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis ( p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients. Discussion: The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed. Conclusion: Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient’s willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient’s care team, especially nurses, could be integrated in the process of truth-telling.

When it's the Time to Switch the Therapeutic Approach on Electroconvulsive Therapy for Residual Positive Symptoms in Schizophrenia?

2017 ◽  
Vol 41 (S1) ◽  
pp. S613-S613
Author(s):  
I. Nechifor ◽  
N. Nita ◽  
M. Buzut
Keyword(s):  
Electroconvulsive Therapy ◽  
Social Life ◽  
Negative Impact ◽  
Paranoid Schizophrenia ◽  
Anxiety And Depression ◽  
Positive Symptoms ◽  
Treatment Resistant ◽  
The Past ◽  
Competing Interest ◽  
Depot Antipsychotics

IntroductionSchizophrenia is clearly one of the most debilitating diseases. Luckily, in the past 20 years, there has been a wide and good change in symptomatology due to the new atypical antipsychotics. Still, there are patients who are treatment resistant after different adjustments like switching or adding antipsychotics. Most of the clinicians consider Clozapine the “last resort”. But what if it doesn’t work so well on some patients?ObjectiveTo determine the point when it's time to try electroconvulsive therapy in schizophrenia treatment-resistant patients or remain on conventional approach.AimsThe aim of this work is to determine whether it's better for those patients who have residual positive symptoms to use oral/depot antipsychotics or to switch on electroconvulsive therapy.MethodsThis work presents the case of the patient C.D., 35 years, diagnosed with paranoid schizophrenia since 2008. Risperidone, Olanzapine, Aripiprazole were introduced during time, with some improvement on the positive symptomatology, but the patient developed several side-effects. At his last admission in our hospital, he came after a suicidal attempt caused by high anxiety and depression due to his false beliefs. Clozapine was introduced, but after one month of treatment, the patient still had the belief that his neighbours want to harm him somehow.ResultsThe patient and his mother definitively refused electroconvulsive therapy because of their personal beliefs. He affirmed that he can live with this “low-dose” of suspiciousness which, unfortunately, had a negative impact on his social life.ConclusionsWe still recommend electroconvulsive therapy in these situations, even though, there are many misconceptions regarding this approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Relationship between malnutrition and the presence of symptoms of anxiety and depression in hospitalized cancer patients

2021 ◽  
Author(s):  
Francisco José Sánchez-Torralvo ◽  
Victoria Contreras-Bolívar ◽  
María Ruiz-Vico ◽  
José Abuín-Fernández ◽  
Inmaculada González-Almendros ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Nutritional Assessment ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Average Score ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Depression Symptomatology

Abstract Background Anxiety and depression are a common issue in patients with cancer, yet understudied among hospitalized patients. The aim of this study was to estimate the prevalence of anxiety and depression symptomatology in cancer inpatients and its relationship with malnutrition. Methods Cross-sectional study in hospitalized cancer patients. A nutritional assessment was done using the Global Leadership Initiative on Malnutrition (GLIM) criteria to diagnose malnutrition. Data regarding anxiety and depression symptomatology was obtained with the Hospital Anxiety and Depression Scale (HADS). Results A total of 282 inpatients were assessed. GLIM criteria found 20% (66) of well-nourished and 80% (216) with malnutrition. HADS presented an average score of 8.3 ± 4.4 with respect to anxiety and an average score of 7.7 ± 4.6 with respect to depression. Up to 54% of the patients showed a possible presence of anxiety, and 45.3% of them showed a possible presence of depression. In malnourished patients, HADS score was non-significantly higher with respect to anxiety (8.5 ± 4.3 in malnourished vs 7.1 ± 4.6 in well-nourished; p = 0.06) and was significantly higher with respect to depression (8.2 ± 4.6 in malnourished vs 5.3 ± 4.0 in well-nourished; p < 0.001). After controlling for potential confounders, malnourished patients were 1.98 times more likely to present anxious symptomatology (95% CI 1.01–3.98; p = 0.049) and 6.29 times more likely to present depressive symptomatology (95% CI 1.73–20.47; p = 0.005). Conclusions The presence of anxiety and depression symptomatology in oncological inpatients is high. There is an association between malnutrition and presenting anxious and depressive symptomatology in hospitalized cancer patients.

scholarly journals Survival of Patients Treated with Antibiotics and Immunotherapy for Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Fausto Petrelli ◽  
Alessandro Iaculli ◽  
Diego Signorelli ◽  
Antonio Ghidini ◽  
Lorenzo Dottorini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Free Survival ◽  
Patients With Cancer ◽  
Hazard Ratios ◽  
The Cochrane Library ◽  
Reporting Data

Antibiotics (ABs) are common medications used for treating infections. In cancer patients treated with immune checkpoint inhibitors (ICIs), concomitant exposure to ABs may impair the efficacy of ICIs and lead to a poorer outcome compared to AB non-users. We report here the results of a meta-analysis evaluating the effects of ABs on the outcome of patients with solid tumors treated with ICIs. PubMed, the Cochrane Library, and Embase were searched from inception until September 2019 for observational or prospective studies reporting prognosis of adult patients with cancer treated with ICIs and with or without ABs. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary endpoint. The effect size was reported as hazard ratios (HRs) with a 95% confidence interval (CI), and an HR &gt; 1 associated with a worse outcome in ABs users compared to no-ABs users. Fifteen publications were retrieved for a total of 2363 patients. In the main analysis (n = 15 studies reporting data), OS was reduced in patients exposed to ABs before or during treatment with ICIs (HR = 2.07, 95%CI 1.51&ndash;2.84; P&lt;.01). Similarly, PFS was inferior in ABs users in n = 13 studies with data available (HR = 1.53, 95%CI 1.22&ndash;1.93; p&lt;.01). In cancer patients treated with ICIs, AB use significantly reduces OS and PFS. Short duration/course of ABs may be considered in clinical situations in which they are strictly needed.

scholarly journals Cancer treatment and research in the context of COVID-19 pandemic: the experience of foreign countries

2020 ◽  
Author(s):  
Oleg Kit ◽  
Yurii Gevorkyan ◽  
Natalya Soldatkina ◽  
Elvina Gevorkyan
Keyword(s):  
Cancer Patients ◽  
Negative Impact ◽  
Immunosuppressive Treatment ◽  
Individual Treatment ◽  
Emergency Plans ◽  
Patients With Cancer ◽  
Community Benefits ◽  
Difficult Time ◽  
Foreign Countries ◽  
Treatment Plans

The coronavirus disease 2019 (COVID-19) has rapidly swept the world. Patients with cancer could be at particular risk of COVID-19, since they are often immunosuppressed by their therapy. Assessing the risk-benefit ratio of potentially immunosuppressive treatment for patients with cancer with insufficient knowledge of this new disease and balancing individual and community benefits poses acute ethical dilemmas for oncologists. Researchers provided the first guidelines for cancer patients treatment. Individual treatment plans should be adjusted to minimise routine visits, procedures and tests. Patients should be categorised into different priorities for receiving active cancer therapy during the pandemic. Oncologists should consider changing intravenous treatments to subcutaneous or oral routes, as well as suspending radiation therapy or using hypofractionation. In case of developing COVID-19 patients with cancer should be treated in the respiratory or intensive care units rather than in the oncology units. Preventive measures and emergency plans to help patients should also be developed. The COVID-19 pandemic has had a serious negative impact on both treatment of cancer patients and research in this area. The support of all stakeholders is the only thing that can help ensure the best possible care for patients at this difficult time.

Immune related adverse effects (IRAEs) in patients with cancer who received immune checkpoint inhibitors (ICIs): A single center experience from rural Maine.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19265-e19265
Author(s):  
Anannya Patwari ◽  
Vineel Bhatlapenumarthi ◽  
Antoine Joseph Harb ◽  
Adam Curtis
Keyword(s):  
Cancer Patients ◽  
Chart Review ◽  
Checkpoint Inhibitors ◽  
Retrospective Chart Review ◽  
Patients With Cancer ◽  
Single Center Experience ◽  
Review Analysis ◽  
Discontinuation Of Treatment ◽  
Males And Females ◽  
Treatment Table

e19265 Background: ICIs are used for a variety of malignancies and have shown to improve survival, but they are associated with IRAEs. We aim to identify the frequency and severity of new IRAEs and flares of preexisting autoimmune (AI) disorders excluding thyroid disorders in cancer patients treated with ICIs at our institution. Methods: We conducted a retrospective chart review analysis of all cancer patients who received ICIs: nivolumab, pembrolizumab, atezolizumab and durvalumab at the Northern Light Cancer Institute from June 2015 to March 2019. We excluded patients who received ipilimumab. We then studied those who developed IRAEs. Results: Out of 465 who received ICIs, 115(24.7%) developed IRAEs. 83 out of 298 (27.9%) nivolumab recipients, 20/121 (15.7%) pembrolizumab recipients, 5/26 (19.2%) atezolizumab and 7/20 (35%) durvalumab recipients developed IRAEs. Some patients had multiple toxicities. Median age at cancer diagnosis was 66 years, evenly split among males and females. Majority (63%) were treated for Lung cancer, followed by melanoma (20%) and genitourinary cancers (12%). Summary of new IRAEs are as noted in the table below. In patients with new IRAEs treatment was held in 29(6%) for a median duration of 7.2 wks. Upon rechallenge with the same ICI in 27 patients, 20(74%) tolerated and 7 did not leading to permanent discontinuation. Majority were treated with steroids and some required immunomodulators. Interestingly 39(8%) patients with underlying AI condition received ICIs. Of these 11(28.2%) developed flares, resulting in permanent discontinuation of drug in 4. The majority tolerated the treatment well. Treatment was permanently discontinued in 70(15%), 26(6%) required hospital admission for IRAEs. Pneumonitis was the most common toxicity necessitating treatment discontinuation and hospital stay. Conclusions: In real world setting the frequency and severity of IRAEs was more than the reported literature data, leading to higher rates of permanent discontinuation of treatment. [Table: see text]

The Factor Structure and Factor Stability of the Hospital Anxiety and Depression Scale in Patients with Cancer

1991 ◽  
Vol 158 (2) ◽  
pp. 255-259 ◽  
Author(s):  
Stirling Moorey ◽  
Steven Greer ◽  
Maggie Watson ◽  
Christine Gorman ◽  
Linda Rowden ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Cancer Patients ◽  
Emotional Disturbance ◽  
Factor Structure ◽  
Depression Scale ◽  
Total Sample ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Patients With Cancer ◽  
Correlated Factors

An exploratory factor analysis of the HAD was carried out in 568 cancer patients. Two distinct, but correlated, factors emerged which corresponded to the questionnaire's anxiety and depression subscales. The factor structure proved stable when subsamples of the total sample were investigated. The internal consistency of the two subscales was also high. These results provide support for the use of the separate subscales of the HAD in studies of emotional disturbance in cancer patients.

scholarly journals Increased Plasma Soluble PD-1 Concentration Correlates with Disease Progression in Patients with Cancer Treated with Anti-PD-1 Antibodies

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1929
Author(s):  
Ryotaro Ohkuma ◽  
Katsuaki Ieguchi ◽  
Makoto Watanabe ◽  
Daisuke Takayanagi ◽  
Tsubasa Goshima ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Small Cell Lung Carcinoma ◽  
Antibody Therapy ◽  
Initial Response ◽  
Predictive Biomarker ◽  
Rate Of Change ◽  
Cancer Type ◽  
Cell Lung Carcinoma ◽  
Patients With Cancer ◽  
Therapeutic Benefits

Immune checkpoint inhibitors (ICIs) confer remarkable therapeutic benefits to patients with various cancers. However, many patients are non-responders or develop resistance following an initial response to ICIs. There are no reliable biomarkers to predict the therapeutic effect of ICIs. Therefore, this study investigated the clinical implications of plasma levels of soluble anti-programmed death-1 (sPD-1) in patients with cancer treated with ICIs. In total, 22 patients (13 with non-small-cell lung carcinoma, 8 with gastric cancer, and 1 with bladder cancer) were evaluated for sPD-1 concentration using enzyme-linked immunosorbent assays for diagnostic and anti-PD-1 antibody analyses. sPD-1 levels were low before the administration of anti-PD-1 antibodies. After two and four cycles of anti-PD-1 antibody therapy, sPD-1 levels significantly increased compared with pretreatment levels (p = 0.0348 vs. 0.0232). We observed an increased rate of change in plasma sPD-1 concentrations after two and four cycles of anti-PD-1 antibody therapy that significantly correlated with tumor size progression (p = 0.024). sPD-1 may be involved in resistance to anti-PD-1 antibody therapy, suggesting that changes in sPD-1 levels can identify primary ICI non-responders early in treatment. Detailed analysis of each cancer type revealed the potential of sPD-1 as a predictive biomarker of response to ICI treatment in patients with cancer.

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