European Journal of Cancer Care最新文献

Background. T cell exhaustion (TEX) is a state of T cells that is characterized by poor function of effectors and increased expression of inhibitory signals. However, the heterogeneity and prognostic values of TEX in lung adenocarcinoma (LUAD) remain not fully understood. Methods. Based on the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) transcriptomic profiles, we screened differentially expressed lncRNAs, miRNAs, and mRNAs and identified differentially expressed TEXs. Univariate cox and LASSO regression analyses were performed to construct TEX-related prognostic signature and risk score and validated their expression using real-time PCR assay. We then investigated the potential mechanism, immune landscape, and antitumor therapy response in LUAD. Results. A total of 315 DE-lncRNAs, 161 DE-miRNAs, and 2589 DEGs were screened, and then 80 DE-TEXGs were identified in LUAD. Based on univariate cox and LASSO regression analyses, CCNA2 and SLC2A1 were identified as TEX-related prognostic signatures, and the risk score subsequently was calculated. LUAD patients were divided into high- and low-risk groups, and high-risk groups were involved in poor survival status, immunosuppression, and more sensitive to anti-CTLA4 therapy. Finally, a TEX-related ceRNA network was constructed and validated based on DE-lncRNAs, DE-miRNAs, and TEX-related prognostic signatures. Conclusion. We constructed the TEX-related prognostic signature and its relevant ceRNA network and discovered the molecular mechanism and prognostic values of TEX in LUAD.

Background. Coiled-coil domain containing 25 (CCDC25) is a receptor for neutrophil extracellular trap (NET) DNA and is involved in various cancers, including CRC. This study aimed to investigate the regulatory role of CCDC25 in CRC using GWAS data, eQTL, transcriptomic profiles, and clinical information of CRC patients. Methods. From open-source databases, GWAS summary data, eQTL expression profiles, and transcriptomic profiles, as well as clinical information were collected for CRC patients. Mendelian randomization (MR) was used to investigate the causal relationship between CCDC25 and CRC risk. The expression of CCDC25 and its associated differentially expressed genes (DEGs) were identified. We explored the relationship between CCDC25 expression and survival, biological functions, immune cell infiltration, immune checkpoint expression, and response to immunotherapy. Results. High CCDC25 expression reduces the risk of CRC. CCDC25 is downregulated in various cancers, particularly in CRC tumor tissues compared to normal tissues. Metabolic pathways are enriched in groups with high CCDC25 expression, while cancer-related pathways are enriched in groups with low CCDC25 expression. High CCDC25 expression is also associated with increased infiltration of resting memory CD4+ T cells, elevated levels of most immune checkpoints, and an enhanced response to anti-PD1 therapy. In addition, 95 DEGs were identified between high-CCDC25 and low-CCDC25 groups, and eight genes (FDFT1, ASAH1, ADAM9, CXCL14, SERPINA1, NAT1, EREG, and GSR) were identified as prognostic genes. Conclusion. CDC25 might serve as a candidate diagnostic and prognostic marker for CRC patients.

Poly (ADP-ribose) polymerase 1 is a versatile enzyme that is deeply involved in diverse cellular processes. It exerts influence on pivotal activities such as DNA repair, transcriptional regulation, and cell death. PARP1 is crucial due to its susceptibility to posttranslational modifications, each of which has distinct roles in shaping its functionality and interactions with other proteins. Among these modifications, the addition of ADP-ribose polymerase 1 and the addition of an acetyl group to lysine residues enhance PARP1 engagement in DNA repair, while ubiquitination and cleavage are involved in the degradation of PARP1. PARP1 modification has been exploited in cancer treatment, particularly in the context of breast and ovarian cancers marked by BRCA1 and BRCA2 mutations. However, resistance to PARP1 inhibitors and selective posttranslational modifications, which confer cellular functions remain elusive. The present review endeavors to detail the extent of PARP1 modifications, shedding light on their profound implications at the cellular remains a challenge, which often drives treatment failure. The effectiveness of PARP1 inhibitors relies on specific level. This trial is registered with NCT04550104, NCT06120491, NCT05367440, NCT05797168, NCT04644068, NCT05573724, NCT05489211, NCT05938270, and NCT02264678.

Objective. Oncology and palliative care guidelines for patients with incurable cancer recommend supporting patients at the end of life (EOL) by considering their personal values, wishes, and goals to facilitate decision making in advance care planning and patient-centered care. It is unclear, though, how to successfully address and integrate personal values in clinical practice. The aim of this study was to explore values, wishes, and goals from the perspective of patients with advanced lung cancer. Methods. Semistructured interviews were conducted with patients with advanced lung cancer and transcribed verbatim. The data were analysed using a structured content analysis. After identification of main categories, values were identified using Schwartz’s Theory of Basic Human Values as a theoretical framework. Results. Identified main categories were “the individual in medical care,” “living now,” and “coming to terms.” Values in the dimensions “conservation” and “openness to change” were described concerning patient-physician interaction, therapy goals, preparedness for EOL, and life goals. “Self-transcendence” values mainly related to caring for the burden on relatives. In general, patients showed reluctance in expressing information about personal values when communicating with physicians. Conclusion. Patients with advanced lung cancer engage in various ways to determine how they want and can influence their life and medical care. Different values and the associated wishes and goals play a crucial role in this context and should be taken into account by healthcare providers. The reluctance to express personal information in medical encounters underscores the need for a proactive attitude in physicians and improved interprofessional collaboration. The study was registered in the German register for clinical trials (DRKS00026993).

Objective. BEP (bleomycin, etoposide, and cisplatin) chemotherapy is a standard regimen for germ cell tumors (GCTs); however, their high emetogenicity is problematic. The control of chemotherapy-induced nausea and vomiting (CINV) is crucial to complete the treatment. We conducted this study to explore the efficacy and safety of antiemetic therapy with dexamethasone and aprepitant for 5 days in combination with palonosetron 0.75 mg on days 1 and 5 in BEP. Methods. This open-label single-arm study was prospectively conducted in 4 hospitals. Chemotherapy-naïve men with GCT who were scheduled to receive the BEP regimen were eligible. The primary endpoint was the complete response (CR) rate of CINV. Results. A total of 19 patients were enrolled. Overall, 16 (84.2%) patients experienced some nausea, whereas only 4 (21.1%) patients had grade 1 emetic events. Overall CR of CINV was achieved in 9 (47.4%) patients. Although 14 (73.7%) patients experienced 22 adverse events after palonosetron administration, severe adverse events (grade 3 or more) attributable to it did not occur. Conclusion. The results suggest that aprepitant, palonosetron, and dexamethasone antiemetic therapy for patients with GCT receiving BEP is safe, whereas the efficacy of additional palonosetron administration on day 5 for prevention of delayed CINV remains unclear. This trial is registered with UMIN000008110.

Aims and Objectives. This prospective study describes the pain relief, analgesic adherence, and constipation experienced by cancer outpatients with pain during the first three cycles of follow-up support based on an information system. Methods. Outpatients with cancer pain who received at least three cycles of follow-up support between 1 July 2020 and 31 March 2022 at our cancer centre were enrolled in this prospective, longitudinal study. Three cycles of follow-up support were provided by trained nurses over the telephone. Pain relief, analgesic adherence, and constipation were reported by the patients and recorded in the information system by trained nurses during the telephone follow-up. Results. A total of 386 cancer patients were enrolled in the study. Pain relief and analgesic adherence improved significantly during the three follow-up cycles after they received support (P < 0.001). The rate of pain relief and analgesic adherence improved at the second cycle compared to the first cycle, but the rate decreased at the third cycle compared to the second cycle. Some patients who had no problems at the first follow-up cycle experienced new problems during the second and third follow-up cycles. There was no significant difference in the incidence of constipation between follow-up cycles (P = 0.078). Conclusions. Cancer outpatients with pain reported increased pain relief and analgesic adherence during follow-up support. Compared to rates at the first and third cycles, pain relief and analgesic adherence were best at the second cycle after follow-up support according to the information system. Relevance to Clinical Practice. Changes in pain intensity, analgesic adherence, and constipation were noted over time, which highlights the need for continuous follow-up to achieve prolonged pain relief in cancer patients after discharge from the hospital.

Objective. Due to various long-term consequences of the disease, cancer survivors (CS) can experience incompatibilities between areas of life (work, family, household, leisure time, and disease) that can be associated with reduced satisfaction with these areas of life. To be able to assess such incompatibilities quantitatively, a six-item instrument (INCOMPAT-CS) was developed and psychometrically evaluated. Methods. Based on relevant theories, a multidisciplinary team developed the items of the INCOMPAT-CS. Descriptive analyses, exploratory and confirmatory factor analyses, as well as validity and reliability assessments were conducted using survey data from n = 293 CS collected as part of the CARES study. Incompatibilities between areas of life were measured with the newly developed INCOMPAT-CS instrument. Results. A one component solution with satisfactory model fit (normed χ² = 1.90, RMSEA = 0.06, CFI = 0.99, and TLI = 0.97) was identified in exploratory and confirmatory factor analyses. The INCOMPAT-CS demonstrated acceptable internal consistency (Cronbach’s α = 0.790) and high test-retest reliability ρ = 0.569 (p < 0.001). Convergent validity could be demonstrated (CR = 0.858 and AVE = 0.506). Hypothesis-consistent correlations with role and social functioning measures further indicate convergent validity. Conclusions. The INCOMPAT-CS is useful to assess incompatibilities among areas of life in CS quantitatively. Moreover, it helps to reveal the areas negatively affected due to incompatibilities. This short instrument can be useful in aftercare or psychosocial support interventions to detect incompatibilities and work towards reducing them as a consequence to increase CS’ wellbeing.

Background . There are well-established, persistent inequities in cancer care and cancer outcomes within and between countries. The aim of this article is to explore how implementation theory, specifically the Consolidated Framework for Implementation Research (CFIR), alongside coproduction principles, could be used to maximise the effectiveness of innovations with a vision of reducing inequity in cancer care. Methods. Workshops were conducted with partners from US, Australia, and UK, participating in the University Global Partnership Network (UGPN), which funded the collaboration. From these workshops, three case studies were identified and the framework was applied to identify ways of using CFIR to maximise the effectiveness of innovations. Results. The three case studies focused on human papillomavirus (HPV) testing and vaccination, participation in clinical trials, and use of translation services. We identified opportunities, for each of the case studies, where CFIR could be applied to improve implementation and proposed recommendations to ensure effective implementation of innovations using CFIR domains, including individual constructs (e.g., awareness and cultural competence), inner setting constructs (e.g., technology infrastructure), and outer setting constructs (e.g., how services are monitored, evaluated, and commissioned). Conclusions. Applying CFIR as an implementation framework offers a structured and holistic approach to consider how to maximise the effectiveness of innovations in the context of reducing inequities in cancer care. Working with other countries to apply this framework also provides a uniform approach to understand and reduce inequities across a range of innovations and address the global mission to improve cancer care for all.

Purpose. To investigate patient perceptions of physical rehabilitation received for various adverse physical effects following breast cancer surgery and the content and delivery methods of the physical rehabilitation received. Methods. Cross-sectional study of 509 Australian women living with breast cancer (n = 178 (35%) (Breast Conserving Surgery (BCS)), n = 168 (33%) (Mastectomy (MAST)), and n = 163 (32%) (Breast Reconstruction Surgery (BRS)). Retrospective, online survey investigated the physical rehabilitation received after surgery/treatment. The survey explored the respondents′ perceptions (open response) and satisfaction levels with the physical rehabilitation received and its content and delivery method (closed responses). Perceptions were analyzed using a thematic analysis; satisfaction levels and delivery methods for each adverse physical effect were tabulated. Results. Major perceptions: (i) unaware of and unprepared for adverse physical effects, (ii) unsuitable information delivery, and (iii) insufficient follow-up from health professionals. Physical rehabilitation content focused on shoulder issues and lymphedema; less than half of respondents received any information about scars, torso, and donor site issues or physical discomfort disturbing sleep. The proportion that received each delivery method varied for each adverse physical effect. Pamphlets and verbal instruction were the most common delivery methods and sessions with health professionals where issues were physically assessed, checked, or progressed the least common. Satisfaction levels varied for each adverse physical effect; all were less than 50%. Conclusion. Women perceived their physical rehabilitation did not prepare them for the adverse physical effects they experienced, the method and timing of delivery did not meet their needs at various stages of recovery, and the follow-up was insufficient. Quantitative data on the content and delivery method support these perceptions. Explanations of why these perceptions occurred and recommendations to improve physical rehabilitation through greater use of patient-related outcome measures and spreading limited physical rehabilitation resources using a three-level model of care are recommended. Although many women recover from breast cancer, improved physical rehabilitation could enable women to manage any immediate or long-term side effects of their breast cancer surgery and treatment.