Medicine and Health Sciences Commons^™

Disparities In Breast Cancer Detection Modalities And Outcomes Among Geriatric Female Cancer Patients, Zhaoli Liu, Mathilda Nicot-Cartsonis, Biai D E Digbeu, Daoqi Gao, Sharon H Giordano, Yong-Fang Kuo

Faculty, Staff and Student Publications

This study examined racial and geographic disparities in breast cancer detection modalities (screening-, diagnostic-, or non-mammography) with cancer stage and mortality. A retrospective cohort study was conducted using Texas Cancer Registry-Medicare linkage data for geriatric women. Cancers detected through screening and diagnostic mammography had 43 % (95 % CI, 39 %-46 %, p < .0001) and 31 % (95 % CI, 27 %-35 %, p < .0001) lower all-cause mortality, and 49 % (95 % CI, 41 %-54 %, p < .0001) and 37 % (95 % CI, 32 %-43 %, p < .0001) lower cancer-specific mortality, respectively, compared to non-mammography-detected breast cancers. Patients from rural areas were 17 % (95 % CI, 1.06 - 1.29) more likely to be diagnosed with mid- (p = .0023) and advanced stage (p = .003) cancers compared to their urban counterparts. Racial or geographic disparities in cancer detection modalities with associated mortality no longer exist after adjusting for covariates. Healthcare professionals can leverage these findings to promote rural cancer health equity.

Organ Of Corti Macrophages: A Distinct Group Of Cochlear Macrophages With Potential Roles In Supporting Cell Degeneration And Survival, Mengxiao Ye, Celia Zhang, Dalian Ding, Guang-Di Chen, Henry J Adler, Rania Sharaf, Bo Hua Hu

Faculty, Staff and Student Publications

Macrophages are the primary immune cells in the cochlea, essential for maintaining cochlear homeostasis and orchestrating inflammatory responses to pathological events. Although these cells have been found in various parts of the cochlea, their presence in the organ of Corti, a critical structure for acoustic sensing, remains poorly understood. The present study was designed to examine macrophage responses to ototoxic drug-induced cochlear damage and age-related cochlear degeneration, with a particular focus on the pathological conditions that trigger macrophage recruitment into the organ of Corti. We used a model of ototoxicity induced by cyclodextrin, a cyclic oligosaccharide known for its ability …

A Cytotoxic Peptide-Drug Conjugate For Tumor-Specific Delivery Of Co-Injected Molecules, Norio Miyamura, Chisato M Yamazaki, Yasuaki Anami, Kyoji Tsuchikama, Kazuki N Sugahara

Faculty, Staff and Student Publications

An ideal cancer therapy enhances anti-tumor effects while minimizing side effects. iRGD, a non-cytotoxic peptide that activates a tumor-specific molecular transport machinery, promotes the penetration of co-injected drugs into tumor tissues. Clinical trials have demonstrated its potential as a tumor-specific delivery scaffold and potentiator of anti-cancer agents. In this study, we synthesized an iRGD conjugate containing monomethyl auristatin F (MMAF), a highly toxic antimitotic agent, and characterized its dual function as a tumor-specific cytotoxic agent and co-injected drug delivery scaffold. The iRGD-MMAF conjugate internalized and killed cultured tumor cells in an αv integrin-dependent manner. When injected systemically, iRGD-MMAF homed selectively …

Integrating Multi-Omics Data To Uncover Prostate Tissue Dna Methylation Biomarkers And Target Genes For Prostate Cancer Risk, Shuai Liu, Jingjing Zhu, Dylan Green, Hua Zhong, Quan Long, Chong Wu, Liang Wang, Youping Deng, Lang Wu

Faculty, Staff and Student Publications

Previous studies have indicated that specific CpG sites may be linked to the risk of prostate cancer (PCa) by regulating the expression of PCa target genes. However, most existing studies aim to identify DNA methylation (DNAm) biomarkers through blood tissue genetic instruments, which impedes the identification of relevant biomarkers in prostate tissue. To identify PCa risk-associated CpG sites in prostate tissue, we established genetic prediction models of DNAm levels using data from normal prostate samples in the GTEx (N = 108) and assessed associations between genetically predicted DNAm in prostate and PCa risk by studying 122,188 cases and 604,640 controls. …

Three-Dimensional Deep Learning Normal Tissue Complication Probability Model To Predict Late Xerostomia In Patients With Head And Neck Cancer, Hung Chu, Suzanne P M De Vette, Hendrike Neh, Nanna M Sijtsema, Roel J H M Steenbakkers, Amy Moreno, Johannes A Langendijk, Peter M A Van Ooijen, Clifton D Fuller, Lisanne V Van Dijk

Faculty, Staff and Student Publications

Purpose: Conventional normal tissue complication probability (NTCP) models for patients with head and neck cancer are typically based on single-value variables, which, for radiation-induced xerostomia, are baseline xerostomia and mean salivary gland doses. This study aimed to improve the prediction of late xerostomia by using 3-dimensional information from radiation dose distributions, computed tomography imaging, organ-at-risk segmentations, and clinical variables with deep learning (DL).

Methods and materials: An international cohort of 1208 patients with head and neck cancer from 2 institutes was used to train and twice validate DL models (deep convolutional neural network, EfficientNet-v2, and ResNet) with 3-dimensional dose distribution, …

Bronchoalveolar Lavage Cell Percentages As Diagnostic Markers Of Immune Checkpoint Inhibitor Pneumonitis, Mahnoor Mir, Felipe Soto, Pedro Antonio Amezcua Gomez, Rodrigo Del Rio Arroyo, Adarsh Suresh, Amber Su, Qiong Gan, John Stewart, Roberto Adachi, Diwakar D Balachandran, Lara Bashoura, Roberto F Casal, Burton F Dickey, George A Eapen, Scott E Evans, Horiana Grosu, Carlos A Jimenez, Julie Lin, David E Ost, Bruce F Sabath, Vickie R Shannon, Aung Naing, Jianjun Gao, Jia Wu, Karthik Suresh, Saadia A Faiz, Mehmet Altan, Ajay Sheshadri

Faculty, Staff and Student Publications

Introduction: Diagnostic biomarkers for immune checkpoint inhibitor pneumonitis (ICIP) are lacking. Bronchoalveolar lavage (BAL) lymphocytosis has been associated with ICIP, but studies have not evaluated BAL lymphocytosis as a diagnostic biomarker for ICIP.

Purpose: This study aimed to measure the association of BAL immune cell percentage with ICIP and test its performance as a diagnostic biomarker.

Methods: We performed a retrospective chart review of 476 patients treated with ICIs for solid organ or hematologic malignancies who underwent BAL between 2016 and 2022. Two independent reviewers, blinded to the results of BAL cell percentage, confirmed the diagnosis of ICIP or other …

Deep Dive Into Targeted Therapies: Understanding Idh1-Mutant Aml Treatments [Podcast], Amer M Zeidan, Courtney Dinardo

Faculty, Staff and Student Publications

This podcast episode reviews recent advances in the treatment of IDH1-mutant acute myeloid leukemia (AML), focusing on the mechanisms, efficacy, and safety profiles of approved IDH1 inhibitors. The purpose is to present expert insights and clinical data from key trials that underscore the clinical benefits of these targeted therapies. Through discussion of key findings from pivotal clinical trial studies, including data supporting the use of these agents in both newly diagnosed and relapsed or refractory (R/R) settings, the episode highlights significant outcomes such as increased overall response and prolonged duration of remission in patients treated with IDH1 inhibitors. The analysis …

Heterogeneous Clustering Of Multiomics Data For Breast Cancer Subgroup Classification And Detection, Joseph Pateras, Musaddiq Lodi, Pratip Rana, Preetam Ghosh

Computer Science Faculty Publications

The rapid growth of diverse -omics datasets has made multiomics data integration crucial in cancer research. This study adapts the expectation–maximization routine for the joint latent variable modeling of multiomics patient profiles. By combining this approach with traditional biological feature selection methods, this study optimizes latent distribution, enabling efficient patient clustering from well-studied cancer types with reduced computational expense. The proposed optimization subroutines enhance survival analysis and improve runtime performance. This article presents a framework for distinguishing cancer subtypes and identifying potential biomarkers for breast cancer. Key insights into individual subtype expression and function were obtained through differentially expressed gene …

Towards Equitable Cancer Outcomes For Rural And Remote Communities: Reflections, Lessons And Recommendations, Anna Ugalde, Hannah Jongebloed, Charlene Wright, Helena Rodi, Anna Chapman, Skye Marshall, Drew Aras, Rebecca J. Bergin, Sophie Boffa, Anna Boltong, Michele Conlin, Fiona Crawford–Williams, Carl De Wet, Wasek Faisal, Lan Gao, Harry Gasper, Kate Gunn, Nicolas H. Hart, Theresa Hayes, Florian Honeyball, Elizabeth A. Johnston, Deme Karikios, Nicole Kiss, Lucy Leigh, Patricia M. Livingston, Carmel O'Kane

Research outputs 2022 to 2026

People living in rural and remote areas continue to face significant inequities in cancer outcomes compared to their metropolitan counterparts. Despite advances in cancer control, these disparities persist across the cancer trajectory. This personal view consolidates findings from our Equitable Cancer Outcomes for Rural and Remote Communities series, highlighting survival disadvantages, challenges in measuring and reporting rurality, barriers to implementing evidence-based interventions, and shortcomings in historical policy. We argue for place-based, system-level reform that genuinely partners with rural communities, leverages local strengths, and embeds rural voices in research, policy, and service delivery. Key recommendations include adopting a formal partnership position …

Feasibility And Impact Of Knowledge-Based Automated Radiotherapy Treatment Planning In Low- And Middle-Income Countries, Awusi Kavuma, Solomon Kibudde, Yao Hao, Baozhou Sun

Faculty, Staff and Students Publications

Background and purpose: A high-quality treatment planning process is crucial in advanced radiotherapy techniques to ensure adequate dose to the target volume (TV) and sparing of organs at risk (OARs). This process often requires intensive labor, creating barriers for deployment in low- and middle-income countries (LMICs). We aimed to establish the feasibility of implementing knowledge-based auto-planning to facilitate clinical efficiency and increase patient throughput in an LMIC.

Materials and methods: We evaluated 60 randomly selected VMAT manual plans (VMPs), including 10 for each of the following sites: head and neck, oesophagus, breast, prostate, cervical, and rectal cancers. Using the same …

Electrochemical Detection Of Prostate Cancer—Associated Mirna-141 Using A Low-Cost Disposable Biosensor, Alexander Hunt, Gymama Slaughter

Center for Bioelectronics Publications

Prostate cancer is the second leading cause of cancer-related deaths among men in the United States. The early detection of aggressive forms is critical. Current diagnostic methods, including PSA testing and biopsies, are invasive and often yield false results. MicroRNA-141 (miRNA-141) has emerged as a promising non-invasive biomarker due to its elevated levels in the urine of patients with metastatic prostate cancer. Here, a low-cost, paper-based electrochemical biosensor for the sensitive detection of miRNA-141 in synthetic urine is reported. The device employs inkjet-printed gold electrodes on photopaper, functionalized with thiolated single-stranded DNA-141 capture probes for specific target recognition. The biosensor …

Protein Marker-Dependent Drug Discovery Targeting Breast Cancer Stem Cells, Ashley V. Huang, Yali Kong, Kan Wang, Milton L. Brown, David Mu

Department of Biomedical and Translational Sciences Faculty Publications

Breast cancer is one of the most common cancers globally. Unfortunately, many patients with breast cancer develop resistance to chemotherapy and tumor recurrence, which is primarily driven by breast cancer stem cells (BCSCs). BCSCs behave like stem cells and can self-renew and differentiate into mature tumor cells, enabling the cancer to regrow and metastasize. Key markers like CD44 and aldehyde dehydrogenase-1 (ALDH1), along with pathways like Wingless-related integration site (Wnt), Notch, and Hedgehog, are critical to regulating this stem-like behavior of BCSCs and, thus, are being investigated as targets for various new therapies. This review summarizes marker-dependent strategies for targeting …

The Human Spinothalamic Tract: Lessons From Cordotomy, Anthony K Allam, Michael Benjamin Larkin, Ishan A Patel, Mohammed Hasen, David Mears, Patrick Dougherty, Ashwin Viswanathan

Faculty, Staff and Student Publications

The spinothalamic tract has long been known as a primary conductor of nociceptive information, with its anatomical and physiological understanding evolving over centuries of research. This comprehensive review traces the history of the spinothalamic tract beginning with Brown-Sequard’s 1860 report of contralateral analgesia following a hemisection of the spinal cord. As clinical and surgical interventions, such as cordotomies have advanced, so did our understanding of the spinothalamic tract’s function and anatomy. The spinothalamic tract’s role as a crossed pathway conducting pain and temperature sensations was solidified by the mid-20th century. However, intricate details of its somatotopic arrangement, anatomical distributions and …

Survivorship From Pediatric And Adult Brain Tumors: The 2024 Brain Tumor Epidemiology Consortium Meeting Report, Scott L Coven, Roberta Mckean-Cowdin, Michael E Scheurer, Kimberly J Johnson, Luc Bauchet, Carol Kruchko, Ching C Lau, Quinn T Ostrom, John Villano, Yan Yuan, Friederike Erdmann

Center for Medical Ethics and Health Policy Staff Publications

The Brain Tumor Epidemiology Consortium (BTEC) is an international organization with membership of individuals from the scientific community with interests related to brain tumor epidemiology, including surveillance, classification, methodology, etiology, and factors associated with morbidity and survival. The 2024 annual BTEC meeting entitled “Survivorship from Pediatric and Adult Brain Tumors” was held in Mainz, Germany, USA, on May 15–17, 2024. The meeting gathered scientists from Africa, Australia, Europe, and North America and included 4 keynote sessions focusing on brain tumor survivorship across the age spectrum. The meeting included 3 abstract sessions, which also included scientific talks around brain …

High Tumor Cd161 Expression Predicts A Survival Advantage And Marks A Th1-Skewed Microenvironment, Briana Amicarella Burns, Manasvi Chandra, Vanaja Konduri, William K Decker

Faculty, Staff and Students Publications

CD8+CD161+ T-cells exhibit augmented memory and cytolytic properties, mediating enhanced immunity in murine tumor models and improved survival in human non-small cell lung cancer. This T-cell subset might serve as a biomarker of positive response to therapy or even be isolated to augment current immunotherapeutic approaches yet limited knowledge of CD161 expression in human cancers restricts practical application. Here we bioinformatically tested the hypothesis that CD161 expression may be associated with positive outcomes in human cancers and investigated mechanisms underlying any observed advantages. Using TCGA-PANCAN dataset, we analyzed expression of CD161 in over 10,000 human tumors, correlating expression levels with …

Dual Inhibitor Of Mdm2 And Nfat1 For Experimental Therapy Of Breast Cancer: In Vitro And In Vivo Anticancer Activities And Newly Discovered Effects On Cancer Metabolic Pathways, Wei Wang, Marlene Aguilar, Sayantap Datta, Abigail Alley, Meheret Tadesse, Xinshi Wang, Xia Gao, Ruiwen Zhang

Faculty, Staff and Students Publications

INTRODUCTION: The oncogene MDM2 has garnered attention not only for its role in cancer as a negative regulator of the tumor suppressor p53 but also for its p53-independent oncogenic activities. MDM2 also involves metabolic reprogramming, such as serine metabolism, respiration, mitochondrial functions, the folate cycle, and redox balance. Traditional MDM2 inhibitors blocking the protein-protein binding between MDM2 and p53 have shown limited clinical success in various stages of clinical trials, most likely due to low efficacy, drug toxicity, and drug resistance, highlighting the need for a novel, p53-independent strategy to inhibit MDM2. The present study investigated the antitumor effects of …

Overview Of The Head And Neck Tumor Segmentation For Magnetic Resonance Guided Applications (Hnts-Mrg) 2024 Challenge, Kareem A Wahid, Cem Dede, Dina M El-Habashy, Serageldin Kamel, Michael K Rooney, Yomna Khamis, Moamen R A Abdelaal, Sara Ahmed, Kelsey L Corrigan, Enoch Chang, Stephanie O Dudzinski, Travis C Salzillo, Brigid A Mcdonald, Samuel L Mulder, Lucas Mccullum, Qusai Alakayleh, Carlos Sjogreen, Renjie He, Abdallah S R Mohamed, Stephen Y Lai, John P Christodouleas, Andrew J Schaefer, Mohamed A Naser, Clifton D Fuller

Faculty, Staff and Student Publications

Magnetic resonance (MR)-guided radiation therapy (RT) is enhancing head and neck cancer (HNC) treatment through superior soft tissue contrast and longitudinal imaging capabilities. However, manual tumor segmentation remains a significant challenge, spurring interest in artificial intelligence (AI)-driven automation. To accelerate innovation in this field, we present the Head and Neck Tumor Segmentation for MR-Guided Applications (HNTS-MRG) 2024 Challenge, a satellite event of the 27th International Conference on Medical Image Computing and Computer Assisted Intervention. This challenge addresses the scarcity of large, publicly available AI-ready adaptive RT datasets in HNC and explores the potential of incorporating multi-timepoint data to enhance RT …

Zic1 Is A Context-Dependent Medulloblastoma Driver In The Rhombic Lip, John J Y Lee, Ran Tao, Zhen You, Parthiv Haldipur, Anders W Erickson, Hamza Farooq, Liam D Hendriske, Namal Abeysundara, Cory M Richman, Evan Y Wang, Neha Das Gupta, Jennifer Hadley, Melissa Batts, Christopher W Mount, Xiaochong Wu, Alex Rasnitsyn, Swneke Bailey, Florence M G Cavalli, Sorana Morrissy, Livia Garzia, Kulandaimanuvel Antony Michealraj, Abhi Visvanathan, Vernon Fong, Jonelle Palotta, Raul Suarez, Bryn G Livingston, Miao Liu, Betty Luu, Craig Daniels, James Loukides, Anne Bendel, Pim J French, Johan M Kros, Andrey Korshunov, Marcel Kool, Fernando Chico Ponce De León, Mario Perezpeña-Diazconti, Boleslaw Lach, Sheila K Singh, Sarah E S Leary, Byung-Kyu Cho, Seung-Ki Kim, Kyu-Chang Wang, Ji-Yeoun Lee, Teiji Tominaga, William A Weiss, Joanna J Phillips, Shizhong Dai, Gelareh Zadeh, Ali G Saad, László Bognár, Almos Klekner, Ian F Pollack, Ronald L Hamilton, Young-Shin Ra, Wieslawa A Grajkowska, Marta Perek-Polnik, Reid C Thompson, Anna M Kenney, Michael K Cooper, Stephen C Mack, Nada Jabado, Mathieu Lupien, Marco Gallo, Vijay Ramaswamy, Mario L Suva, Hiromichi Suzuki, Kathleen J Millen, L Frank Huang, Paul A Northcott, Michael D Taylor

Faculty, Staff and Students Publications

Transcription factors are frequent cancer driver genes, exhibiting noted specificity based on the precise cell of origin. We demonstrate that ZIC1 exhibits loss-of-function (LOF) somatic events in group 4 (G4) medulloblastoma through recurrent point mutations, subchromosomal deletions and mono-allelic epigenetic repression (60% of G4 medulloblastoma). In contrast, highly similar SHH medulloblastoma exhibits distinct and diametrically opposed gain-of-function mutations and copy number gains (20% of SHH medulloblastoma). Overexpression of ZIC1 suppresses the growth of group 3 medulloblastoma models, whereas it promotes the proliferation of SHH medulloblastoma precursor cells. SHH medulloblastoma ZIC1 mutants show increased activity versus wild-type ZIC1, whereas G4 medulloblastoma …

Outcomes In Pediatric Cholesteatoma, Katherine M Miller, Yi-Chun Carol Liu, Jaqueline E Weinstein, Michael S Cohen, David H Chi, Samantha Anne

Faculty, Staff and Students Publications

OBJECTIVE: The objective of the study is to evaluate the outcomes of surgical management options for cholesteatoma using a national database.

STUDY DESIGN: Database analysis of the Pediatric Health Information System database to identify children undergoing surgical intervention for cholesteatoma from October 2015 to December 2022.

METHODS: Patients were categorized by initial surgical modality: tympanoplasty (TM), tympanoplasty with canal wall-up tympanomastoidectomy (TM-CWU), and tympanoplasty with canal wall-down tympanomastoidectomy (TM-CWD). Group comparisons were done on number of surgical revisions and number of patients identified with recommendations for hearing aids.

RESULTS: A total of 6304 patients were identified in the database who …

Molecular Testing Of Lung Cancer In Australia: Consensus Best Practice Recommendations From The Royal College Of Pathologists Of Australasia In Collaboration With The Thoracic Oncology Group Of Australasia, Wendy A. Cooper, Benhur Amanuel, Caroline Cooper, Stephen B. Fox, Jon W.A. Graftdyk, Peter Jessup, Sonja Klebe, Wei Sen Lam, Trishe Y.M. Leong, Zarnie Lwin, Rachel Roberts-Thomson, Benjamin J. Solomon, Rebecca Y. Tay, Rebecca Trowman, Janney L. Wale, Nick Pavlakis

Research outputs 2022 to 2026

Molecular testing plays a critical role in guiding optimal treatment decisions for lung cancer patients across a variety of clinical settings. While guidelines for biomarker testing exist in other jurisdictions, to date no best practice guidelines have been developed for the Australian setting. To address this need, the Royal College of Pathologists of Australasia collaborated with the Thoracic Oncology Group of Australasia to identify state-based pathologists, oncologists and consumer representatives to develop consensus best practice recommendations. Sixteen recommendations were established encompassing appropriate biomarkers, lung cancer subtype, tumour stage, specimen types, assay selection and quality assurance protocols that can inform and …

Quality Cancer Survivorship Care: A Modified Delphi Study To Define Nurse Capabilities, Gemma Mcerlean, Heidi Hui, Fiona Crawford-Williams, Nicolas H. Hart, Meinir Krishnasamy, Bogda Koczwara, Thomas Walwyn, Mahesh Iddawela, Rebecca Mcintosh, Raymond J. Chan, Michael Jefford

Research outputs 2022 to 2026

Purpose: To establish capabilities required by nurses to deliver quality cancer survivorship care in Australia. Methods: A two-round online modified Delphi involving Australian cancer nurses. Initial domains and capability statements were based on the Quality of Cancer Survivorship Care Framework and supplemented by national and international nursing frameworks. In Round 1 (R1), experts categorised the applicability of 53 capabilities for cancer nurses, across eight domains, in relation to Australian National Professional Development Framework for Cancer Nursing (EdCaN) groups: ‘All’, ‘Many’, ‘Some’, and ‘Few’ nurses, or not relevant. In Round 2 (R2), experts rated agreement with capabilities allocated to the nurse …

Effect Of Exercise On Bone-Related Outcomes In Patients With Cancer Affected By Bone Metastases Or Bone Loss: A Systematic Review And Meta-Analysis, Anita Borsati, Gloria Adamoli, Diana Giannarelli, Lorenzo Belluomini, Andrea Trevisan, Piero Schenal, Francesco Bettariga, Anna M. Markarian, Federico Schena, Michele Milella, Robert U. Newton, Sara Pilotto, Alice Avancini

Research outputs 2022 to 2026

Introduction: This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on bone mineral density (BMD), bone mineral content (BMC), and bone turnover markers in patients with cancer and compromised bone health. Materials and Methods: A comprehensive search of four electronic databases was conducted to identify randomized controlled trials evaluating the effect of exercise intervention compared to supplementation or bone-targeted agents only on BMD, BMC and bone turnover markers. Meta-analyses were performed using random-effects models to calculate effect sizes (ES) with 95% confidence intervals (CI). Results: Eighteen studies were included, involving 1,478 patients with mainly breast and …

Prognostic And Predictive Value Of Gastric Acid Suppressants In The Eortc 1325/Keynote-054 Randomized Phase Iii Trial Of Pembrolizumab Vs Placebo In Resected Stage Iii Melanoma, Emanuel Bührer, Nina Glassee, Michal Kicinski, Oliver J. Kennedy, Christian U. Blank, Georgina V. Long, Victoria G. Atkinson, Stéphane Dalle, Andrew M. Haydon, Andrey Meshcheryakov, Adnan Khattak, Matteo S. Carlino, Shahneen Sandhu, James Larkin, Susana Puig, Paolo A. Ascierto, Piotr Rutkowski, Dirk Schadendorf, Marye Boers-Sonderen, Anna Maria Di Giacomo, Alfonsus J.M. Van Den Eertwegh, Jean Jacques Grob, Ralf Gutzmer, Rahima Jamal, Alexander C.J. Van Akkooi, Sara Gandini

Research outputs 2022 to 2026

Background: The gut microbiome plays a pivotal role in regulating immunity. Gastric acid suppressants (GAS) are known to alter the gut microbiome and might therefore modify response to immunotherapy in cancer patients. We estimated associations of GAS with recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in the EORTC 1325/KEYNOTE-054 trial. Methods: Patients with resected stage III melanoma were randomized to receive 200 mg of pembrolizumab or placebo. Pembrolizumab prolonged RFS and DMFS (reported elsewhere). We used Cox models to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association between GAS at baseline, and RFS and …

Accounting For Unmet Needs Resulting From Cancer-Related Cognitive Impairment, Darren Haywood, Alexandre Chan, Raymond J. Chan, Evan Dauer, Haryana M. Dhillon, Ashley M. Henneghan, Maryam B. Lustberg, Moira O’Connor, Janette L. Vardy, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

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. Methods: Four hundred and fifty-six (n = 456) cancer survivors responded to a range of demographic and clinical questions, as well as measures of CRCI-related unmet needs (MASCC COG-IMPACT), perceived cognitive impairment (PROMIS-COG), and psychological distress (DASS-21). Descriptive statistics, bivariate correlations, and …

Exercise In Cancer Care For People With Lung Cancer: A Narrative Synthesis, Kellie Toohey, David Mizrahi, Nicolas H. Hart, Ben Singh, Pedro Lopez, Maddison Hunter, Robert U. Newton, Kathryn H. Schmitz, Diana Adams, Lara Edbrooke, Sandi Hayes

Research outputs 2022 to 2026

Objectives: Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. Design: Narrative cornerstone review. Methods: A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. Results: Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation …

Activity Behaviours And Quality Of Life In Patients With Malignant Pleural Effusion, Bianca M. Iacopetta, David C.L. Lam, Jenny C.L. Ngai, Johnny W.M. Chan, Fifian Chiang, Macy M.S. Lui, W. L. Law, Ken K.P. Chan, Joanne Mcveigh, Carolyn J. Peddle-Mcintyre, Y. C.Gary Lee

Research outputs 2022 to 2026

Background and objective Accelerometery is used to measure activity behaviours in patients with malignant pleural effusion (MPE). This study aimed to evaluate physical activity and sedentary behaviour profiles of patients with MPE in Hong Kong, and to explore relationships between activity behaviours and quality of life (QoL). We also compared clinician-recorded performance status measures with objective measures of activity levels. Methods Participants wore an Actigraph GT3X+ accelerometer continuously for 7 consecutive days. The EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) was used to assess five dimensions of QoL and correlate with activity behaviours. The Eastern Cooperative Oncology Group (ECOG) performance status …

Bone Mineral Density In Childhood Cancer Survivors During And After Oncological Treatment: A Systematic Review And Meta-Analysis, Anna Maria Markarian, Dennis R. Taaffe, Francesco Bettariga, Hao Luo, Daniel A. Galvão, Jodie Cochrane Wilkie, Carolyn J. Peddle-Mcintyre, Robert U. Newton

Research outputs 2022 to 2026

Osteoporosis poses a significant concern for childhood cancer survivors (CCS). While recommendations for surveillance and management of bone mineral density (BMD) exist, no systematic review and meta-analysis has been undertaken to quantify BMD Z-scores in childhood cancer patients undergoing cancer treatment and survivors who have completed treatments. Accordingly, we conducted a systematic review with a 3-level mixed-effects meta-analysis to examine the course of BMD Z-scores in childhood cancer patients and survivors and identified possible moderators using meta-regression models. A systematic search was conducted in CINAHL, Embase, PubMed, SPORTDiscus, and Web of Science databases from inception to November 2023. We included …

Exercise And Inflammation In Female Survivors Of Breast Cancer: Systematic Review And Meta-Analysis With Secondary Mediation Analysis On Body Composition, Francesco Bettariga, Dennis R. Taaffe, Anita Borsati, Alice Avancini, Sara Pilotto, Stefano G. Lazzarini, Pedro Lopez, Luca Maestroni, Umberto Crainich, Enrico Bandini, John P. Campbell, Timothy D. Clay, Daniel A. Galvão, Robert U. Newton

Research outputs 2022 to 2026

Purpose: Inflammation plays a key role in breast cancer recurrence and mortality by promoting tumor progression. Exercise significantly reduces pro-inflammatory markers such as IL-6, TNF-α, and CRP, potentially reducing mortality risk. However, it is yet to be determined whether exercise-induced changes in body composition can modulate inflammatory biomarker responses in the breast cancer setting. Methods: We conducted a secondary mediation analysis based on the findings from our previously published systematic review with meta-analysis. Randomized controlled trials examining the effects of exercise on IL-1β, IL-6, IL-8, IL-10, TNF-α, and CRP and body composition and anthropometry measures such as lean mass (LM), …

Treatment Refusal By Cancer Patients: A Qualitative Study Of Oncology Health Professionals’ Views And Experiences In Australia, Moira O’Connor, Ashleigh Pantaleo, Tracey Williams, Mary Theophilus, Jordan Joseph, Nicolas H. Hart, Darren Haywood

Research outputs 2022 to 2026

In some cases, against medical advice, a person with cancer decides not to undergo any conventional, evidence-based cancer treatments including chemotherapy, radiotherapy hormone therapy and others. Estimates for treatment refusal range from 2.6% to 14.55%. Refusing evidence-based conventional cancer treatments is linked to rapid deterioration, poor prognosis and a higher risk of premature death. This study aimed to explore oncology health professionals’ experiences and views on why patients refuse standard cancer treatments. We employed an in-depth qualitative research design, adopting a social constructionist framework. Fourteen health professionals in Western Australia (WA) with experience working in oncology were interviewed. Four themes …

Faculty Of Radiation Oncology 2022 Workforce Census, Hon Trinh, Nathan Stevens, Gerard Adams, Raphael Chee, Tuan Ha, Marcel Knesl, Jack Mitchell, Sakshi Nagpal, Edward Sia, Daniel Xing

Research outputs 2022 to 2026

Introduction: This paper reports the key findings of the Faculty of Radiation Oncology 2022 workforce census. This is the first census since the COVID-19 pandemic and questions have been updated to assess the impact on RANZCR trainees and fellows. This report focuses on the analysis of respondents from Australia, New Zealand and overseas members, with a separate paper to follow focusing exclusively on New Zealand respondents. Method: The census was conducted in mid-late 2022 with many questions repeated from previous censuses. New questions were asked about theranostics, working remotely, hypofractionation and the impact of COVID-19 on work practices. Results: The …