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  • Mitchell, Duane  (2)
  • 1
    In: Neuro-Oncology, Oxford University Press (OUP), Vol. 24, No. Supplement_7 ( 2022-11-14), p. vii245-vii245
    Abstract: Patients diagnosed with primary brain tumors (pPBTs) exhibit high psychological distress. This study assessed how symptoms of anxiety and depression change over time in pPBTs and identified factors that may predict patients’ symptom trajectories. METHODS Ninety-nine adult pPBTs completed psychosocial assessments at routine neuro-oncology clinical appointments over 6 to 18 months, with a minimum 8-week interval between assessments. Symptoms of anxiety and depression were assessed with the PROMIS Anxiety and Depression Short-Forms. The prevalence and incidence of patients with clinically elevated anxiety and depression symptoms throughout follow-up were examined, along with the prevalence of patients that experienced clinically meaningful changes in symptoms between follow-ups. Linear mixed-effects models evaluated changes in symptoms over time at the group level and latent class growth analysis (LCGA) evaluated changes in symptoms over time at the individual level. RESULTS At baseline, 51.5% and 32.3% of patients exhibited clinically elevated levels of anxiety and depression, respectively. Of patients with any follow-up data (N = 74), 54.1% and 50% experienced clinically meaningful increases in anxiety and depression scores, respectively. The incidence of moderate to severe anxiety and depression was 15.6% and 8.3%, respectively. There was no significant change in symptoms over time at the group level, but better physical, functional, and brain-cancer well-being predicted significantly lower anxiety and depression symptoms (p & lt; .001). Results from LCGA showcased 5-unique subgroups of patients with distinct anxiety and depression symptom trajectories. CONCLUSION pPBTs commonly experience elevated anxiety and depression. Symptoms of anxiety and depression change in clinically meaningful manners throughout the disease, even in the absence of significant group-level time effects. Routine screening for elevated symptoms is needed to capture clinically meaningful changes in symptoms and identify factors affecting symptoms to intervene.
    Type of Medium: Online Resource
    ISSN: 1522-8517 , 1523-5866
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2094060-9
    Location Call Number Limitation Availability
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  • 2
    In: Neuro-Oncology, Oxford University Press (OUP), Vol. 24, No. Supplement_7 ( 2022-11-14), p. vii60-vii61
    Abstract: Immunotherapy is limited in efficacy for glioblastoma (GBM). The objective of this study was to evaluate the efficacy and immune effects of the pp65 mRNA dendritic cell (DC) vaccine with the use of lysosomal-associated membrane protein (LAMP) in two different formulations (full-length (fl) and short-length (sh). METHODS Patients who underwent resection of newly diagnosed GBM were enrolled and randomized to one of 3 arms: Arm 1) pp65-shLAMP mRNA DC with GM-CSF, Arm 2) pp65-flLAMP mRNA DC with GM-CSF, Arm 3) Unpulsed peripheral blood mononuclear cells (PBMC). After surgery, patients underwent leukapheresis for PBMC isolation and vaccines generation. Patients were treated with standard radiation and temozolomide followed by dose intensified adjuvant temozolomide at 75-100 mg/m2 x 21 days (aged less than 70) or standard dose at 150-200 mg/m2 x 5 days (patients 70 and older). Immunization started days 22-24 of cycle #1 with vaccines 1-3 delivered at 2 week intervals. All patients received tetanus-toxoid booster prior to vaccine 1. Patients continued to receive monthly vaccines for up to 10 vaccines with tetanus-diphtheria toxoid skin prep prior to vaccines 3, 6 and 9 (arms 1 and 2). Safety, efficacy and immune labs were evaluated. RESULTS Overall DC vaccines were well-tolerated with 2 SAEs possibly attributed to DC vaccination that met criteria as DLTs. Of recorded grade 2 or lower AEs, 2 were possibly attributable to DC vaccination. One patient was removed from the study due to failure to produce DC vaccines that met QA/QC release criteria. CONCLUSION In a large randomized and blinded patient cohort, delivery of CMV LAMP pp65 mRNA DC vaccines is feasible and safe in a multi-institutional setting. The primary endpoint of survival will be analyzed at the conclusion of the study.
    Type of Medium: Online Resource
    ISSN: 1522-8517 , 1523-5866
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2094060-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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