Introduction: The objective was to assess quality of life (QoL) in lung cancer survivors, compare it to the general population, and identify factors associated with global QoL, physical functioning, emotional functioning, fatigue, pain, and dyspnea. Methods: Data from NSCLC patients who had survived 1 year or longer after diagnosis were collected crosssectionally in a multicenter study. QoL was assessed with the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and the lung cancer module QLQ-LC13 across different clinical subgroups and compared to age-and sex-standardized general population reference values. Multivariable linear regression analyses were performed to test the associations of patient-, tumor-, and treatmentrelated factors with the six primary QoL scales. Results: Six hundred fifty-seven NSCLC patients participated in the study with a median time since diagnosis of 3.7 years (range, 1.0-21.2 years). Compared to the age-and sex-standardized general population, clinically meaningful differences in the QoL detriment were found on almost all domains: lung cancer survivors had clinically relevant poorer global QoL (10 points, p < 0.001). Whereas in 12 months or longer treatment-free patients this detriment was small (8.3), it was higher in patients currently in treatment (16.0). Regarding functioning and symptom scales, respective detriments were largest for dyspnea (41 points), role function (33 points), fatigue (27 points), social function (27 points), physical function (24 points), and insomnia (21 points) observed across all subgroups. The main factor associated with poorer QoL in all primary QoL scales was mental distress (b j19-31j, all p < 0.001). Detriments in QoL across multiple primary QoL scales were also observed with current treatment (b j8-12j, p < 0.01),
Objective Despite the high incidence of lung cancer, little is known about distress in lung cancer survivors and patients who have survived diagnose for at least 1 year. We investigated distress prevalence and associated factors. Methods We performed a multicenter (n = 6 hospitals) cross‐sectional study. Data were collected using medical records, questionnaires, and a telephone interview. Distress was measured with the Patient Health Questionnaire (PHQ‐4). Odds ratios (OR) for factors potentially associated with distress were calculated using multivariable logistic regression. Results We included 561 complete case participants with a mean time since diagnosis of 4.4 years. Nineteen percent of them reported depression and 19% anxiety; 26% had 1 or both. Woman had nearly 2‐times the odds of being distressed than men (OR 1.92). Participants with UICC stage II or III at diagnosis had lower odds of being distress compared with stage I (ORs 0.41, 0.44). Participants in current treatment were less likely to be anxious or depressed than those off treatment (OR 0.32). Those with self‐reported progressing disease had 3‐times the odds of distress than people in complete remission (OR 3.00). Time since diagnosis, pain, dyspnea, lung cancer stigma as well as decreased physical functioning were related to increased distress (ORs per unit increase 0.90, 1.02, 1.03, 1.05, and 0.9, respectively). Conclusions With a quarter of patients affected, psychological distress is a common problem in this population. Being off treatment does not imply less distress. People with poor physical functioning and pain are especially affected. Treating these symptoms is therefore very important.
Purpose To investigate the work situation of lung cancer survivors and to identify the factors associated with their returning to work. Methods Descriptive analysis and logistic regression were used to evaluate study population characteristics and independent factors of subsequently returning to work. To analyze time to return to work, Cox regression was used. Results The study sample included 232 lung cancer survivors of working age from 717 enrolled participants in the multi-center cross-sectional LARIS (Quality of Life and Psychosocial Rehabilitation in Lung Cancer Survivors) study. About 67% of the survivors were not employed during the survey. More than 51% of the survivors who were employed before their illness did not return to their work. The survivors who had returned to their careers were younger, associated with higher household income, lower fatigue score, and stable relationship and vocational training. Patients who received social service counseling showed a higher chance of regaining their career. Conclusions Lung cancer survivors were found to be associated with a high risk of unemployment and very low professional reintegration after interruption due to illness. More comprehensive studies are needed to support lung cancer survivors and targeting of patients in need of special attention in rehabilitation that would benefit from the findings in the present study.
Background: Polo like kinase 1 (PLK1) is frequently upregulated in tumors and is thus viewed as a promising therapeutic target in various cancers. Several PLK1 inhibitors have recently been developed and clinically tested in solid cancers, albeit with limited success. So far, no predictive biomarkers for PLK1 inhibitors have been established. To this end, we conducted a post-hoc biomarker analysis of tumor samples from non-small cell lung cancer (NSCLC) patients treated with the PLK1 inhibitor BI2536 in a phase II study. Methods: We analyzed formalin-fixed paraffin-embedded surplus tumor tissue from 47 study patients using immunohistochemistry (IHC) and DNA sequencing of KRAS, EGFR, BRAF, and PIK3CA. Results:KRAS-mutated patients showed numerically prolonged progression-free survival, but statistical significance was not established. Interestingly, when pathways rather than single genes were analyzed, a positive correlation between IHC staining of activated ERK (p-ERK) and mutated KRAS was detected, whereas KRAS mutation status was found to be negatively correlated with activated AKT (p-AKT). Conclusion: With this hypothesis-generating study in BI2531-treated patients, we could not establish a correlation between KRAS mutations and relevant clinical endpoints. Future clinical trials with concomitant systematic biosampling and comprehensive molecular analyses are required to identify biomarkers predictive for response to PLK1 inhibitors.
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