Background
There has been a significant increase in the use of immunotherapy and cannabis recently, two modalities that have immunomodulatory effects and may have possible interaction. We evaluated ...the influence of cannabis use during immunotherapy treatment on response rate (RR), progression‐free survival (PFS), and overall survival (OS).
Subjects, Materials, and Methods
In this retrospective, observational study, data were collected from the files of patients treated with nivolumab in the years 2015–2016 at our hospital, and cannabis from six cannabis‐supplying companies. Included were 140 patients (89 nivolumab alone, 51 nivolumab plus cannabis) with advanced melanoma, non‐small cell lung cancer, and renal clear cell carcinoma. The groups were homogenous regarding demographic and disease characteristics. A comparison between the two arms was made.
Results
In a multivariate model, cannabis was the only significant factor that reduced RR to immunotherapy (37.5% RR in nivolumab alone compared with 15.9% in the nivolumab‐cannabis group (p = .016, odds ratio = 3.13, 95% confidence interval 1.24–8.1). Cannabis use was not a significant factor for PFS or OS. Factors affecting PFS and OS were smoking (adjusted hazard ratio HR = 2.41 and 2.41, respectively (and brain metastases (adjusted HR = 2.04 and 2.83, respectively). Low performance status (adjusted HR = 2.83) affected OS alone. Tetrahydrocannabinol and cannabidiol percentages did not affect RR in any group (p = .393 and .116, respectively).
Conclusion
In this retrospective analysis, the use of cannabis during immunotherapy treatment decreased RR, without affecting PFS or OS and without relation to cannabis composition. Considering the limitations of the study, further prospective clinical study is needed to investigate possible interaction.
Implications for Practice
Although the data are retrospective and a relation to cannabis composition was not detected, this information can be critical for cannabis users and indicates that caution is required when starting immunotherapy.
The therapeutic potential of the cannabis plant in cancer treatment has recently been considered. This article evaluates the clinical influence of cannabis use during immunotherapy treatment with nivolumab on response rate, progression‐free survival, and overall survival.
Abstract
Since January 2022 in Israel, high-risk populations with underlying health conditions were advised to receive a fourth dose of the BNT162b2 vaccine (Pfizer-BioNTech) against severe acute ...respiratory syndrome coronavirus 2 (SARS-CoV-2). We monitored vaccine-induced immunity among oncology patients undergoing systemic anti-cancer therapy before and after the 4th-BNT162b2-dose. Three groups of patients were included in the study: those who received 3rd-BNT162b2-dose and had no breakthrough infection (control), those who received 3rd-BNT162b2-dose and had the breakthrough infection, and those who received the 4th-BNT162b2-dose and had no breakthrough infection. Anti-SARS-CoV-2 immunoglobulin-G (IgG) levels of the control group exhibited a rapid decrease over time, whereas IgG titers of patients with breakthrough-infections or patients vaccinated with the 4th-BNT162b2-dose were considerably elevated, consistent with the capacity of the second booster to induce anti-SARS-CoV-2 IgG levels. Additionally, oncology patients’ humoral immune response was significantly greater after breakthrough-infection than in response to the 4th dose of BNT162b2.
Since January 2022 in Israel, high-risk populations with underlying health conditions were advised to receive a fourth dose of the BNT162b2 vaccine against SARS-CoV-2. This article reports on vaccine-induced immunity among oncology patients undergoing systemic anti-cancer therapy before and after the 4th-BNT162b2-dose.
Background
A sense of place (SOP) is defined as the emotional bonds, values, meaning, and symbols attached to a place.
Aim
To assess SOP of patients with cancer during end‐of‐life care at home ...(home‐hospice service) versus at a hospital in relation to place of care, social support, and emotional distress.
Methods
Participants were 150, stage IV, cancer patients with a life expectancy of less than 6 months, as defined by oncological staff, who were not receiving any life‐prolonging care. Seventy‐five patients received care at home (home‐hospice), and the other 75 received care at the oncology department at the hospital, by palliative unit staff. Participants completed the Brief Symptom Inventory anxiety and depression subscales, questionnaires on perceived support and both questionnaires on home SOP and hospital SOP.
Results
Mean scores of emotional distress were similar for patients in home‐hospice and at the hospital. Home SOP among individuals receiving care at home was high, and hospital SOP was high among hospitalized individuals. The structural equation model had good fit indexes, showing that each of the SOP variables mediated the association between place of care and emotional distress. Perceived support was associated with lower distress only in the hospital setting.
Conclusions
The SOP concept is relevant to understanding emotional distress in relation to place of care at end of life. Strengthening SOP in relation to place of care should be considered. As newly introduced concept regarding place of care at the EoL, SOP warrants further research.
Background Chronic kidney disease patients are at increased risk of mortality with cardiovascular diseases and infections as the two leading causes of death for end-stage kidney disease treated with ...hemodialysis (HD). Mortality from bacterial infections in HD patients is estimated to be 100-1000 times higher than in the healthy population. Methods We comprehensively characterized highly pure circulating neutrophils from HD and healthy donors. Results Protein levels and transcriptome of HD patients' neutrophils indicated massive neutrophil degranulation with a dramatic reduction in reactive oxygen species (ROS) production during an oxidative burst and defective oxidative cellular signaling. Moreover, HD neutrophils exhibit severely impaired ability to generate extracellular NET formation (NETosis) in NADPH oxidase-dependent or independent pathways, reflecting their loss of capacity to kill extracellular bacteria. Ectopic hydrogen peroxidase (H.sub.2O.sub.2) or recombinant human SOD-1 (rSOD-1) partly restores and improves the extent of HD dysfunctional neutrophil NET formation. Conclusions Our report is one of the first singular examples of severe and chronic impairment of NET formation leading to substantial clinical susceptibility to bacteremia that most likely results from the metabolic and environmental milieu typical to HD patients and not by common human genetic deficiencies. In this manner, aberrant gene expression and differential exocytosis of distinct granule populations could reflect the chronic defect in neutrophil functionality and their diminished ability to induce NETosis. Therefore, our findings suggest that targeting NETosis in HD patients may reduce infections, minimize their severity, and decrease the mortality rate from infections in this patient population. Keywords: Neutrophils, Hemodialysis, Infections, Neutrophil degranulation, Neutrophil extracellular traps (NETosis)
Abstract Background Spiritual distress is present in ∼25% of oncology patients. We examined the extent to which this measure is identical to a variety of other measures, such as spiritual well-being, ...spiritual injury, spiritual pain, and general distress. Methods Structured interview of oncology outpatients over 12 months, approached non-selectively. The presence or absence of spiritual distress was compared against spiritual pain and two spiritual well-being tools: FACIT-Sp-12 and the Spiritual Injury Scale (SIS). We also examined whether a general distress Visual Analogue Scale sufficed to identify spiritual distress. Other questions concerned demographic and clinical data. Results Of 416 patients approached, 202 completed the interview, of whom 23% reported spiritual distress. All measures showed significant correlation (Receiver Operating Characteristic, area under the curve 0.79, SIS; 0.68, distress thermometer; 0.67, Facit-Sp-12), yet none were identical with spiritual distress (sensitivity/specificity 64%/79%, SIS; 72%/76%, spiritual pain; 41%/76%, distress thermometer; 57%/72%, Facit-Sp-12). Of the FACIT-Sp-12 subscales, only Peace correlated with spiritual distress. A significant predictor of spiritual distress was patients’ self-evaluation of grave clinical condition (odds ratio 3.3, 95% confidence intervals 1.1-9.5). Multivariable analysis of individual measure items suggests an alternative three-parameter model for spiritual distress: not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one's illness. Conclusions The distress thermometer is not sufficient to identify spiritual distress. The Peace subscale of Facit-Sp-12 is a better match than the measure as a whole. The SIS is the best match for spiritual distress, although an imperfect one.
PURPOSE OF REVIEWSeveral nutritional compounds are the focus of public attention because of their potential beneficial health effects. Turmeric is a spice that comes from the root Curcuma longa. ...Extensive research over the past half century and especially in recent years has revealed important functions of curcumin and a timely review of clinical state-of-the-art using curcumin.
RECENT FINDINGSIn-vitro and in-vivo research has shown various activities, such as anti-inflammatory, antiviral, antifungal, cytokines release, antioxidant, immunomodulatory, enhancing of the apoptotic process, and antiangiogenic properties. Curcumin also have been shown to be a mediator of chemo-resistance and radio-resistance.
SUMMARYVarious in-vitro and in-vivo and scarce number of clinical studies on curcumin were identified. The various effects and properties of curcumin are summarized in this review, including preclinical and especially clinical studies. This review concentrates on recent knowledge and research with curcumin clinical applications, and clinical studies, focusing on studies published between 2008 and 2011 demonstrating the gap between preclinical and clinical research.
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