Cardiopulmonary Function and Age-Related Decline Across the Breast Cancer Survivorship Continuum

To evaluate cardiopulmonary function (as measured by peak oxygen consumption [VO2peak]) across the breast cancer continuum and its prognostic significance in women with metastatic disease

A Pilot Study of IL-2Rα Blockade during Lymphopenia Depletes Regulatory T-cells and Correlates with Enhanced Immunity in Patients with Glioblastoma

Preclinical studies in mice have demonstrated that the prophylactic depletion of immunosuppressive regulatory T-cells (T(Regs)) through targeting the high affinity interleukin-2 (IL-2) receptor (IL-2Rα/CD25) can enhance anti-tumor immunotherapy. However, therapeutic approaches are complicated by the inadvertent inhibition of IL-2Rα expressing anti-tumor effector T-cells.To determine if changes in the cytokine milieu during lymphopenia may engender differential signaling requirements that would enable unarmed anti-IL-2Rα monoclonal antibody (MAbs) to selectively deplete T(Regs) while permitting vaccine-stimulated immune responses.A randomized placebo-controlled pilot study was undertaken to examine the ability of the anti-IL-2Rα MAb daclizumab, given at the time of epidermal growth factor receptor variant III (EGFRvIII) targeted peptide vaccination, to safely and selectively deplete T(Regs) in patients with glioblastoma (GBM) treated with lymphodepleting temozolomide (TMZ).Daclizumab treatment (n = 3) was well-tolerated with no symptoms of autoimmune toxicity and resulted in a significant reduction in the frequency of circulating CD4+Foxp3+ TRegs in comparison to saline controls (n = 3)( p = 0.0464). A significant (p<0.0001) inverse correlation between the frequency of TRegs and the level of EGFRvIII specific humoral responses suggests the depletion of TRegs may be linked to increased vaccine-stimulated humoral immunity. These data suggest this approach deserves further study.ClinicalTrials.gov NCT00626015

Where is She?: Pandemic Teaching, Freedom, and Bodies (not) on Zoom

Are we better teachers because we’re teaching from home? Maybe. At the very least, we’re willing to say that we’re more comfortable and more able to focus on our content and our students because some of the worry about our corporeal representations and restrictions in a classroom have been lessened. In this piece, we explore the possibilities and opportunities afforded by remote teaching at the university level due to the covid-19 pandemic. While much has--and will be--said about the difficulties posed by this pedagogical shift, we argue that for some, there are important aspects of the lived and embodied practice of teaching that have been and may continue to be improved in digital and off-campus teaching spaces. We write from our shared perspectives as fat, cis-gender, queer women living with chronic illnesses and embodiments that have highlighted the restrictive and performative nature of in-person teaching pre-covid. Based on our discussions of these lived and embodied experiences both before and during the pandemic, we offer a conversation that refuses the romanticization of the “before times” and poses questions about how our lived experiences of teaching in the age of covid might inform richer understandings of the pandemic on the complex intersections of marginalized bodies and pedagogy

Cardiopulmonary Function and Age-Related Decline Across the Breast Cancer Survivorship Continuum

PURPOSE: To evaluate cardiopulmonary function (as measured by peak oxygen consumption [VO(2peak)]) across the breast cancer continuum and its prognostic significance in women with metastatic disease. PATIENTS AND METHODS: Patients with breast cancer representing four cross-sectional cohorts—that is, (1) before, (2) during, and (3) after adjuvant therapy for nonmetastatic disease, and (4) during therapy in metastatic disease—were studied. A cardiopulmonary exercise test (CPET) with expired gas analysis was used to assess VO(2peak). A Cox proportional hazards model was used to estimate the risk of death according to VO(2peak) category (< 15.4 v ≥ 15.4 mL · kg(−1) · min(−1)) with adjustment for clinical factors. RESULTS: A total of 248 women (age, 55 ± 8 years) completed a CPET. Mean VO(2peak) was 17.8 ± a standard deviation of 4.3 mL · kg(−1) · min(−1), the equivalent of 27% ± 17% below age-matched healthy sedentary women. For the entire cohort, 32% had a VO(2peak) less than 15.4 mL · kg(−1) · min(−1)—the VO(2peak) required for functional independence. VO(2peak) was significantly different across breast cancer cohorts for relative (mL · kg(−1) · min(−1)) and absolute (L · min(−1)) VO(2peak) (P = .017 and P < .001, respectively); VO(2peak) was lowest in women with metastatic disease. In patients with metastatic disease (n = 52), compared with patients achieving a VO(2peak) ≤ 1.09 L · min(−1), the adjusted hazard ratio for death was 0.32 (95% CI, 0.16 to 0.67, P = .002) for a VO(2peak) more than 1.09 L · min(−1). CONCLUSION: Patients with breast cancer have marked impairment in VO(2peak) across the entire survivorship continuum. VO(2peak) may be an independent predictor of survival in metastatic disease