Psychological and somatic symptoms among breast cancer patients in four European countries : A cross-lagged panel model

Psychological and physical health among women with breast cancer are linked. However, more research is needed to test the interrelations between psychological and somatic symptoms, over time and throughout the different phases of breast cancer treatment, to determine when and which interventions should be prioritized. Six hundred and eighty nine women from four countries (Finland, Israel, Italy and Portugal) completed questionnaires during their first clinical consultation following diagnosis with breast cancer, and again after 3 and 6 months. The questionnaires included self-reported measures of psychological symptoms (Hospital Anxiety and Depression Scale; the Positive and Negative Affect Schedule Short Form) and somatic symptoms [selected items from the International European Organization for Research and Treatment of Cancer (EORTC) questionnaires]. Psychological and somatic symptoms were relatively stable across the three time-points. Cross-lagged paths leading from somatic to psychological symptoms (beta coefficients of 0.08-0.10), as well as vice-versa (beta 0.11-0.12), were found to be significant. No evidence was found for cross-cultural differences in mutual effects of psychological and somatic symptoms. The findings of this study call for tailoring personal interventions for breast cancer patients-either from a somatic perspective or a psychological perspective-and adjust them to the specific experiences of the individual patient.Peer reviewe

Trajectories of Quality of Life among an International Sample of Women during the First Year after the Diagnosis of Early Breast Cancer: A Latent Growth Curve Analysis

The current study aimed to track the trajectory of quality of life (QoL) among subgroups of women with breast cancer in the first 12 months post-diagnosis. We also aimed to assess the number and portion of women classified into each distinct trajectory and the sociodemographic, clinical, and psychosocial factors associated with these trajectories. The international sample included 699 participants who were recruited soon after being diagnosed with breast cancer as part of the BOUNCE Project. QoL was assessed at baseline and after 3, 6, 9, and 12 months, and we used Latent Class Growth Analysis to identify trajectory subgroups. Sociodemographic, clinical, and psychosocial factors at baseline were used to predict latent class membership. Four distinct QoL trajectories were identified in the first 12 months after a breast cancer diagnosis: medium and stable (26% of participants); medium and improving (47%); high and improving (18%); and low and stable (9%). Thus, most women experienced improvements in QoL during the first year post-diagnosis. However, approximately one-third of women experienced consistently low-to-medium QoL. Cancer stage was the only variable which was related to the QoL trajectory in the multivariate analysis. Early interventions which specifically target women who are at risk of ongoing low QoL are needed

A randomized controlled phase III study of VB-111 combined with bevacizumab vs bevacizumab monotherapy in patients with recurrent glioblastoma (GLOBE).

BackgroundOfranergene obadenovec (VB-111) is an anticancer viral therapy that demonstrated in a phase II study a survival benefit for patients with recurrent glioblastoma (rGBM) who were primed with VB-111 monotherapy that was continued after progression with concomitant bevacizumab.MethodsThis pivotal phase III randomized, controlled trial compared the efficacy and safety of upfront combination of VB-111 and bevacizumab versus bevacizumab monotherapy. Patients were randomized 1:1 to receive VB-111 1013 viral particles every 8 weeks in combination with bevacizumab 10 mg/kg every 2 weeks (combination arm) or bevacizumab monotherapy (control arm). The primary endpoint was overall survival (OS), and secondary endpoints were objective response rate (ORR) by Response Assessment in Neuro-Oncology (RANO) criteria and progression-free survival (PFS).ResultsEnrolled were 256 patients at 57 sites. Median exposure to VB-111 was 4 months. The study did not meet its primary or secondary goals. Median OS was 6.8 versus 7.9 months in the combination versus control arm (hazard ratio, 1.20; 95% CI: 0.91-1.59; P = 0.19) and ORR was 27.3% versus 21.9% (P = 0.26). A higher rate of grades 3-5 adverse events was reported in the combination arm (67% vs 40%), mainly attributed to a higher rate of CNS and flu-like/fever events. Trends for improved survival with combination treatment were seen in the subgroup of patients with smaller tumors and in patients who had a posttreatment febrile reaction.ConclusionsIn this study, upfront concomitant administration of VB-111 and bevacizumab failed to improve outcomes in rGBM. Change of treatment regimen, with the lack of VB-111 monotherapy priming, may explain the differences from the favorable phase II results.Clinical trials registrationNCT02511405

Pre-stimulus inhibition of eye movements reflects temporal expectation rather than time estimation

Eye movements are inhibited prior to the occurrence of temporally predictable events. This ‘oculomotor inhibition effect’ has been demonstrated with various tasks and modalities. Specifically, it was shown that when intervals between cue and target are fixed, saccade-rate prior to the target is lower than when they are varied. However, it is still an open question whether this effect is linked to temporal expectation to the predictable target, or to the duration estimation of the interval preceding it. Here we examined this question in 20 participants while they performed an implicit temporal expectation and an explicit time estimation task. In each trial, following cue onset, two consecutive grating-patches were presented, each preceded by an interval. Temporal expectation was manipulated by setting the first interval duration to be either fixed or varied within each block. Participants were requested to compare either the durations of the two intervals (time estimation), or the tilts of the two grating-patches (temporal expectation). Saccade rate, measured prior to the first grating, was lower in the fixed relative to the varied condition of both tasks. This suggests that the inhibition effect is elicited by target predictability and indicates that it is linked to temporal expectation, rather than to time estimation processes. Additionally, this finding suggests that the oculomotor inhibition is independent of motor readiness, as it was elicited even when no response was required. We conclude that the pre-stimulus oculomotor inhibition effect can be used as a marker of temporal expectation, and discuss its potential underlying mechanisms

Exposure to temporal randomness promotes subsequent adaptation to new temporal regularities

Noise is intuitively thought to interfere with perceptual learning; However, human and machine learning studies suggest that, in certain contexts, variability may reduce overfitting and improve generalizability. Whereas previous studies have examined the effects of variability in learned stimuli or tasks, it is hitherto unknown what are the effects of variability in the temporal environment. Here, we examined this question in two groups of adult participants (N=40) presented with visual targets at either random or fixed temporal routines and then tested on the same type of targets at a new fixed temporal routine. Findings reveal that participants of the random group performed better and adapted quicker following a change in the timing routine, relative to participants of the fixed group. Corroborated with eye-tracking and computational modeling, these findings suggest that prior exposure to temporal randomness improves the formation of new temporal expectations and enhances generalizability in a dynamic environment