Browsing by Author "Hao, Desiree"

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    Acceptability of automatic referrals to supportive and palliative care by patients living with advanced lung cancer: qualitative interviews and a co-design process
    (2024-04-02) Ahmed, Sadia; Simon, Jessica; Biondo, Patricia; Slobogian, Vanessa; Shirt, Lisa; King, Seema; Paolucci, Alessandra; Pabani, Aliyah; Hao, Desiree; Bossio, Emi; Cross, Ralph; Monds, Tim; Nieuwenhuis, Jane; Sinnarajah, Aynharan
    Abstract Purpose Timely access to supportive and palliative care (PC) remains a challenge. A proposed solution is to trigger an automatic referral process to PC by pre-determined clinical criteria. This study sought to co-design with patients and providers an automatic PC referral process for patients newly diagnosed with stage IV lung cancer. Methods In Step 1 of this work, nine one on one phone interviews were conducted with advanced lung cancer patients on their perspectives on the acceptability of phone contact by a specialist PC provider triggered by an automatic referral process. Interviews were thematically analysed. Step 2: Patient advisors, healthcare providers (oncologists, nurses from oncology and PC, clinical social worker, psychologist), and researchers were invited to join a working group to provide input on the development and implementation of the automatic referral process. The group met biweekly (virtually) over the course of six months. Results From interviews, the concept of an automatic referral process was perceived to be acceptable and beneficial for patients. Participants emphasized the need for timely support, access to peer and community resources. Using these findings, the co-design working group identified eligibility criteria for identifying newly diagnosed stage IV lung cancer patients using the cancer centre electronic health record, co-developed a telephone script for specialist PC providers, handouts on supportive care, and interview and survey guides for evaluating the implemented automatic process. Conclusion A co-design process ensures stakeholders are involved in program development and implementation from the very beginning, to make outputs relevant and acceptable for stage IV lung cancer patients.
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    The Impact of Sex on Survival in Patients with Non-Small Cell Lung Cancer
    (2023-01-16) Ford-Sahibzada, Chelsea A.; Peters, Cheryl; Brenner, Darren; Cheung, Winson; Hao, Desiree; Ezeife, Doreen
    Background Lung cancer is the leading cause of cancer-related mortality in Canada and globally. Non-small cell lung cancer (NSCLC) is the most common histological subtype of the disease in Canada, with several known prognostic factors. There is growing evidence of the role of sex in NSCLC survival, which is of great clinical and population health interest. The aim of this study was to assess the impact of sex on survival in a real-world population of Canadian NSCLC patients. Methods Retrospective cohort studies were completed using real-world data from the Glans-Look Lung Cancer Research database (GLR). The analyses included patients diagnosed with NSCLC between 2010 and 2020 in Alberta, Canada. The primary study analyzed 10,849 NSCLC patients, where the secondary study analyzed 627 NSCLC patients who tested positive for specific biomarkers and were treated with targeted or immunotherapy. Descriptive statistics were used for cohort characterization, with basic survival analyses completed with Kaplan-Meier estimates and log rank tests. Cox proportional hazards models were utilized for univariable and multivariable analyses. Results In the primary analysis, there was a significant association between male sex and increased hazard of death. The unadjusted and adjusted hazard ratios (HR) for male sex were 1.32 (95% CI 1.26-1.37) and 1.28 (95% CI 1.23-1.34), respectively. The effect of sex remained among advanced stage patients (Stage 4 adjusted HR: 1.26, 95% CI: 1.19 – 1.33). In the secondary analysis, there was no survival differences by sex for the total, ALK mutated, and PD-L1 high expression cohorts. The EGFR cohort found a crude HR for male sex of 1.24 (95% CI: 1.01 – 1.54), but the significance of the association disappeared in the adjusted model 1.30 (95% CI: 0.94 – 1.82). Conclusions In this population-based Canadian cohort, females with NSCLC tended to have longer survival than males with NSCLC, after accounting for the effect of known prognostic factors. There is suggestion of differences in this association based on biomarker status. Future research should focus on examining potential biological and behavioural based explanations for the female survival advantage in NSCLC.
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    MYB-NFIB gene fusions identified in archival adenoid cystic carcinoma tissue employing NanoString analysis: an exploratory study
    (2019-07-13) McIntyre, John B; Ko, Jenny J; Siever, Jodi; Chan, Angela M Y; Simpson, Roderick H W; Hao, Desiree; Lau, Harold Y
    Abstract Background Adenoid cystic carcinoma (ACC) is a slow growing salivary gland malignancy that is molecularly characterized by t(6:9)(q22–23;p23–24) translocations which predominantly result in MYB-NFIB gene fusions in nearly half of tumours. Detection of MYB-NFIB transcripts is typically performed with fresh ACC tissue using conventional RT-PCR fragment analysis or FISH techniques, which are prone to failure when only archival formalin fixed paraffin embedded (FFPE) tissue is available. The purpose of this pilot study was to evaluate the utility of NanoString probe technology for the detection of MYB-NFIB transcripts in archival ACC tissue. Methods A NanoString probeset panel was designed targeting the junctions of three currently annotated MYB-NFIB fusion genes as well as 5′/3′ MYB probesets designed to detect MYB gene expression imbalance. RNA isolated from twenty-five archival ACC specimens was profiled and analyzed. RT-qPCR and sequencing were performed to confirm NanoString results. MYB protein expression was analyzed by immunohistochemistry. Results Of the 25 samples analyzed, 11/25 (44%) expressed a high degree of MYB 5′/3′ imbalance and five of these samples were positive for at least one specific MYB-NFIB variant in our panel. MYB-NFIB variant detection on NanoString analysis was confirmed by direct cDNA sequencing. No clinical correlations were found to be associated with MYB fusion status. Conclusion We conclude that the application of NanoString digital probe counting technology is well suited for the detection and quantification of MYB-NFIB fusion transcripts in archival ACC specimens.
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    The Impact of Exercise on Gut Microbiota in a Survivor to Germ-free Mouse Translational Model of Breast Cancer
    (2021-12-17) Sampsell, Kara; Reimer, Raylene; Culos-Reed, S. Nicole; Hao, Desiree
    Breast cancer is the leading cause of global cancer incidence. Strategies to improve breast cancer treatment and health outcomes in survivors are needed to decrease mortality, mitigate side effects, and prevent recurrence. The gut microbiota is altered in individuals with breast cancer, can be affected by treatments such as chemotherapy, and plays a role in response to cancer treatments. It may be modified by environmental factors such as dietary components and exercise. In the present study, the Alberta Cancer Exercise (ACE) program was investigated as a strategy to favorably modify the gut microbiota of breast cancer survivors who had undergone chemotherapy. In a follow-up germ-free mouse study, the ability of exercise-responsive gut microbiota, alone or with prebiotic fiber supplementation, to alter tumor growth was interrogated using fecal microbiota transfer (FMT). In the cancer survivors, there was a significant enrichment in Dialister, Oscillospiraceae, and Paraprevotella following exercise (p < 0.01). In the germ-free mice, tumor volume trended consistently lower over time in the groups colonized with post-exercise gut microbiota compared to the group colonized with pre-exercise gut microbiota, with statistically significant differences found on day 16 and day 22. Tumor volume was further suppressed with prebiotic fiber supplementation. Gut microbial alpha and beta diversity differed across groups. Beta diversity and differential abundance analyses revealed that both the tumor cell injection and chemotherapy altered the gut microbial community in the mice. A potentially beneficial enhancement of Parasutterella and Lachnospiraceae and depletion of Anaerostipes and Ruminococcus gnavus was identified on day 22 in the group receiving prebiotic. Cytokine analysis of tumor tissue and serum indicated that the influence of the various FMTs resulted in distinct tumor microenvironments. The tumors of mice colonized with exercise-responsive microbiota exhibited lower levels of angiogenic VEGF among other markers, and greater levels of cytokines previously associated with positive Paclitaxel response. This was augmented with prebiotic supplementation. Exercise and prebiotic demonstrated potential to enhance anti-tumor immunity through advantageous gut microbiota modulation in breast cancer populations and should be further explored as adjuvants.