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Simple Summary: Physical inactivity and sleep problems are commonly reported by women going through chemotherapy for gynecologic cancer. Inflammation from cancer and its treatment might contribute to these issues, but existing findings are limited. We examined relationships between biomarkers of inflammation and data from wearable devices to objectively measure physical activity and sleep. We collected data from women with gynecologic cancer during chemotherapy and followed up with them for a year after completing chemotherapy. We also compared their results to women without cancer who were assessed at similar time intervals. We found that women with cancer were less active and had more sleep problems than controls even a year after completing chemotherapy. Greater inflammation was also related to less physical activity and more sleep problems. Future research should test whether interventions aimed at reducing inflammation can help women with cancer to be more active and have fewer sleep problems. Little is known regarding associations between inflammatory biomarkers and objectively measured physical activity and sleep during and after chemotherapy for gynecologic cancer; thus, we conducted a longitudinal study to address this gap. Women with gynecologic cancer (patients) and non-cancer controls (controls) completed assessments before chemotherapy cycles 1, 3, and 6 (controls assessed contemporaneously), as well as at 6- and 12-month follow-ups. Physical activity and sleep were measured using wrist-worn actigraphs and sleep diaries, and blood was drawn to quantify circulating levels of inflammatory markers. Linear and quadratic random-effects mixed models and random-effects fluctuation mixed models were used to examine physical activity and sleep over time, as well as the associations with inflammatory biomarkers. On average, patients (n = 97) and controls (n = 104) were 62 and 58 years old, respectively. Compared to controls, patients were less active, more sedentary, had more time awake after sleep onset, and had lower sleep efficiency (p-values < 0.05). Across groups, higher levels of TNF-α were associated with more sedentary time and less efficient sleep (p-values ≤ 0.05). Higher levels of IL-1β, TNF-α, and IL-6 were associated with lower levels of light physical activity (p-values < 0.05). Associations between inflammatory biomarkers, physical activity, and sleep did not differ between patients and controls. Given these results, we speculate that inflammation may contribute to less physical activity and more sleep problems that persist even 12 months after completing chemotherapy. [ABSTRACT FROM AUTHOR]

Simple Summary: Treatment-related symptoms such as fatigue, depression, and disruptions in sleep and physical activity are common and distressing in gynecologic cancer patients. The aim of our study was to examine whether higher levels of inflammation are associated with worse symptomatology, and if these associations are stronger for patients with gynecologic cancer (n = 121) than age-matched women without a cancer history (i.e., controls; n = 105). Elevated levels of C-reactive protein were associated with depression and disrupted physical activity, but there were no other significant associations between inflammation and treatment-related symptoms. Findings suggest that inflammation may not play a significant role in the development of fatigue or sleep disturbance among gynecologic cancer patients but may contribute to depression and physical inactivity. Previous research suggests that inflammation triggers cancer-treatment-related symptoms (i.e., fatigue, depression, and disruptions in sleep and physical activity), but evidence is mixed. This study examined relationships between inflammatory biomarkers and symptoms in patients with gynecologic cancer compared to age-matched women with no cancer history (i.e., controls). Patients (n = 121) completed assessments before chemotherapy cycles 1, 3, and 6, and 6 and 12 months later. Controls (n = 105) completed assessments at similar timepoints. Changes in inflammation and symptomatology were evaluated using random-effects mixed models, and cross-sectional differences between patients and controls in inflammatory biomarkers and symptoms were evaluated using least squares means. Associations among inflammatory biomarkers and symptoms were evaluated using random-effects fluctuation mixed models. The results indicated that compared to controls, patients typically have higher inflammatory biomarkers (i.e., TNF-alpha, TNFR1, TNFR2, CRP, IL-1ra) and worse fatigue, depression, and sleep (ps < 0.05). Patients reported lower levels of baseline physical activity (p = 0.02) that became more similar to controls over time. Significant associations were observed between CRP, depression, and physical activity (ps < 0.05), but not between inflammation and other symptoms. The results suggest that inflammation may not play a significant role in fatigue or sleep disturbance among gynecologic cancer patients but may contribute to depression and physical inactivity. [ABSTRACT FROM AUTHOR]

Chimeric antigen receptor T‐cell therapy with axicabtagene ciloleucel (axi‐cel) has considerably improved survival in adults with relapsed/refractory large B‐cell lymphoma. This study reports patient‐reported outcomes (PROs) such as quality of life (QOL) and toxicity in the first 90 days after treatment. Hematologic cancer patients treated with axi‐cel (N = 103, mean age = 61, 39% female) completed SF‐36 or PROMIS‐29 QOL questionnaires prior to treatment and 90 days after. PRO‐Common Terminology Criteria for Adverse Events toxicity items were completed by patients at baseline and 14, 30, 60, and 90 days after treatment. Mixed models examined change in PROs over time. From preinfusion to 90 days later, patients reported improvements in physical functioning, pain, and fatigue (ps < 0.01), but worsening of anxiety (p = 0.02). Patient‐reported toxicities worsened by day 14 with improvement thereafter. The five most severe symptoms at day 14 included fatigue, decreased appetite, dry mouth, diarrhea frequency, and problems with concentration. Results indicate improvement in some domains of QOL over time with transient patient‐reported toxicities. [ABSTRACT FROM AUTHOR]

Abstract Objective Increasing age has been associated with higher risk of chemotherapy-related toxicities, often resulting in treatment disruptions or discontinuations. Age has also been evaluated as a potential risk factor for chemotherapy-induced peripheral neuropathy (CIPN), but current understanding of recovery from CIPN in older adults after treatment is limited. The goal of the current study was to: 1) evaluate longitudinal change in patient-reported CIPN symptoms from the start of chemotherapy to one year post-chemotherapy; and 2) examine treatment modifications in older (≥65 years) and younger patients (<65 years). Methods As part of a larger ongoing study, gynecologic cancer patients (n = 90) treated with cytoxic chemotherapy reported their CIPN symptoms via the EORTC-CIPN20 three times during active treatment and at 6 and 12 months post-treatment. Medical record reviews were conducted to abstract clinical information during active treatment. Results Piecewise mixed models revealed that older and younger patients reported similar increases in CIPN during the active treatment phase. However, older patients did not recover from CIPN after treatment completion, whereas younger patients exhibited significant declines in CIPN symptoms post-treatment. No age differences were observed in the presence of provider-recorded sensory neuropathy and pain; neuropathy-related treatment delays, changes in chemotherapy dose, regimen, or discontinuations; or falls (all p -values > 0.05). Conclusions Results from the current study indicate that older adults are at higher risk for chronic CIPN. Older survivors may require additional education and treatment for chronic CIPN symptoms. Additional studies are needed to explore novel interventions to manage chronic CIPN in older cancer survivors. Highlights • Chemotherapy-induced peripheral neuropathy is commonly reported. • On average, neuropathy significantly decreases for younger patients after treatment. • Older adults report chronic neuropathy, extending well past the end of treatment. • No differences in treatment modifications by age group were observed. [ABSTRACT FROM AUTHOR]