MASCC • Supportive Care makes excellent cancer care possible Multinational Association of Supportive Care in Cancer • www.mascc.org November 2017 This month, I was invited to Omiya, Japan to attend the Second Annual Meeting of the Japanese Association of Supportive Care in Cancer (JASCC). Professor Katsuo Tamura, who established the group and is its President, is also a MASCC Board member. I presented a vision of the strategic direction of MASCC at a roundtable meeting. I also co-chaired a joint MASCC/JASCC session on antiemetics with simultaneous translation. At this session, Richard Gralla and Mitsue Saito gave excellent presentations, which were followed by general discussion. An amazing achievement of this second meeting is that it attracted 660 delegates from multiple disciplines! Interest in supportive care is thriving in Japan and elsewhere in Asia. We had excellent Japanese representation at the MASCC meetings in both Adelaide and Washington. Other speakers at the JASCC meeting were from Korea, which has established survivorship centers consisting of multidisciplinary teams in order to provide a full spectrum of supportive care for survivors. One presenter, Professor Hak Jin Kim, a Korean oncocardiologist, spoke to me about his desire to establish a Korean Association of Supportive Care in Cancer (KASCC). JASCC recognizes MASCC for providing the model upon which its own new society is based, and I have indicated that we will provide similar support for KASCC. Given this strong emerging interest in supportive care in the region, MASCC plans to hold its Annual Meeting in Japan in 2021 (following Vienna in 2018, San Francisco in 2019, and Seville, Spain in 2020). To that end, I visited Yokohama, which has a large convention center on the waterfront. The area has many tourist attractions, restaurants, and retail outlets within easy walking distance and is serviced by hotels ranging from 2 to 5 stars. Ease of access by coach or train from both Narita and Haneda airports make it an ideal location for a MASCC meeting. We have been unable to find a convention center either in Tokyo or the close prefectures that was not already booked. The situation would have been the same in Yokohama, but for a large extension that is being added to the Pacifico Yokohama Convention Centre. This will open in 2020 and will serve us well the following year. The whole infrastructure of the region is being enhanced by preparations for the Tokyo Olympics in 2020, so our timing is ideal. We plan to hold a joint meeting with JASCC in Yokohama and are uncertain about the total number of delegates we will need to accommodate by then. JASCC alone predicts 1500 attendees! A major aim of MASCC’s strategic plan is to spread expertise in cancer supportive care around the world. Our initiatives in Asia supplement previous successes in Europe, Australia, and planned collaborations in Latin America. ~ Ian Olver NEWS Welcome to the November Issue of the MASCC Society News This month, we highlight the research of all of our Young Investigator Award winners from the 2017 Annual Meeting. We also have a report of community health activities from Stella Rithara, who received the Cynthia N. Rittenberg Travel Scholarship this year. As usual, we have lots of announcements of upcoming deadlines and conference reminders. We extend a warm welcome to the new members who joined us in September. And we encourage every member to be a MASCC ambassador! All issues of the MASCC Society News are available online at www.mascc.org/society-news. Older issues (through August, 2016) can be found in the back pages of our journal, Supportive Care in Cancer. ~ Toni Clark, Editor A Message from MASCC President Ian Olver Presiden?al Dinner at the Second Annual Mee?ng of JASCC. Among the aGendees are Ian Olver, Richard Gralla, Kazuo Tamura, and Mitsue Saito, whose birthday was celebrated.
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M A S C C • S u p p o r t i v e C a r e m a k e s e x c e l l e n t c a n c e r c a r e p o s s i b l e
Multinational Association of Supportive Care in Cancer • www.mascc.org
November2017
Thismonth,IwasinvitedtoOmiya,JapantoattendtheSecondAnnualMeetingoftheJapaneseAssociationofSupportiveCareinCancer(JASCC).ProfessorKatsuoTamura,whoestablishedthegroupandisitsPresident,isalsoaMASCCBoardmember.IpresentedavisionofthestrategicdirectionofMASCCataroundtablemeeting.Ialsoco-chairedajointMASCC/JASCCsessionon antiemetics with simultaneoustranslation. At this session, RichardGralla and Mitsue Saito gave excellentpresentations, which were followed bygenera l d iscuss ion. An amazingachievement of this second meeting isthat it attracted 660 delegates frommultipledisciplines!
Interest in supportive care is thriving inJapan and elsewhere in Asia. We hadexcellentJapaneserepresentationattheMASCC meetings in both Adelaide andWashington. Other speakers at theJASCCmeetingwere fromKorea,whichhas established survivorship centersconsisting of multidisciplinary teams inorder to provide a full spectrum ofsupportive care for survivors. Onepresenter,ProfessorHakJinKim,aKoreanoncocardiologist,spoketomeabouthisdesiretoestablishaKoreanAssociationofSupportiveCareinCancer(KASCC).JASCCrecognizesMASCCforprovidingthemodeluponwhichitsownnewsocietyisbased,andIhaveindicatedthatwewillprovidesimilarsupportforKASCC.
NEWSWelcome to the November Issue of the MASCC Society News Thismonth,wehighlighttheresearchofallofourYoungInvestigatorAwardwinnersfromthe2017AnnualMeeting.WealsohaveareportofcommunityhealthactivitiesfromStellaRithara,whoreceivedtheCynthiaN.RittenbergTravelScholarshipthisyear.Asusual,wehavelotsofannouncementsofupcomingdeadlinesandconferencereminders.WeextendawarmwelcometothenewmemberswhojoinedusinSeptember.AndweencourageeverymembertobeaMASCCambassador!
M A S C C • S u p p o r t i v e C a r e m a k e s e x c e l l e n t c a n c e r c a r e p o s s i b l e
Multinational Association of Supportive Care in Cancer • www.mascc.org
Rising Stars: Our Young Investigators Each year, the MASCC Awards Committee recognizes the achievements of up-and-coming researchers through its YoungInvestigatorAwards.Successfulapplicantsmustbe less than40yearsold,andtheirabstractsmust rank in thetop20%ofthosesubmittedtotheAnnualMeeting.Fromamongtheawardwinners,oneisselectedastheOutstandingYoungInvestigator.
Bronwen Mayo (Australia) —Alterations of Gut Microbiome Associated with Tyrosine Kinase Inhibitor-InducedDiarrhoeaandtheEffectoftheGLP-2AgonistElsiglutideAsnotedinourJuly2017issue,thehonorofMASCC’s2017OutstandingYoungInvestigatorwenttoBronwenMayo,aPhDcandidateat theUniversityofSouthAustralia inAdelaide.Bronwen’s researchexplores themechanismofmucocutaneoustoxicity associated with EGFR-targeted cancer therapies. Treatment with lapatinib was associated with mild to moderatediarrhea,whichwasmitigatedbyelsiglutide.Thefindingssuggestthatchangesinthegutmicrobiomemayplayaroleintheprogressionofdiarrheainducedbylapatinib.ElsiglutideeffectivelyinhibitedthisadverseeffectandmayprovideprotectionagainstharmfulmicrobialalterationsintheGItract.
Jung-woo Chae (Singapore) — Reduction of Chemotherapy Concentrations in Hair Follicles After ScalpCoolingforPreventionofChemotherapy-InducedAlopecia
Scalp cooling is hypothesized to reduce chemotherapy-related hair loss byway of vasoconstriction,which limits the druguptake.Butuntilnow,noformalstudieshaveestablishedthatscalpcoolingactuallyreducesdruglevelsinthehairfollicles.Jung-woo and colleagues compared drug concentrations in the hair follicles of cancer patients being treated withcyclophosphamideand/ordoxorubicin.Thosewhoreceivedthescalpcoolinghadlowermeanfollicleconcentrationsofthedrugsthanthosewhohadnoscalpcooling.Also,alowconcentrationofcyclophosphamidewasassociatedwithpreventionofhair loss in the scalp-cooling group. This is the first study to show that scalp cooling reduces the concentration ofchemotherapyinhairfollicles.
NilupaGaspeMudiyanselage(USA)—PROEvaluationUsingtheLoss3-ItemGlobalIndex(3-IGI)toReduceHospitalizationinPatientsReceivingChemotherapy:Resultsofa164PatientProspectiveTrialinNSCLCPrevious research shows that the3-ItemGlobal Index (3-IGI) (qualityof life, activities, distress) of thewell-validated LungCancer Symptom Scale predicts survival more accurately than performance status and requires only two minutes toadminister.Nilupaandhercolleaguesinvestigatedwhetherthe3-IGIaccuratelypredictscancer-relatedortreatmenttoxicity-relatedhospitalizationrisk.Theyshowedthatitsignificantlypredictedriskofcancer-relatedhospitalizationinpatientswithadvancedNSCLC,butdidnotpredict treatment toxicity-relatedhospitalization.Predicting riskofhospitalization for cancercarecouldhelpidentifypatientsmostlikelytobenefitfrompreventiveinterventions.
Chao-Pin Hsiao (USA)—DeterminingMitochondrial Bioenergetics Profiles in FatiguedMenwith ProstateCancerReceivingLocalizedRadiationTherapyChao-Pinandher colleaguesproposedamitochondrialbioenergeticsmechanism for radiation-induced fatigue—one thatlinks cancer-related fatigue to the reduced production of adenosine triphosphate (ATP), which is triggered by radiation-induced cellular damage. As part of a prospective, longitudinal study to determine associations between mitochondrialbioenergetics and fatigue, they used high-resolution respirometry to establish mitochondrial bioenergetics profiles andassessedbaseline,midpoint,andendpointfatigue. Inthefirst20patientstocompletethestudy, fatiguewas intensifiedatmidpoint and remained elevated at the completion of radiation therapy (RT). Compared to baseline, oxidativephosphorylationwas decreased at themidpoint and endpoint of the RT andwas associatedwith increased fatigue. Suchfindingscanhelpidentifypotentialtargetsforinterventionsforradiation-inducedfatigue.
Tamara Lacourt (USA) — Differential Mechanisms of Cancer- Versus Cancer Therapy-Related Fatigue inPatientswithAcuteMyeloidLeukemiaTamaraLacourtandhercolleaguesundertookastudytoidentifytherelativecontributionofinflammationtofatiguebeforeandduringremission inductionchemotherapyforAML.Theyalsoassessedthepredictivevalueofclinicalvariables,stress,and stool microbiome factors. Stress was associated with fatigue at every time point studied, but clinical lab values,microbiome diversity, and specific strains were not, even though cancer therapy changed the microbiome diversity.Inflammation was an important determinant of chemotherapy-related fatigue, while stress was a strong, independentpredictor of AML-related fatigue. The findings suggest that stress contributes to fatigue during chemotherapy viainflammatorypathways.
YOUNG INVESTIGATORS
M A S C C • S u p p o r t i v e C a r e m a k e s e x c e l l e n t c a n c e r c a r e p o s s i b l e
Multinational Association of Supportive Care in Cancer • www.mascc.org
NumerousMASCCmemberswillbepresentingat,orattending,the2017AnnualMeetingofSIOG,theInternationalSocietyforGeriatricOncologyinWarsaw,PolandfromNovember9to 11. Among the Track Leaders areMASCCmembers Petra Stolz-Baskett, Karis Kin-FongCheng,HollyHolmes,MartinePuts,andCarlaRipamonti.ThefacultyalsoincludesMASCCmembers Charles Kelly, Kah Poh Loh, and Karen Mustian. Matti Aapro serves on theScientificProgramCommittee.Thisyear’smeetingwillincludemultidisciplinarysessionsonsolidtumors,hematologicalmalignancies,newtherapies,geriatricassessment,supportivecare,andaneducationalforumfornurses.
Join Us at
Our Young Investigators, continued SandipMukhopadhyay(India)—Low-DoseOlanzapineinChemotherapy-InducedNauseaandVomiting:ABalanceGameBetweenSedationandNausea?Olanzapine,usedtopreventCINV,isassociatedwithahighincidenceofsedation.Sandipandhiscolleaguesconductedapilotstudytodeterminetherelativeefficacy,safety,andassociatedsedationofalowerdoseofolanzapine.Theyshowedthata5mg/day dose of olanzapine controlled CINV as well as the usual 10 mg dose. And patients receiving the 5 mg dose reportedsignificantlylessdaytimesedation.Qualityoflifewassimilarforbothgroups.ThefindingssuggestthatloweringthedosageofolanzapinecouldalleviatesedationorsomnolenceformanypatientswithoutcompromisingitseffectivenessinpreventingCINV.
Thepainoforalmcuositisoftenrequireshighdosesofanalgesicdrugsandcanjeopardizecontinuationoftreatment.Lasertherapyisausefulsupportivetherapyforthiscondition.Itsanalgesicpropertyiswellknown,butitsmoleculartargetshavenotbeenelucidated. In apreclinical study,Giula andher colleaguesused two laserprotocols to investigate theeffectsofirradiationonERKproteinactivationandTRPV1expression.BothERKandTRPV1moleculesarepotentiallycorrelatedwithpain-signalingpathways.Afterlaserexposure,thephosphorylationofERKandTRPV1expressionincreasedsignificantly.Thetwodifferentlaserprotocolsaffectedsensoryneuronsthatlikelyinfluencenociception.
Christina Signorelli (Australia) — What is the Role of Primary Care Physicians in Childhood CancerSurvivorshipCare?AMixed-Methods,Multi-PerspectiveStudyLong-termfollow-upcareisrecommendedtomanagelatecomplicationsofcancertreatment,butsufficientfollow-upbyPCPsisoftenlacking.Christinaandhercolleaguesexploredcancersurvivors’preferencesandPCPs’confidenceindeliveringsurvivorshipcare.Ingeneral,survivors(orparentsifunderage16)preferredoncologiststoPCPsforfollow-up,but25%feltthataPCPcouldbestmeettheirneeds.About50%ofthesesurvivors’PCPswereconfidentintheirabilitytoprovidepediatricsurvivorshipcare,though 92% admitted lacking information about their patients’ survivorship health needs. Better communication betweentertiaryandprimarycaremightincreaseconfidenceofbothsurvivorsandPCPs,aswellasthequalityofcare.
Angela Wan (Canada) — Genetic Biomarkers Associated with Changes in Quality of Life and CancerSymptomsFollowingPalliativeRadiotherapyinPatientswithBoneMetastasesPatients with bone metastases who undergo palliative radiotherapy often report reduced QOL linked to function andsymptoms. Angela and her colleagues designed this study to identify single-nucleotide variant (SNV) genetic biomarkersassociatedwithchangesincancersymptomsandQOL.Theyidentifiedbiomarkerssignificantlyassociatedwithdeteriorationor improvementofglobalQOL,aswellaswith functionandsymptomscales inpatientswithbonemetastases. IdentifyingsuchgeneticbiomarkersmayenableearlytargetingofpatientsneedinginterventiontoimproveQOL.
XiaotaoZhang(USA)—MajorDepressionandSurvivalinOlderCancerPatientsMore than 60% of cancer patients are older adults andmajor depression is common in this group. Xiaotao Zhang and hiscolleaguesconductedaretrospectivestudytoassesstheprevalenceofdepressionandevaluateitseffectonmortalityinoldercancerpatientswithhematologicorsolidtumors.Majordepressionwasdiagnosedin85patients(about28%).Amultivariatemodel (includingage, cancer stage, functional impairment,andmajordepression) showeddepression tobea significant riskfactor for mortality, along with functional impairment andmetastatic disease. The results suggest that early detection andantidepressanttherapy,aswellascontinuityofcarefordepression,couldpotentiallyimproveclinicaloutcomes.
M A S C C • S u p p o r t i v e C a r e m a k e s e x c e l l e n t c a n c e r c a r e p o s s i b l e
Multinational Association of Supportive Care in Cancer • www.mascc.org
Spreading the Word About Supportive and Palliative Care in Kenya
We’re pleased to share a report from StellaMwariRithara,RN,ofKenya.Atthe2017MASCC/
ISOO Annual Meeting, Stella was awarded this year’sCynthia N. Rittenberg Travel Scholarship. This award recognizes thehighest-ranking nurse applicant among those applying for a MASCCTravel Scholarship to the Annual Meeting. Stella is a palliative carenurse and lecturer at the KenyaMedical Training College in Nairobi,Kenya. She is also Founder and Director of Ongata Ngong PalliativeCare Community, a community-based organization that provideseducation,palliativecareservices,andhomevisits.
Stella shared with us her recent efforts to raise awareness aboutcancerpreventionand treatmentaswell as supportiveandpalliativecare. In recognition of Cancer Awareness Week in October, Stellainvitedother professionals to join her in a three-dayproject.On thefirstday,twocommunityhealtheducationworkers,asocialworker,anurse, a pastor, and two caregivers joined in. The team visitedNgarusha village in Kajiado County to help educate local healthworkers.On the secondday, a team consistingof twopalliative carenurses, a counselor, and a social worker visited CornerstoneDeliverance Church in Inyonyori village, Maasailand, also in KajiadoCounty. Here, they discussed cancer issues with members of thecongregation, enlisted community health workers to be trained inpalliativecare,andpaidacallonasickwoman inhervillage.Onthethirdday,Stellaandabreastcancersurvivorvisitedprisonofficerstopromote cancer awareness and educate them about supportive andpalliativecare.Whilemostadmittedthatpalliativecareisanewtermtothem,theyneverthelessembracedtheideaofsupportingresidentsduringillnessandtreatment.
Inall,Stellareportsthattheweekwasfruitfulandtheteamslearnedthat there isa lotofeducationandcoordinationyet tobedone.Sheinvites allMASCCmembers, especially the Education Study Group, tohelpwith ideas on how to reachmore communitieswith informationaboutcancerprevention,treatment,andsupportiveandpalliativecare.
StellaRitharavisi?ngasickwomanathome
OngataNgongPallia?veCareCommunity
StellaMwariRitharaexplainingconceptsin
suppor?veandpallia?vecare
Reminder:Supportive Care in Cancer for Eastern Europe and the Balkan Region The Second Regional Educational Meeting on Supportive Care inCancerPatientsforEasternEuropeandtheBalkanRegionwillbeheldinBelgrade,Serbia,December1-2,2017.MASCCmemberMattiAaprowill deliver the Plenary Lecture, “Supportive Care Makes ExcellentCancer Care Possible,” and several other MASCC members will bespeaking.Formoremeetinginformation,seetheMeetingWebsite.
Janndiscusses themainpointsof twoobservational studies reportedatESMO2017,oneregardingpre-chemotherapynutritionalstatusandchemotherapy response; the other describing cancer cachexia,anorexia,andsarcopeniainpatientswithNSCLC.
JannisHeadoftheGastrointestinalandNutritionServiceattheTumorBiology Center, University of Freiburg in Freiburg, Germany. He is amember ofMASCC StudyGroups onMucositis, Nutrition& Cachexia,andPalliativeCare.
InterviewwithKarinJordan,MD
NewDataonAnti-EmesisAgentsIn this interview,Karindiscusses the importanceof theGAND-EmesistrialbyRuhlmannetal.,presentedatESMO2017,explainingthefocusofthestudyandwhatthefindingsmeanforsupportivecare.
Karin is Leading Senior Physician, Department of Haematology andOncology,University ofHeidelberg and is amember ofMASCC StudyGroupsonAntiemetics,NeurologicalComplications,andSkinToxicities.
InterviewwithAntonSnegovoy,MD,PhD
NewApproachestoManagingCachexia
Antonreviewsvariousstudiesoncancercachexiaandweightlossasanindependent risk factor for mortality. He stresses the importance ofassessingnutritionalstatusbeforeanycancertherapyisinitiated.
Anton Snegovoy is Head of the Department of OutpatientChemotherapy, N.N. Blokhin Russian Cancer Research Center inMoscow. He is a member of MASCC Study Groups on Antiemetics,Neutropenia,Infection&Myelosuppression,andBone.
M A S C C • S u p p o r t i v e C a r e m a k e s e x c e l l e n t c a n c e r c a r e p o s s i b l e
Multinational Association of Supportive Care in Cancer • www.mascc.org
Early Abstract SubmissionDeadline: December 31, 2017 SeeMASCC/ISOOAnnualMeetingwebsiteforabstracttopicsandmoreinformation.>>SUBMITYOURABSTRACT
MASCC/ISOO 2018Help Spread the Word! Our2018MeetingToolkitisnowavailable.http://www.mascc.org/meeting-toolkit FindPowerPointslidesets,banners,adverts,andemailsignaturebanners.
Be a MASCC/ISOO Ambassador! SayafewwordsaboutMASCC/ISOOandourAnnualMeetingatyournextspeakingengagement.ContactMelissaatmchin@mascc.orgforMASCCslidestoaddtoyourpresentation.
November 3, 2017 First Annual Scientific Day of the Quebec Research Network in Palliative and End of Life Care Quebec City, Quebec, Canada
December 1 - 2, 2017 Second Regional Educational Meeting on Supportive Care in Cancer Patients for Eastern Europe and the Balkan Region Belgrade, Serbia
Have any news items to share? Please send contributions to Toni at [email protected].
Melissa Arnell, Australia Ariel Blanchard, United States
Nadia Corsini, Australia Eva Culakova, United States
Corina Dellmann, France Marion Eckert, Australia
Brenda Ernst, United States Tabitha Kelock, Australia
Irena Laska, Albania
Valeria Mercadante, United Kingdom Jeanne Murphy, United States
Razvan-Adrian Negreanu, Romania Patricia Soek Hui Neo, Singapore
Tiberiu Rugea, Romania Andrea Sander, Brazil
Diana Schulz, Australia Michael Thirlwell, Canada
Katy Walshe, Australia
MASCC welcomes the new members who joined us in September!
CONFERENCE REMINDERS
Join Our Community • Get Updates & Get Connected
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Travel ScholarshipDeadline: December 31, 2017 MASCCoffers a limitednumberof travel scholarships to attend theMASCC/ISOOAnnualMeeting. Scholarship recipients receive complimentarymeetingregistration and reimbursement of travel expenses up to an amountdetermined annually by the MASCC Executive Board. Scholarships arepresentedtoawardeesattheAnnualMeeting.Thisscholarship isgiventooncologyhealthcareprofessionalswhosepracticeorresearchfocusesonsupportivecareincancer,includingphysicians,nurses,social workers, pharmacists, dental hygienists, and psychologists. Qualifiedapplicants must affirm their inability to attend the meeting withoutscholarshipfundsandmustliveandworkinacountryoflimitedresources.Formoreinformationandanapplication,seeMASCCAwardsandScholarships.
