Browsing by Author "Peppercorn, Jeffrey"

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    Clinical characteristics, racial inequities, and outcomes in patients with breast cancer and COVID-19: A COVID-19 and cancer consortium (CCC19) cohort study.
    (eLife, 2023-10) Nagaraj, Gayathri; Vinayak, Shaveta; Khaki, Ali Raza; Sun, Tianyi; Kuderer, Nicole M; Aboulafia, David M; Acoba, Jared D; Awosika, Joy; Bakouny, Ziad; Balmaceda, Nicole B; Bao, Ting; Bashir, Babar; Berg, Stephanie; Bilen, Mehmet A; Bindal, Poorva; Blau, Sibel; Bodin, Brianne E; Borno, Hala T; Castellano, Cecilia; Choi, Horyun; Deeken, John; Desai, Aakash; Edwin, Natasha; Feldman, Lawrence E; Flora, Daniel B; Friese, Christopher R; Galsky, Matthew D; Gonzalez, Cyndi J; Grivas, Petros; Gupta, Shilpa; Haynam, Marcy; Heilman, Hannah; Hershman, Dawn L; Hwang, Clara; Jani, Chinmay; Jhawar, Sachin R; Joshi, Monika; Kaklamani, Virginia; Klein, Elizabeth J; Knox, Natalie; Koshkin, Vadim S; Kulkarni, Amit A; Kwon, Daniel H; Labaki, Chris; Lammers, Philip E; Lathrop, Kate I; Lewis, Mark A; Li, Xuanyi; Lopes, Gilbert de Lima; Lyman, Gary H; Makower, Della F; Mansoor, Abdul-Hai; Markham, Merry-Jennifer; Mashru, Sandeep H; McKay, Rana R; Messing, Ian; Mico, Vasil; Nadkarni, Rajani; Namburi, Swathi; Nguyen, Ryan H; Nonato, Taylor Kristian; O'Connor, Tracey Lynn; Panagiotou, Orestis A; Park, Kyu; Patel, Jaymin M; Patel, Kanishka GopikaBimal; Peppercorn, Jeffrey; Polimera, Hyma; Puc, Matthew; Rao, Yuan James; Razavi, Pedram; Reid, Sonya A; Riess, Jonathan W; Rivera, Donna R; Robson, Mark; Rose, Suzanne J; Russ, Atlantis D; Schapira, Lidia; Shah, Pankil K; Shanahan, M Kelly; Shapiro, Lauren C; Smits, Melissa; Stover, Daniel G; Streckfuss, Mitrianna; Tachiki, Lisa; Thompson, Michael A; Tolaney, Sara M; Weissmann, Lisa B; Wilson, Grace; Wotman, Michael T; Wulff-Burchfield, Elizabeth M; Mishra, Sanjay; French, Benjamin; Warner, Jeremy L; Lustberg, Maryam B; Accordino, Melissa K; Shah, Dimpy P; COVID-19 and Cancer Consortium

    Background

    Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.

    Methods

    This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.

    Results

    1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32-1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70-6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83-12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63-3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20-2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66-3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89-22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.

    Conclusions

    Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients.

    Funding

    This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.

    Clinical trial number

    CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.
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    Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer.
    (BMC Cancer, 2010-10-06) Jones, Lee W; Douglas, Pamela S; Eves, Neil D; Marcom, P Kelly; Kraus, William E; Herndon, James E; Inman, Brant A; Allen, Jason D; Peppercorn, Jeffrey
    BACKGROUND: The Exercise Intensity Trial (EXcITe) is a randomized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training, relative to attention control, on aerobic capacity, physiologic mechanisms, patient-reported outcomes, and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy. METHODS/DESIGN: Using a single-center, randomized design, 174 postmenopausal women (58 patients/study arm) with histologically confirmed, operable breast cancer presenting to Duke University Medical Center (DUMC) will be enrolled in this trial following completion of primary therapy (including surgery, radiation therapy, and chemotherapy). After baseline assessments, eligible participants will be randomized to one of two supervised aerobic training interventions (moderate-intensity or moderate/high-intensity aerobic training) or an attention-control group (progressive stretching). The aerobic training interventions will include 150 mins.wk⁻¹ of supervised treadmill walking per week at an intensity of 60%-70% (moderate-intensity) or 60% to 100% (moderate to high-intensity) of the individually determined peak oxygen consumption (VO₂peak) between 20-45 minutes/session for 16 weeks. The progressive stretching program will be consistent with the exercise interventions in terms of program length (16 weeks), social interaction (participants will receive one-on-one instruction), and duration (20-45 mins/session). The primary study endpoint is VO₂peak, as measured by an incremental cardiopulmonary exercise test. Secondary endpoints include physiologic determinants that govern VO₂peak, patient-reported outcomes, and biomarkers associated with breast cancer recurrence/mortality. All endpoints will be assessed at baseline and after the intervention (16 weeks). DISCUSSION: EXCITE is designed to investigate the intensity of aerobic training required to induce optimal improvements in VO₂peak and other pertinent outcomes in women who have completed definitive adjuvant therapy for operable breast cancer. Overall, this trial will inform and refine exercise guidelines to optimize recovery in breast and other cancer survivors following the completion of primary cytotoxic therapy. TRIAL REGISTRATION: NCT01186367.