Background: In spite of antiemetics, postchemotherapy side effects continue to be common and may affect compliance to cancer treatment. Among the known factors associated with increased symptom severity are: younger age, treatment toxicity, expected severity, and distress, but little is still known about the role of other factors. The aim of our study was to investigate the role of individual differences related to sensory perception for posttreatment side effects. Methods: Hundred and twenty-five women receiving adjuvant chemotherapy for breast cancer completed measures of absorption, autonomic perception, somatosensory amplification, trait anxiety, and expected severity at baseline. Pretreatment distress and posttreatment nausea, vomiting, and fatigue were assessed at the 1st, 4th, 6th and last cycles of chemotherapy. Results: While univariate analyses showed several factors to be associated with side effects, only absorption and pretreatment distress remained independent predictors of nausea and fatigue when controlling for the remaining factors. Posttreatment vomiting was only predicted by expected severity of vomiting. Conclusion: Chemotherapy-induced side effects are related to increased autonomic nervous system activity, and absorption has been associated with increased autonomic nervous system reactivity to stress. The results suggest that individuals with high absorption may be at greater risk for developing side effects. Improved precision in identifying patients at risk of experiencing more severe side effects after cancer treatment will increase the ability to target treatments aimed at reducing these side effects.

Purpose:The clinical efficacy of breast elastography may be limited when the authors employ the assumption that soft tissues exhibit linear, frequency-independent isotropic mechanical properties during the recovery of shear modulus. Thus, the purpose of this research was to evaluate the degradation in performance incurred when linear-elastic MR reconstruction methods are applied to phantoms that are fabricated using viscoelastic materials. Methods: To develop phantoms with frequency-dependent mechanical properties, the authors measured the complex modulus of two groups of cylindrical-shaped gelatin samples over a wide frequency range ͑up to 1 kHz͒ with the established principles of time-temperature superposition ͑TTS͒. In one group of samples, the authors added varying amounts of agar ͑1%-4%͒; in the other group, the authors added varying amounts of sucrose ͑2.5%-20%͒. To study how viscosity affected the performance of the linear-elastic reconstruction method, the authors constructed an elastically heterogeneous MR phantom to simulate the case where small viscoelastic lesions were surrounded by relatively nonviscous breast tissue. The breast phantom contained four linear, viscoelastic spherical inclusions ͑10 mm diameter͒ that were embedded in normal gelatin. The authors imaged the breast phantom with a clinical prototype of a MRE system and recovered the shear-modulus distribution using the overlapping-subzone-linear-elastic image-reconstruction method. The authors compared the recovered shear modulus to that measured using the TTS method. Results: The authors demonstrated that viscoelastic phantoms could be fabricated by including sucrose in the gelation process and that small viscoelastic inclusions were visible in MR elastograms recovered using a linear-elastic MR reconstruction process; however, artifacts that degraded contrast and spatial resolution were more prominent in highly viscoelastic inclusions. The authors also established that the accuracy of the MR elastograms depended on the degree of viscosity that the inclusion exhibited. Conclusions:The results demonstrated that reconstructing shear modulus from other constitutive laws, such as viscosity, should improve both the accuracy and quality of MR elastograms of the breast.

Our results partly confirm the results of a previous study showing absorption and autonomic perception as predictors of anticipatory side effects in cancer patients receiving chemotherapy. Individuals high in absorption may be more autonomically reactive to aversive stimuli and, subsequently, more conditionable. Additional radiotherapy could be a competing stimulus, reducing the conditioning of chemotherapy-related nausea. Further studies investigating possible psycho-physiological mechanisms in the development of AN are needed.

Background Imaging technologies monitoring and predicting breast cancer response to neoadjuvant chemotherapy (NAC) are of increasing interest. The utility of conventional imaging approaches varies and identifies the need for alternate functional imaging strategies. The use of model-based photon migration methods to quantitatively separate light absorption from scattering in multiply-scattering tissues is a type of near-infrared spectroscopy (NIRS) broadly referred to as diffuse optical spectroscopy (DOS) [Bevilacqua, et al. Applied Optics, 2000; Jakubowski, et al., J of Applied Optics, 2009]. DOSI is a promising experimental technology that allows patients undergoing NAC to be followed with a “no significant risk” device meeting Food and Drug Administration criteria for exempt status. The current design is a mobile device which offers increased accessibility and is relatively simple to perform and interpret, as compared to mammography, magnetic resonance imaging, and positron emission tomography. Due to its size and portability, DOSI is a low barrier-to-access technology, creating new opportunities for patients to receive personalized treatment and for physicians to gain new insight into response mechanisms. The long-term goal is to provide oncologists with a relatively simple, risk-free bedside tool that can be used to help inform medical decisions on chemotherapy regimen, duration, and timing of surgery, thereby maximizing therapeutic response and minimizing unnecessary toxicity. Trial design: In this phase I/II prospective single arm study, patients will receive SOC NAC at five (5) NCI Network for Translational Research in Optical Imaging (NTROI) clinical sites with identical DOSI instruments and procedures. Patients will receive four DOSI exams: at baseline before chemotherapy, at early therapy 5–10 days after NAC initiation, at mid therapy, and at post therapy prior to surgery. The protocol will evaluate a harmonized DOSI technology platform that has been standardized for NAC monitoring. Eligibility: Women who have been diagnosed with breast cancer, have had confirmation by pre-treatment biopsy, and are scheduled to receive NAC followed by surgery are eligible for this trial. Specific aims: The primary aim of this clinical trial is to determine whether the baseline to mid-therapy changes in the DOSI measurement of the quantitative tumor tissue optical index can predict final pathologic complete response in patients with breast cancer undergoing NAC. The secondary aims investigate the correlation between additional DOSI quantitative measurements of tumor biochemical composition obtained at other timepoints, the full range of pathologic response (i.e. complete, partial, and non-response), and any corresponding imaging measurements. Statistical methods: Logistic regression models will be used to study the relationships between pathological complete response and percent change in tissue optical index tumor to normal ratio at different imaging time points. Study size: A total of sixty (60) patients will be enrolled in this imaging study. Currently, one patient has accrued. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT2-05-02.