Baseline Immune Biomarkers as Predictors of MBSR(BC) Treatment Success in Off-Treatment Breast Cancer Patients

Abstract

Researchers focused on patient-centered medicine are increasingly trying to identify baseline factors that predict treatment success. Because the quantity and function of lymphocyte subsets change during stress, we hypothesized that these subsets would serve as stress markers and therefore predict which breast cancer patients would benefit most from mindfulness-based stress reduction (MBSR)-facilitated stress relief. The purpose of this study was to assess whether baseline biomarker levels predicted symptom improvement following an MBSR intervention for breast cancer survivors (MBSR[BC]). This randomized controlled trial involved 41 patients assigned to either an MBSR(BC) intervention group or a no-treatment control group. Biomarkers were assessed at baseline, and symptom change was assessed 6 weeks later. Biomarkers included common lymphocyte subsets in the peripheral blood as well as the ability of T cells to become activated and secrete cytokines in response to stimulation with mitogens. Spearman correlations were used to identify univariate relationships between baseline biomarkers and 6-week improvement of symptoms. Next, backward elimination regression models were used to identify the strongest predictors from the univariate analyses. Multiple baseline biomarkers were significantly positively related to 6-week symptom improvement. The regression models identified B-lymphocytes and interferon-γ as the strongest predictors of gastrointestinal improvement (p < .01), +CD4+CD8 as the strongest predictor of cognitive/psychological (CP) improvement (p = .02), and lymphocytes and interleukin (IL)-4 as the strongest predictors of fatigue improvement (p < .01). These results provide preliminary evidence of the potential to use baseline biomarkers as predictors to identify the patients likely to benefit from this intervention.

Effectiveness of mindfulness-based stress reduction and mindfulness-based cognitive therapies on people living with HIV: A systematic review and meta-analysis

“…Reich et al [47] reported that the baseline biomarkers of study participants can influence the benefits they receive from MBSR training, and that adherence to an intervention protocol is also a key factor for ensuring that patients benefit from MBSR therapy [36,48].Although our meta-analysis contained no information regarding protocol adherence, our findings clearly showed that MBT was more effective for treating stress and depression than for treating anxiety. Therefore,…”

Being mindful of mindfulness interventions in cancer: A systematic review of intervention reporting and study methodology

“…Eight m‐MBSR studies explicitly referred to a cancer‐specific version of MBSR known as mindfulness‐based cancer recovery (MBCR), and 3 stated delivering MBSR but provided no reference to the protocol and included insufficient intervention details to assess adherence to the original MBSR protocol. Five studies stated delivering the MBCT protocol: one reported delivering MBSR with components of MBCT, 2 reported using both MBSR and a second mindfulness protocol, and 2 did not provide any theoretical framework …”

“…Of the 28 studies reporting modifications to original MBSR or MBCT protocols, only one provided a full justification for why components were modified. A further 5 studies provided partial justification for the modifications to intervention components; however 19 studies mentioned but did not explain why modifications were necessary beyond participants being cancer patients . Mean quality score for justification of component changes was 1.27 (SD 0.8, range 0–3).…”

“…Studies were assessed for inclusion of rationale for therapeutic benefits of mindfulness to the target population. Fourteen studies provided a full justification, 9 a partial rationale for the potential benefits of mindfulness in their population, 4 studies mentioned but did not justify population, while 3 provided no rationale . Mean score for population selection justification was 2.13 (SD 1.0; range 0–3).…”

La intervención psicológica en pacientes oncológicos: una revisión de la literatura (2000-2014)

“…Con distintos tipos de intervención, tales como grupos psico-educativos y de apoyo, la meditación e imaginación, el uso de técnicas de reducción de estrés, promoción de conductas de salud y mantenimiento y adherencia al tratamiento se observaron incrementos en la supervivencia (62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73). Los datos evidencian de los posibles beneficios de la intervención psicológica en distintos parámetros biológicos, en el incremento de la supervivencia y en la reducción en el riesgo de recaída.…”