Publications by authors named "Peppercorn J"

Background: Little is known about the role that charitable copay assistance (CPA) plays in addressing access to care and financial distress. The study sought to evaluate financial distress and experience with CPA among patients with cancer and autoimmune disease.

Methods: This is a national cross-sectional self-administered anonymous electronic survey conducted among recipients of CPA to cover the costs of a drug for cancer or autoimmune disease.

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Financial toxicity (FT) is now a well-recognized issue affecting many patients with cancer and their families. The field is rapidly moving from a focus on describing this problem to efforts to optimize screening and identify management solutions. There are now multiple validated tools to study FT in the research setting.

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Optimal timing and dosing of adjuvant cyclin-dependent kinase (CDK) 4/6 inhibitor in early breast cancer is controversial. This prospective phase II clinical trial investigated tolerability and safety of two ribociclib dosing schedules. Patients with stage I-III hormone receptor-positive (HR+)/HER2- breast cancer on adjuvant endocrine therapy (ET) were randomized to two ribociclib dosing schedules: 400 mg continuous vs 600 mg intermittent, with initiation in early (prior ET < 2 years) vs delayed (prior ET ≥ 2 years) setting.

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Introduction: Fear of cancer recurrence (FCR) is prevalent and distressing among survivors of cancer. Evidence-based mind-body and cognitive-behavioral skills lack integration and testing in scalable formats.

Objective: This pilot randomized controlled trial (NCT04876599) tested a synchronous, virtual mind-body group resiliency intervention for FCR (IN FOCUS).

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Importance: Young adults aged 18 to 39 years represent the minority of breast cancer diagnoses but are particularly vulnerable to financial hardship. Factors contributing to sustained financial hardship are unknown.

Objectives: To identify financial hardship patterns over time and characterize factors associated with discrete trajectories; it was hypothesized that treatment-related arm morbidity, a key source of expense, would be associated with long-term financial difficulty.

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Background: Cancer survivorship guidelines emphasize Lifestyle Medicine (LM) pillars, including physical activity, healthy eating, restorative sleep, stress management, and avoiding risky substance use. We describe the development and patient population of a multidisciplinary LM clinic in oncology.

Methods: The clinic launched virtually in 2020.

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Purpose: In this study, we describe the geographic distribution of US cancer treatment trials to identify disparities and opportunities for targeted improvements in access to research for people with cancer.

Methods: US-based phase I-III cancer treatment trials registered on ClinicalTrials.gov were tabulated for the years they were open to enrollment (2017-2022), overall and by county, and supplemented with data from the US Census Bureau, National Cancer Institute, Centers for Disease Control and Prevention, and US Department of Agriculture.

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Article Synopsis
  • Many young women diagnosed with breast cancer (BC) are interested in breastfeeding after treatment, but there's limited information on their experiences.
  • In a study of 143 women diagnosed with BC, around 55% attempted breastfeeding, with satisfaction rates high despite challenges such as mastectomies and low milk production.
  • There's a need for more specific resources and support for BC survivors who want to breastfeed, as many women reported receiving helpful information only from their oncology teams or online.*
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  • The study investigates the impact of a group cognitive behavioral intervention (STRIDE) on adherence to adjuvant endocrine therapy (AET) in hormone-sensitive breast cancer patients who report medication-related distress.
  • With 100 participants, the results indicate that STRIDE significantly improved adherence rates over time for those encountering difficulties with AET and having strong expectations for its benefits compared to a control group.
  • The findings suggest that discussions led by clinicians addressing patient perceptions about AET can enhance adherence to treatment, indicating that tailored behavioral interventions could be beneficial.
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  • Young women with a type of breast cancer called HR-positive can benefit from a treatment that suppresses ovarian function, but they might still have some hormones called estrogen (E2) that sneak through.
  • In a study of women under 40, many still had higher levels of estrogen 1 and 4 years after starting treatment, especially if they hadn't had chemotherapy before.
  • The study found that the estrogen levels didn't really change the chances of surviving early cancer, but for more advanced cases, those with higher estrogen levels seemed to have a higher death rate, suggesting we need more research to find the best treatment.
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Article Synopsis
  • - The study examined the cardiovascular disease (CVD) risk linked to cancer treatments in young women (≤40 years) with breast cancer, focusing on data from 372 survivors over five years.
  • - Findings revealed that radiation treatment, especially left-sided radiation, was associated with a significant increase in excess heart age, while systemic cancer treatments showed no correlation with heart age changes.
  • - The authors suggest that CVD risk assessment tools should integrate cancer treatment history to better identify young breast cancer survivors at high risk for cardiovascular issues.
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Purpose: Compared with older women diagnosed with breast cancer, younger women are more likely to die of breast cancer and more likely to suffer psychosocially in both the short-term and long term. The Young Women's Breast Cancer Study (YWS) is a multisite prospective cohort study established to address gaps in our knowledge about this vulnerable and understudied population.

Participants: The YWS enrolled 1302 women newly diagnosed with stages 0-IV breast cancer at age 40 years or younger at 13 academic and community sites in North America between 2006 and 2016.

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Objectives: We sought to understand why some women with early-stage breast cancer decide to forgo or discontinue endocrine therapy (ET), and to identify factors that might lead to greater acceptance of, and long-term adherence to, this treatment.

Methods: We conducted in-depth interviews with N = 53 stage I-III HR+ women who were either non-initiators of ET, initiators who discontinued or initiators who continued with variable daily patterns of adherence. An inductive content analysis was performed to explore the decision-making process of women prescribed ET.

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Background: Individuals with cancer and other medical conditions often experience financial concerns from high costs-of-care and may utilize copay assistance programs (CAP). We sought to describe CAP recipients' experiences/preferences for cost discussions with clinicians.

Methods: We conducted a national, cross-sectional electronic-survey from 10/2022 to 11/2022 of CAP recipients with cancer or autoimmune conditions to assess patient perspectives on cost discussions.

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Importance: The five 1997 Office of Management and Budget races in the US include American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White, with Hispanic ethnicity. Despite the Affordable Care Act mandating Office of Management and Budget-based collecting and reporting standards, race and ethnicity publishing in medical journals is inconsistent, despite being necessary to achieve health equity.

Objective: To quantify race and ethnicity reporting rates and calculate representation quotients (RQs) in published oncology clinical trials.

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Purpose: The antibody-drug conjugate (ADC) sacituzumab govitecan (SG) comprises the topoisomerase 1 (TOP1) inhibitor (TOP1i) SN-38, coupled to a monoclonal antibody targeting trophoblast cell surface antigen 2 (TROP-2). Poly(ADP-ribose) polymerase (PARP) inhibition may synergize with TOP1i and SG, but previous studies combining systemic PARP and TOP1 inhibitors failed due to dose-limiting myelosuppression. Here, we assess the proof-of-mechanism and clinical feasibility for SG and talazoparib (TZP) employing an innovative sequential dosing schedule.

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This article reviews the implementation challenges to the American Society of Clinical Oncology's ethical framework for including research biopsies in oncology clinical trials. The primary challenges to implementation relate to the definitions of secondary endpoints, the scientific and regulatory framework, and the incentive structure that encourages inclusion of biopsies. Principles of research stewardship require that the clinical trials community correctly articulate the scientific goals of any research biopsies, especially those that are required for the patient to enroll on a trial and receive an investigational agent.

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Purpose: Although patients with metastatic breast cancer (MBC) have been living longer with the advent of more effective treatments such as targeted therapy and immunotherapy, the disease remains incurable, and most patients will undergo therapy indefinitely. When beginning therapy, patients are typically prescribed dose often based upon the maximum tolerated dose identified in phase I clinical trials. However, patients' perspectives about tolerability and willingness to discuss individualized dosing of drugs upon initiation of a new regimen and throughout the course of treatment have not been comprehensively evaluated.

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