Survey on the effectiveness of telephone-based communication with relatives of hospitalized cancer patients in COVID-19 era in Italy.

OBJECTIVE: No-visitor policies adopted to prevent coronavirus disease-19 (COVID-19) spread in hospital wards have deeply impacted communication with patients and their relatives. Whereas in pre-COVID-19 era family-clinician meetings were held in person, during the pandemic interactions often took place over the phone, frequently causing feelings of uncertainty and distress to the close ones at home. The goal of this study was to assess and improve the effectiveness of structured telephone-based communication with hospitalized onco-hematological patients' relatives in COVID-19 era. METHODS: After no-visitor policy was adopted in the Onco-Hematological Unit of Modena, inpatients' relatives were contacted daily for clinical updates. After discharge, a telephone satisfaction survey was administered to all contact people of patients consecutive admitted between December 2020 and January 2021 (n = 97). Mean score of response and potential statistically significative differences depending on respondents' characteristics were assessed. RESULTS: Most relatives were satisfied with the communication received with a mean total score of 4.69 on a 5-point Likert scale (standard deviation: 0.60). Results showed high satisfaction rate with both the informative (mean ± SD: 4.66 ± 0.64) and emotional (mean ± SD: 4.66 ± 0.58) content, with no significant difference depending on respondents' demographic characteristics (p > 0.05). CONCLUSION: A structured telephone-based communication may be a reasonable substitute for face-to-face meetings; especially if regular in time, conducted by the same doctor and integrated with video calls. Our findings might assist health workers in implementing measures to minimize the psychological effects of no-visitor policies during hospitalization. Clinical updates delivery through structured phone calls and video calls could become an opportunity also in post-COVID era.

Increased mean corpuscular volume of red blood cells in patients treated with capecitabine for advanced breast and colon cancer.

PURPOSE: Capecitabine has demonstrated significant activity in metastatic breast and colorectal cancer. During the course of treatment with capecitabine, we observed that a relevant number of patients developed elevated levels of the mean corpuscular volume (MCV) of red blood cells. METHODS: This retrospective analysis reviewed treatment with capecitabine in 35 patients with histologically proven advanced breast and colon cancer. After 9 weeks of treatment, restaging was performed using the criteria proposed by the Committee of the Response Evaluation Criteria in Solid Tumours. RESULTS: Prior to the first cycle of capecitabine treatment, there were no abnormalities in red blood cells, white blood cells, haemoglobin or platelets. The median haemoglobin level prior to the first cycle was 13 g/dl and the MCV (normal range 80-98 fl) was 86.5 fl in colon cancer patients and 12.8 g/dl and 88.7 fl in breast cancer patients, respectively. During the course of treatment, 12 weeks after the baseline evaluation, an increase in MCV was documented, while haemoglobin levels remained stable. An MCV increase was documented between baseline and the end of treatment. We noticed an increase in MCV at the end of treatment both in patients with stable disease or a partial response (n = 17) compared to patients with tumour progression (n = 11) at the first evaluation (12-14 weeks). DISCUSSION: Preliminary results showed that there is a significant MCV increase in patients receiving capecitabine for metastatic colon and breast cancer after 12 weeks of treatment. However, when we compared the MCV rise after 12 weeks that occurred with stable disease or a partial response compared to that in patients with disease progression at the first evaluation, the analysis was not statistically significant.

Adipose-derived mesenchymal stem cells as stable source of tumor necrosis factor-related apoptosis-inducing ligand delivery for cancer therapy.

Adipose-derived mesenchymal stromal/stem cells (AD-MSC) may offer efficient tools for cell-based gene therapy approaches. In this study, we evaluated whether AD-MSC could deliver proapoptotic molecules for cancer treatment. Human AD-MSCs were isolated and transduced with a retroviral vector encoding full-length human tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), a proapoptotic ligand that induces apoptosis in a variety of human cancers but not normal tissues. Although several studies have documented the antitumor activity of recombinant human TRAIL, its use in vivo is limited by a short half-life in plasma due to a rapid clearance by the kidney. We found that these limitations can be overcome using stably transduced AD-MSC, which could serve as a constant source of TRAIL production. AD-MSC armed with TRAIL targeted a variety of tumor cell lines in vitro, including human cervical carcinoma, pancreatic cancer, colon cancer, and, in combination with bortezomib, TRAIL-resistant breast cancer cells. Killing activity was associated with activation of caspase-8 as expected. When injected i.v. or s.c. into mice, AD-MSC armed with TRAIL localized into tumors and mediated apoptosis without significant apparent toxicities to normal tissues. Collectively, our results provide preclinical support for a model of TRAIL-based cancer therapy relying on the use of adipose-derived mesenchymal progenitors as cellular vectors.