Breast Cancer, Ductal Carcinoma In Situ
Conditions
Keywords
Social Determinants of Health, IL-6, cytokine profile, immune marker profile
Brief summary
This is a pilot trial to assess how measures of inflammation are correlated with Social Determinants of Health (SDoH) in breast cancer patients. Expected duration of subject participation is one single time point. The patients will fill out questionnaires and provide a plasma sample.
Detailed description
OBJECTIVE: To understand the link between adverse Social Determinants of Health (SDoH) on inflammation, a known contributor to cancer progression and metastases. PRIMARY: Patients with newly diagnosed, biopsy proven breast cancer will be screened for SDoH and distress via a distress screen and for biomarkers. The primary endpoint will be to understand the relationship between measured social determinants of health and inflammation as found in the plasma and buffy coat sample. SDoH will be evaluated as per the Centers for Medicare and Medicaid Services (CMS) survey. This survey was chosen due to the documented validity of the questions based on the literature backing each question, the scoring system that accompanies it and the questions relationship with health outcomes. Based on the local Philadelphia population, the investigators chose to add several questions to understand potential social isolation. Levels of IL-6 will be measured and this will be used as a surrogate for inflammation. SECONDARY: Patient characteristics such as weight, body composition, food recall and outcomes will be monitored. Additionally, members of the IGF-1R-AKT pathway, IL1β, and insulin in the plasma , will be assessed to create a molecular signature of response to this therapy.
Interventions
OTHERSurvey Assessments
The CMS Social Determinant of Health (SDOH) Survey refers to CMS's standardized screening tool used to identify patient needs related to housing, food, transportation, utilities, and safety. It helps providers address non-medical barriers to care and improve health outcomes by documenting social risk factors in a consistent manner. The NCCN Distress Thermometer and Problem List is a screening tool developed by the National Comprehensive Cancer Network (NCCN) to help identify and assess distress in people with cancer. It includes a 0-10 distress rating scale and a Problem List that allows patients to indicate specific practical, emotional, physical, social, and spiritual concerns contributing to their distress.
OTHERDiet Recall
A diet recall is a nutrition assessment method where an individual reports all foods and beverages consumed over a specific period, most commonly the previous 24 hours. It captures detailed information-such as portion sizes, preparation methods, and timing-to help clinicians or researchers evaluate dietary intake and identify nutritional patterns or deficiencies
OTHERBlood Biomarker Collection
The blood specimens will be processed for plasma and buffy coat.
Sponsors
Thomas Jefferson University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Individuals must meet all the following inclusion criteria to be eligible to participate in the study: 1. Female 2. \>18 years old at time of consent 3. Biopsy proven invasive breast cancer or ductal carcinoma in situ 4. Candidate has not yet received cancer therapy for their breast cancer diagnosis 5. ECOG Performance Status \< 2 6. Able to provide consent 7. Must be English speaking
Exclusion criteria
* An individual who meets any of the following criteria will be excluded from participation in this study: 1. Patient has started therapy or already had definitive oncologic surgery 2. Another malignancy within the past 6 months that was not a non-melanomatous skin lesion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation Between Breast Cancer Patients' Social Determinants of Health (SDoH) and Systematic Inflammation | At Visit 1 (1 day) | Patients with newly diagnosed, biopsy proven breast cancer will be screened for SDoH and distress via a distress screen and for biomarkers. The primary endpoint will be to understand the relationship between measured social determinants of health and inflammation as found in the plasma and buffy coat sample. Levels of IL-6 will be measured and this will be used as a surrogate for inflammation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| At-Risk Patients Identified for Illness-Related Psychosocial Complications | At Visit 1 (1 day) | The National Comprehensive Cancer Network Distress Thermometer (NCCN Distress Thermometer) and Problem List will be used to identify patients with illness-related psychological complications. NCCN Distress Thermometer is a screening tool used to quickly assess psychological distress in patients with cancer. It consists of a single-item scale where patients rate their distress over the past week on a 0-10 scale, with 0 = No distress and 10 = Extreme distress. Higher scores indicate worse outcomes (greater distress), while lower scores indicate less distress. |
| Cytokine Profiling | At Visit 1 (1 day) | Using a LP-compliant Quantibody® Multiplex ELISA platform, 200 analytes including Il-6, will be evaluated on plasma before and after diet to include: cytokines, growth factors, proteases, and soluble receptors. After determining statistically significant alterations, GO Pathway analysis will be performed. It is expected that Sparse Principal Component Analysis (SPCA) of these 200 analytes will reveal a small subset (up to \~10 cytokines) and their linear combination that provides a more precise measure of systemic inflammation than IL-6 alone. This composite biomarker will serve as a secondary endpoint in the clinical trial proposed in Project 2C. |
| Immune Function | At Visit 1 (1 day) | Flow cytometry will be performed to characterization anti-tumor immunity (CD8 T-cells: CD3+CD8+, PD-1), T-cell activation (IFNɣ+), and an immune suppressive environment (Treg as per CD25+FOXP3+). |
Countries
United States
Contacts
CONTACTNicole Simone, MD
PRINCIPAL_INVESTIGATORNicole Simone, MD
Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University
Outcome results
None listed