Thursday, September 13

Thursday, September 13

4:45 – 5:05 pm

Paper Presentation: Engaging Patients and Providers in the Research Process — Engaging Children and Healthcare Providers in the Co-Design of a Mobile, Technology-Based Symptom Assessment App (210-1)

1CNE Basis of inquiry: Mobile technology supports child-centric approaches to symptom reporting by incorporating game-based features to support children in reporting symptoms.

Purpose/Objectives: We describe the development of a child-centric symptom assessment app using school-age children (6–12 years) receiving treatment for cancer and pediatric oncology healthcare providers as co-designers. 

5:05 – 5:25 pm

Paper Presentation: Engaging Patients and Providers in the Research Process — KAM: Kids are Moving—An Exercise Program for Children with Cancer (210-2)

1CNE  Basis of inquiry: During cancer treatment, children are significantly less active than their healthy peers. Inactivity persists into survivorship, negatively influencing health and quality of life. Children with cancer report that fatigue is one of the most distressing, treatment-related symptom impacting their quality of life; yet children with increased physical activity (PA) have less fatigue. In this study, we sought to evaluate if children could decrease their level of fatigue over the trajectory of treatment by increasing their physical activity.

5:25 – 5:45 pm

Paper Presentations: Engaging Patients and Providers in the Research Process — The Influence of Pediatric Oncology Summer Camp Attendance on Physical Activity, Fatigue, and Oxidative Stress (210-3)

1CNE  Basis of Inquiry: Childhood cancer patients and survivors are less physically active and report increased fatigue. Improved physical activity may reduce fatigue. Over 130 summer camps serve pediatric oncology patients and survivors. Camps promote physical activity and offer a unique opportunity to explore the relationship between physical activity and fatigue.

Purpose: This study was conducted to determine if summer camp attendance increased physical activity in childhood cancer patients and survivors and how physical activity interacts with fatigue. An exploratory aim was to examine changes in oxidative stress which is hypothesized to impact fatigue.

Methods: A repeated measures study design was utilized. Accrual of 60 children over 2 years planned (data collection ends June 2018).

Eligibility: (a) 8–17 years; (b) English speaking; (c) current diagnosis or history of cancer; (d) willingly wear physical activity monitor daily x 2 weeks (beginning 7 days before camp); (e) complete surveys and provide urine samples x 2; (f) attend a 6 day Oncology Summer Camp (g) no neurological disorders/syndromes; (h) without physical limitations. Physical activity was reported as steps/day and intensity level as minutes/day. Oxidative stress measured as urine isoprostane. Paired t-test were conducted to examine change in scores for the Pediatric PROMIS measures, steps/day and isoprostane levels. Pearson’s r was used to calculate correlation coefficients.

Findings/Outcomes: Thirty children enrolled in year 1.

Demographics: 57% male; 70% Caucasian, 20% Asian, 7% African American; 77% off therapy; 40% Leukemia/Lymphoma, 20% Solid tumors, 20% CNS tumors, 20% Unknown. Mean steps/day increased during camp by 7709 (p < .001; 95% CI; 6209 to 9210). Fatigue (p=0.47), anxiety (p=.021) and depression (p=.005) all decreased during camp. Weak non–significant negative correlation, in first 24 samples, between change in oxidative stress and physical activity (r = –.144; p=.50).

Disclaimer: [1 CH] will be awarded for attending all three paper presentations presented during this timeslot. Partial credit is not available.

4:45 –5:45 pm

A Tale of Two MABs: Blinatumomab and Inotuzumab in COG Clinical Trials for Relapsed B ALL (C211)

coglogo

1CNE  Survival for pediatric patients with relapsed B lineage acute lymphoblastic leukemia (ALL) is sub-optimal. Traditionally, treatment protocols for relapsed ALL have relied on cytotoxic chemotherapy. Despite substantial acute and long-term toxicity, there has been no significant improvement in survival in patients treated on these protocols over the past several decades. Chemoresistance is commonly cited as a reason for treatment failure. Treatment failure is defined as either the inability to achieve clinical remission post-relapse or a subsequent relapse following traditional therapy that includes intensified chemotherapy with or without stem cell transplant. The ideal therapy would be the use of a cellular targeted approach that destroys leukemia cells but spares other cells and improves response and survival while minimizing distressing and sometimes life-threatening toxicities. Early phase clinical trials with the synthetic antibodies Blinatumomab (BiTE) and Inotuzumab (INO) have shown great promise in achieving clinical response in heavily pre-treated pediatric and adult patients with relapsed and refractory ALL. This session will detail the targeted approach of these novel antibodies and their unique mechanisms of action: Blinatumomab modulates the immune system to destroy cancer cells, while Inotuzumab provides a link to deliver cytotoxic treatment directly to the cancer cell. These two novel agents will be compared, including their reported efficacy from early phase trials, toxicity profiles, and administration principles. Highlights from the current COG clinical trials AALL1331 and AALL1621 will be reviewed, with a focus on the uniqueness of each trial, including phase type and eligibility criteria. Additionally, AALL1331 has been activated since December 2014, providing an opportunity to share clinical examples and practical tips regarding the nursing care of patients receiving Blinatumomab.