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Sutton, Linda Marie

Overview:

Clinical

Positions:

Associate Professor of Medicine

Medicine, Medical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Medical Director, Duke Oncology Consortium

Medicine
School of Medicine

Education:

M.D. 1987

M.D. — U Mass Memorial Medical Center

Grants:

Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 01, 2016
End Date
June 30, 2021

MaRCC-Sutton

Administered By
Duke Cancer Institute
AwardedBy
Pfizer, Inc.
Role
Principal Investigator
Start Date
October 15, 2015
End Date
October 14, 2020

A Self-Management Intervention for Women with Breast Cancer and Diabetes

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Co Investigator
Start Date
July 01, 2016
End Date
June 30, 2020

Public Health Surveillance of Bleeding

Administered By
Medicine, Hematology
AwardedBy
Centers for Disease Control and Prevention
Role
Co Investigator
Start Date
September 30, 2011
End Date
September 29, 2016

A Quality Improvement Approach to the Management of CLL--Research

Administered By
Duke Clinical Research Institute
AwardedBy
Genentech, Inc.
Role
Principal Investigator
Start Date
January 30, 2015
End Date
April 23, 2016

Caregiver-Assisting Coping Skills Training for Lung Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 06, 2002
End Date
May 31, 2008

Spouse Guided Pain Management Training for Cancer Pain

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
February 22, 2000
End Date
January 31, 2003

Spore In Breast Cancer

Administered By
Surgery
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 30, 1995
End Date
August 31, 1998
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Publications:

CHAMBER: A Regional Performance Improvement CME Initiative for Breast Cancer Health Care Providers.

CHAMBER was a regional educational initiative for providers of care to patients with HER2+ breast cancer. The study goals were to (1) enhance testing for HER2/neu overexpression in patients with invasive breast cancer; (2) increase the appropriate use of targeted therapy for patients with HER2+ breast cancer; and (3) enhance patients' coping ability. This Performance Improvement Continuing Medical Education (PI-CME) initiative included clinical practice assessment, educational activities, and reassessment. Chart review revealed a high rate of HER2 testing (98%) before and after education. Targeted therapy for patients with HER2+ breast cancer declined after the program (from 96% to 61%), perhaps attributable to an increase in awareness of medical reasons to avoid use of targeted therapy. Assessment for patients' emotional coping ability increased after education (from 55% to 76%; P=.01). Rates of testing for HER2 amplification and assessment of emotional well-being after education were consistent with ASCO Quality Oncology Practice Initiative benchmark values. Documentation of actions to address emotional problems remained an area for improvement.

Authors
Sutton, LM; Geradts, J; Hamilton, EP; Havlin, KA; Kimmick, GG; Marcom, PK; Spector, NL; Watson, M; Rabin, DU; Bruno, TO; Noe, A; Miller, S; Subramaniam, C; Layton, S; Grichnik, K
MLA Citation
Sutton, LM, Geradts, J, Hamilton, EP, Havlin, KA, Kimmick, GG, Marcom, PK, Spector, NL, Watson, M, Rabin, DU, Bruno, TO, Noe, A, Miller, S, Subramaniam, C, Layton, S, and Grichnik, K. "CHAMBER: A Regional Performance Improvement CME Initiative for Breast Cancer Health Care Providers." J Natl Compr Canc Netw 13.8 (August 2015): 1005-1011.
PMID
26285246
Source
pubmed
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
13
Issue
8
Publish Date
2015
Start Page
1005
End Page
1011

Palliative care, Version 1.2014. Featured updates to the NCCN Guidelines.

The NCCN Guidelines for Palliative Care provide interdisciplinary recommendations on palliative care for patients with cancer. These NCCN Guidelines Insights summarize the NCCN panel's discussions and guideline updates from 2013 and 2014. These include modifications/additions to palliative care screening and assessment protocols, new considerations for discussing the benefits and risks of anticancer therapy, and approaches to advance care planning. Recent updates focus on enhanced patient-centered care and seek to promote earlier integration of palliative care and advance care planning in oncology.

Authors
Levy, MH; Smith, T; Alvarez-Perez, A; Back, A; Baker, JN; Block, S; Codada, SN; Dalal, S; Dans, M; Kutner, JS; Kvale, E; Misra, S; Mitchell, W; Sauer, TM; Spiegel, D; Sutton, L; Taylor, RM; Temel, J; Tickoo, R; Urba, SG; Van Zyl, C; Weinstein, SM; Bergman, MA; Scavone, JL
MLA Citation
Levy, MH, Smith, T, Alvarez-Perez, A, Back, A, Baker, JN, Block, S, Codada, SN, Dalal, S, Dans, M, Kutner, JS, Kvale, E, Misra, S, Mitchell, W, Sauer, TM, Spiegel, D, Sutton, L, Taylor, RM, Temel, J, Tickoo, R, Urba, SG, Van Zyl, C, Weinstein, SM, Bergman, MA, and Scavone, JL. "Palliative care, Version 1.2014. Featured updates to the NCCN Guidelines." Journal of the National Comprehensive Cancer Network : JNCCN 12.10 (October 2014): 1379-1388.
PMID
25313178
Source
epmc
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
12
Issue
10
Publish Date
2014
Start Page
1379
End Page
1388

Development of a virtual multidisciplinary lung cancer tumor board in a community setting.

PURPOSE: Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. METHODS: Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. RESULTS: Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. CONCLUSION: The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan.

Authors
Stevenson, MM; Irwin, T; Lowry, T; Ahmed, MZ; Walden, TL; Watson, M; Sutton, L
MLA Citation
Stevenson, MM, Irwin, T, Lowry, T, Ahmed, MZ, Walden, TL, Watson, M, and Sutton, L. "Development of a virtual multidisciplinary lung cancer tumor board in a community setting." J Oncol Pract 9.3 (May 2013): e77-e80.
PMID
23942505
Source
pubmed
Published In
Journal of Oncology Practice
Volume
9
Issue
3
Publish Date
2013
Start Page
e77
End Page
e80
DOI
10.1200/JOP.2013.000882

Palliative care: Clinical practice guidelines in oncology

These guidelines were developed and updated by an interdisciplinary group of experts based on clinical experience and available scientific evidence. The goal of these guidelines is to help patients with cancer experience the best quality of life possible throughout the illness trajectory by providing guidance for the primary oncology team for symptom screening, assessment, palliative care interventions, reassessment, and afterdeath care. Palliative care should be initiated by the primary oncology team and augmented by collaboration with an interdisciplinary team of palliative care experts. © JNCCN-Journal of the National Comprehensive Cancer Network.

Authors
Levy, MH; Adolph, MD; Back, A; Block, S; Codada, SN; Dalal, S; Deshields, TL; Dexter, E; Dy, SM; Knight, SJ; Misra, S; Ritchie, CS; Sauer, TM; Smith, T; Spiegel, D; Sutton, L; Taylor, RM; Temel, J; Thomas, J; Tickoo, R; Urba, SG; Roenn, JHV; Weems, JL; Weinstein, SM; Freedman-Cass, DA; Bergman, MA
MLA Citation
Levy, MH, Adolph, MD, Back, A, Block, S, Codada, SN, Dalal, S, Deshields, TL, Dexter, E, Dy, SM, Knight, SJ, Misra, S, Ritchie, CS, Sauer, TM, Smith, T, Spiegel, D, Sutton, L, Taylor, RM, Temel, J, Thomas, J, Tickoo, R, Urba, SG, Roenn, JHV, Weems, JL, Weinstein, SM, Freedman-Cass, DA, and Bergman, MA. "Palliative care: Clinical practice guidelines in oncology." JNCCN Journal of the National Comprehensive Cancer Network 10.10 (2012): 1284-1309.
PMID
23054879
Source
scival
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
10
Issue
10
Publish Date
2012
Start Page
1284
End Page
1309

A phase II trial of bevacizumab plus everolimus for patients with refractory metastatic colorectal cancer.

PURPOSE: For patients with metastatic colorectal cancer (mCRC), no standard therapy exists after progression on 5-fluorouracil, oxaliplatin, irinotecan, bevacizumab, and cetuximab or panitumumab. Preclinical data demonstrated that combined vascular endothelial growth factor and mammalian target of rapamycin inhibition has greater antiangiogenic and antitumor activity than either monotherapy. A phase I study of bevacizumab plus everolimus demonstrated that the combination is safe; activity was seen in several patients with refractory mCRC. METHODS: Fifty patients with refractory mCRC were enrolled and received bevacizumab at 10 mg/kg every 2 weeks and everolimus at 10 mg orally daily. RESULTS: Of the 50 patients enrolled, the median age was 56 years and the median number of prior regimens was four. Forty-seven patients (96%) had prior bevacizumab exposure and 42 patients (84%) had documented progression on prior bevacizumab-based therapy. Forty-nine patients were evaluable for response; eight patients had minor responses (16%) and an additional 15 patients (30%) had stable disease (SD). No complete or partial responses were seen. The median progression-free survival interval was 2.3 months; however, 26% of patients achieved prolonged SD for ≥6 months, and three patients (6%) were on study for >1 year. The median overall survival duration was 8.1 months. The most common grade 1-2 toxicities were mucositis (68%) and hyperlipidemia (64%). Clinically significant grade ≥3 toxicities included hypertension (14%), fistula/abscess/perforation (8%), mucositis (6%), and hemorrhage (2%). CONCLUSIONS: Bevacizumab plus everolimus is generally tolerable but may have risks related to mucosal damage and/or wound healing. Bevacizumab plus everolimus appears to have modest activity in refractory mCRC in patients.

Authors
Altomare, I; Bendell, JC; Bullock, KE; Uronis, HE; Morse, MA; Hsu, SD; Zafar, SY; Blobe, GC; Pang, H; Honeycutt, W; Sutton, L; Hurwitz, HI
MLA Citation
Altomare, I, Bendell, JC, Bullock, KE, Uronis, HE, Morse, MA, Hsu, SD, Zafar, SY, Blobe, GC, Pang, H, Honeycutt, W, Sutton, L, and Hurwitz, HI. "A phase II trial of bevacizumab plus everolimus for patients with refractory metastatic colorectal cancer." Oncologist 16.8 (2011): 1131-1137.
PMID
21795432
Source
pubmed
Published In
The oncologist
Volume
16
Issue
8
Publish Date
2011
Start Page
1131
End Page
1137
DOI
10.1634/theoncologist.2011-0078

Caregiver-assisted coping skills training for lung cancer: Results of a randomized clinical trial

Context: Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers. Objectives: This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer. Methods: Two hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers completed measures assessing psychological distress, caregiver strain, and self-efficacy for helping the patient manage symptoms. Results: Patients in both treatment conditions showed improvements in pain, depression, QOL, and self-efficacy, and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up. Results of exploratory analyses suggested that the CST intervention was more beneficial to patients/caregivers with Stage II and III cancers, whereas the education/support intervention was more beneficial to patients/caregivers with Stage I cancer. Conclusion: Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change. © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Porter, LS; Keefe, FJ; Garst, J; Baucom, DH; McBride, CM; McKee, DC; Sutton, L; Carson, K; Knowles, V; Rumble, M; Scipio, C
MLA Citation
Porter, LS, Keefe, FJ, Garst, J, Baucom, DH, McBride, CM, McKee, DC, Sutton, L, Carson, K, Knowles, V, Rumble, M, and Scipio, C. "Caregiver-assisted coping skills training for lung cancer: Results of a randomized clinical trial." Journal of Pain and Symptom Management 41.1 (2011): 1-13.
PMID
20832982
Source
scival
Published In
Journal of Pain and Symptom Management
Volume
41
Issue
1
Publish Date
2011
Start Page
1
End Page
13
DOI
10.1016/j.jpainsymman.2010.04.014

"Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma.

The purpose of this study was to evaluate the efficacy and safety of short-course bortezomib, melphalan, prednisone (VMP) in previously untreated multiple myeloma as frontline therapy for transplant-ineligible patients and induction prior to autologous stem cell transplantation (ASCT). Patients received up to 6 28-day cycles of bortezomib 1.3 mg/m(2), days 1, 4, 8, and 11, plus melphalan 6 mg/m(2) and prednisone 60 mg/m(2), days 1-7. After 2-6 cycles, eligible and consenting patients could proceed to ASCT. Responses were assessed by International Uniform Response Criteria. The primary endpoint was complete response (CR) rate with VMP. Forty-five patients were enrolled. Among 44 evaluable patients, response rate was 95%, including 18% >or=CR (9% stringent CR), 27% very good partial responses (VGPR), and 50% partial responses (PR). Twenty patients proceeded to ASCT. Stem cell collection was successful in all; median yield was 5.6 x 10(6) CD34(+) cells/kg. Posttransplant response rates were 30% >or=CR (10% stringent CR), 65% VGPR, and 5% PR. After median follow-up of 14.0/14.6 months, median time to progression and progression-free survival were both 19.8/27.9 months in non-ASCT/ASCT patients. Seven patients have died; 1-year survival rates were 82%/95% in non-ASCT/ASCT patients. The most common grade 3/4 toxicities were thrombocytopenia (20%), neutropenia (28%), and infection (9%). Peripheral neuropathy grade 2-4 was the most common nonhematopoietic side effect occurring 17 patients (38%), although it was typically reversible, and only 5 patients (11%) discontinued therapy as a result of it. Short-course VMP is highly effective and generally well tolerated, both as initial treatment in non-ASCT patients and induction prior to ASCT. VMP did not negatively affect stem cell collection. Longer follow-up and prospective phase III trials are required to validate these initial observations.

Authors
Gasparetto, C; Gockerman, JP; Diehl, LF; de Castro, CM; Moore, JO; Long, GD; Horwitz, ME; Keogh, G; Chute, JP; Sullivan, KM; Neuwirth, R; Davis, PH; Sutton, LM; Anderson, RD; Chao, NJ; Rizzieri, D
MLA Citation
Gasparetto, C, Gockerman, JP, Diehl, LF, de Castro, CM, Moore, JO, Long, GD, Horwitz, ME, Keogh, G, Chute, JP, Sullivan, KM, Neuwirth, R, Davis, PH, Sutton, LM, Anderson, RD, Chao, NJ, and Rizzieri, D. ""Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma." Biol Blood Marrow Transplant 16.1 (January 2010): 70-77.
PMID
19733251
Source
pubmed
Published In
Biology of Blood and Marrow Transplantation
Volume
16
Issue
1
Publish Date
2010
Start Page
70
End Page
77
DOI
10.1016/j.bbmt.2009.08.017

Palliative care

Authors
Levy, MH; Back, A; Benedetti, C; Billings, JA; Block, S; Boston, B; Bruera, E; Dy, S; Eberle, C; Foley, KM; Karver, SB; Knight, SJ; Misra, S; Ritchie, CS; Spiegel, D; Sutton, L; Urba, S; Roenn, JHV; Weinstein, SM
MLA Citation
Levy, MH, Back, A, Benedetti, C, Billings, JA, Block, S, Boston, B, Bruera, E, Dy, S, Eberle, C, Foley, KM, Karver, SB, Knight, SJ, Misra, S, Ritchie, CS, Spiegel, D, Sutton, L, Urba, S, Roenn, JHV, and Weinstein, SM. "Palliative care." JNCCN Journal of the National Comprehensive Cancer Network 7.4 (2009): 436-437+462-472-.
PMID
19406043
Source
scival
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
7
Issue
4
Publish Date
2009
Start Page
436-437+462-472

Interleukin-6, multidrug resistance protein-1 expression and response to paclitaxel in women with metastatic breast cancer: Results of cancer and leukemia group B trial 159806

Several reports have suggested that breast cancer patients with elevated serum levels of interleukin-6 (IL-6) have a worse prognosis than patients with lower levels. We have studied IL-6 in breast cancer cell lines and have shown that autocrine production of IL-6 can confer multi-drug resistance in vitro by inducing multidrug resistance gene-1 transcription with subsequent overexpression of P-glycoprotein (PGP). Both IL-6 and PGP expression can be measured in malignant cells using immunohistochemical (IHC) techniques. We hypothesized that patients whose tumors expressed higher amounts of IL-6 or PGP would be less likely to respond to paclitaxel, an agent affected by the PGP pathway. If so, then IL-6 could serve as a predictive factor for paclitaxel sensitivity. Both IL-6 and PGP expression were measured in patients treated in a randomized trial that compared three doses of single agent paclitaxel (175, 210, and 250 mg/m2 over 3 h every 3 weeks) in 469 women with metastatic breast cancer (CALGB 9342). No difference in complete and partial response was found among the three treatment arms. Tissue blocks in this trial were analyzed for IL-6 (154 patients) and PGP (149 patients) in paraffin-embedded sections from tumor samples; clinical characteristics of these patients were similar to the total sample of 469 patients. There were no significant differences among IL-6 or PGP scores whether measured as continuous or dichotomous variables, or by other scoring, and response to paclitaxel. In multivariate analysis neither IL-6 nor PGP was a significant predictor of time to progression or overall survival. IHC expression of IL-6 and PGP levels in tumor cells is not a predictive marker for response to paclitaxel in women with metastatic breast cancer. © 2006 Springer Science+Business Media, LLC.

Authors
Rincon, M; Broadwater, G; Harris, L; Crocker, A; Weaver, D; Dressler, L; Berry, D; Sutton, L; Michaelson, R; Messino, M; Kirshner, J; Fleming, G; Winer, E; Hudis, C; Appel, S; Norton, L; Muss, H
MLA Citation
Rincon, M, Broadwater, G, Harris, L, Crocker, A, Weaver, D, Dressler, L, Berry, D, Sutton, L, Michaelson, R, Messino, M, Kirshner, J, Fleming, G, Winer, E, Hudis, C, Appel, S, Norton, L, and Muss, H. "Interleukin-6, multidrug resistance protein-1 expression and response to paclitaxel in women with metastatic breast cancer: Results of cancer and leukemia group B trial 159806." Breast Cancer Research and Treatment 100.3 (2006): 301-308.
PMID
16773437
Source
scival
Published In
Breast Cancer Research and Treatment
Volume
100
Issue
3
Publish Date
2006
Start Page
301
End Page
308
DOI
10.1007/s10549-006-9251-7

Palliative care clinical practice guidelines in oncology

Over the past 20 years, increasing attention has been paid to quality-of-life issues in oncology. As the hospice movement has grown in this country, palliative care has developed into an integral part (rather than the antithesis) of comprehensive cancer care. Palliative care must be integrated earlier into the continuum of cancer care, and palliative, symptom-modifying therapy should be provided simultaneously with disease-modifying therapy from diagnosis. The goal of the NCCN palliative care guidelines is to help assure that each patient with cancer experiences the best possible quality of life throughout the illness trajectory. These guidelines are intended to help oncology teams provide the best care possible for their patients with incurable cancer. © Journal of the National Comprehensive Cancer Network.

Authors
Levy, MH; Back, A; Bazargan, S; Benedetti, C; Billings, JA; Block, S; Bruera, E; Carducci, MA; Dy, S; Eberle, C; Foley, KM; Harris, J-D; Knight, SJ; Milch, R; Rhiner, M; Slatkin, NE; Spiegel, D; Sutton, L; Urba, S; Roenn, JHV; Weinstein, SM
MLA Citation
Levy, MH, Back, A, Bazargan, S, Benedetti, C, Billings, JA, Block, S, Bruera, E, Carducci, MA, Dy, S, Eberle, C, Foley, KM, Harris, J-D, Knight, SJ, Milch, R, Rhiner, M, Slatkin, NE, Spiegel, D, Sutton, L, Urba, S, Roenn, JHV, and Weinstein, SM. "Palliative care clinical practice guidelines in oncology." JNCCN Journal of the National Comprehensive Cancer Network 4.8 (2006): 776-818.
PMID
16948956
Source
scival
Published In
Journal of the National Comprehensive Cancer Network : JNCCN
Volume
4
Issue
8
Publish Date
2006
Start Page
776
End Page
818

Partner-guided cancer pain management at the end of life: a preliminary study.

This preliminary study tested the efficacy of a partner-guided cancer pain management protocol for patients who are at the end of life. Seventy-eight advanced cancer patients meeting criteria for hospice eligibility and their partners were randomly assigned to a partner-guided pain management training intervention, or usual care control condition. The partner-guided pain management training protocol was a three-session intervention conducted in patients' homes that integrated educational information about cancer pain with systematic training of patients and partners in cognitive and behavioral pain coping skills. Data analyses revealed that the partner-guided pain management protocol produced significant increases in partners' ratings of their self-efficacy for helping the patient control pain and self-efficacy for controlling other symptoms. Partners receiving this training also showed a trend to report improvements in their levels of caregiver strain. Overall, the results of this preliminary study suggest that a partner-guided pain management protocol may have benefits in the context of cancer pain at the end of life. Given the significance of pain at the end of life, future research in this area appears warranted.

Authors
Keefe, FJ; Ahles, TA; Sutton, L; Dalton, J; Baucom, D; Pope, MS; Knowles, V; McKinstry, E; Furstenberg, C; Syrjala, K; Waters, SJ; McKee, D; McBride, C; Rumble, M; Scipio, C
MLA Citation
Keefe, FJ, Ahles, TA, Sutton, L, Dalton, J, Baucom, D, Pope, MS, Knowles, V, McKinstry, E, Furstenberg, C, Syrjala, K, Waters, SJ, McKee, D, McBride, C, Rumble, M, and Scipio, C. "Partner-guided cancer pain management at the end of life: a preliminary study." J Pain Symptom Manage 29.3 (March 2005): 263-272.
PMID
15781177
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
29
Issue
3
Publish Date
2005
Start Page
263
End Page
272
DOI
10.1016/j.jpainsymman.2004.06.014

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Authors
Keefe, FJ; Ahles, TA; Porter, LS; Sutton, LM; McBride, CM; Pope, MS; McKinstry, ET; Furstenberg, CP; Dalton, J; Baucom, DH
MLA Citation
Keefe, FJ, Ahles, TA, Porter, LS, Sutton, LM, McBride, CM, Pope, MS, McKinstry, ET, Furstenberg, CP, Dalton, J, and Baucom, DH. "The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life." Pain 103.1-2 (May 2003): 157-162.
PMID
12749970
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
157
End Page
162

Management of terminal cancer in elderly patients.

Advances in health care and changing demographics worldwide have led to an ageing population whose care at the end of life has become increasingly complicated. Clinicians face a difficult challenge in the effective management of symptoms and suffering of elderly patients with terminal cancer, against a backdrop of complicated family and social structures. We describe the most pertinent features of management of key symptoms, focusing on pain, dyspnoea, constipation, and anorexia-cachexia syndromes. We present a rational approach to nutritional issues along with a description of the psychosocial issues that must be included in the overall management of these patients.

Authors
Sutton, LM; Demark-Wahnefried, W; Clipp, EC
MLA Citation
Sutton, LM, Demark-Wahnefried, W, and Clipp, EC. "Management of terminal cancer in elderly patients." Lancet Oncol 4.3 (March 2003): 149-157. (Review)
PMID
12623360
Source
pubmed
Published In
The Lancet Oncology
Volume
4
Issue
3
Publish Date
2003
Start Page
149
End Page
157

Cancer pain at the end of life: a biopsychosocial perspective.

Authors
Sutton, LM; Porter, LS; Keefe, FJ
MLA Citation
Sutton, LM, Porter, LS, and Keefe, FJ. "Cancer pain at the end of life: a biopsychosocial perspective." Pain 99.1-2 (September 2002): 5-10. (Review)
PMID
12237179
Source
pubmed
Published In
PAIN
Volume
99
Issue
1-2
Publish Date
2002
Start Page
5
End Page
10

Multicenter phase II study of a 28-day regimen of orally administered eniluracil and fluorouracil in the treatment of patients with anthracycline- and taxane-resistant advanced breast cancer

Purpose: Eniluracil (776C85), a potent inactivator of dihydropyrimidine dehydrogenase, allows fluorouracil (5-FU) to be administered orally on a schedule that simulates continuous-infusion 5-FU. The primary objective of this study was to estimate the objective tumor response rate of orally administered eniluracil and 5-FU in the treatment of anthracycline- and taxane-resistant advanced breast cancer. Patients and Methods: Patients with anthracycline- and taxane-resistant advanced breast cancer were enrolled onto this open-label, phase II, multicenter study. Patients received orally administered 5-FU 1.0 mg/m2 with eniluracil given in a 10:1 ratio (eniluracil:5-FU) twice daily for the first 28 days of each 35-day cycle. Results: Eighty-four patients were enrolled. Eight partial responses were observed in 84 patients (10%; 95% confidence interval [CI], 4.2% to 17.9%), and 20 patients (24%) had stable disease. The median duration of partial response was 20.1 weeks (95% CI, 12 to 26.7 weeks). The median duration of progression-free survival and overall survival for all patients was 9.9 weeks and 40.4 weeks, respectively. Most adverse events were grade 1 or 2 in intensity. Diarrhea, nausea, malaise/fatigue, vomiting, and mucositis were the most common treatment-related nonhematologic adverse events. The most frequently occurring grade 3 or 4 treatment-related adverse events were malaise/fatigue and diarrhea, occurring in 17% and 7% of patients, respectively. The incidence of grade 3 or 4 hematologic toxicity was low. Grade 3 or 4 hyperbilirubinemia occurred in 17% of patients. Conclusion: Eniluracil-5-FU has modest antitumor activity and an acceptable safety profile in anthracycline- and taxane-resistant breast cancer. Treatment was convenient, and patient compliance was high. © 2002 by American Society of Clinical Oncology.

Authors
Rivera, E; Sutton, L; Colwell, B; Graham, M; Frye, D; Somerville, M; Conklin, HS; McGuirt, C; Levin, J; Hortobagyi, GN
MLA Citation
Rivera, E, Sutton, L, Colwell, B, Graham, M, Frye, D, Somerville, M, Conklin, HS, McGuirt, C, Levin, J, and Hortobagyi, GN. "Multicenter phase II study of a 28-day regimen of orally administered eniluracil and fluorouracil in the treatment of patients with anthracycline- and taxane-resistant advanced breast cancer." Journal of Clinical Oncology 20.4 (2002): 987-993.
PMID
11844821
Source
scival
Published In
Journal of Clinical Oncology
Volume
20
Issue
4
Publish Date
2002
Start Page
987
End Page
993
DOI
10.1200/JCO.20.4.987

Promoting informed decision making: hormone replacement therapy.

Authors
Bastian, L; Couchman, G; Rimer, BK; McBride, CM; Sutton, L; Siegler, IC
MLA Citation
Bastian, L, Couchman, G, Rimer, BK, McBride, CM, Sutton, L, and Siegler, IC. "Promoting informed decision making: hormone replacement therapy." Cancer Treat Res 97 (1998): 129-147. (Review)
PMID
9711414
Source
pubmed
Published In
Cancer Treatment and Research
Volume
97
Publish Date
1998
Start Page
129
End Page
147

A review of hereditary breast cancer: from screening to risk factor modification.

The identification of genetic mutations thought to be directly responsible for the development of breast cancer represents a major advance in our understanding of this disease. Mutations in BRCA1 and BRCA2 are thought to be responsible for the majority of inherited breast cancer. Although these mutations account for approximately 5% of breast cancer cases, the identification of these genes will have a profound impact on the way patients and their physicians view breast cancer risk. Genetic testing for BRCA1 and BRCA2 mutations is already available. Interpreting results of genetic tests for these mutations is problematic and the clinical management of women carrying these gene mutations is far from straightforward. The purpose of this paper is to review recent developments in the genetic aspects of breast cancer, including genetic testing, to critically review risk factor modification, and to discuss screening and potential prophylactic measures.

Authors
Warmuth, MA; Sutton, LM; Winer, EP
MLA Citation
Warmuth, MA, Sutton, LM, and Winer, EP. "A review of hereditary breast cancer: from screening to risk factor modification." Am J Med 102.4 (April 1997): 407-415. (Review)
PMID
9217624
Source
pubmed
Published In
The American Journal of Medicine
Volume
102
Issue
4
Publish Date
1997
Start Page
407
End Page
415

Pharmacokinetics and clinical impact of all-trans retinoic acid in metastatic breast cancer: a phase II trial.

PURPOSE: The purpose of this trial was to evaluate tumor cytoreduction by all-trans retinoic acid (ATRA) in patients with metastatic breast cancer and to characterize the initial pharmacokinetics of this agent. METHODS: The study was a single institution, phase II study. The treatment regimen consisted of ATRA administered orally at a dose of 50 mg/m2 three times a day for 14 consecutive day of a 21-day cycle. Cycles were repeated until disease progression, unacceptable toxicity or patient withdrawal. Plasma samples were obtained following the first dose of ATRA for pharmacokinetic analysis. RESULTS: A total of 17 patients with metastatic breast cancer were enrolled in the study, and 14 completed at least one cycle of therapy and were evaluable for response. One patient achieved a partial response in soft tissue of 4 months duration. Three patients had stable disease for 4, 2, and 2 months duration. The remainder had progressive disease. ATRA was reasonably well tolerated. Pharmacokinetic analysis revealed a high degree of interpatient variability in systemic exposure following the initial dose of ATRA. CONCLUSIONS: We conclude, that in the dose and schedule tested, ATRA does not have significant activity in patients with hormone-refractory, metastatic breast cancer. Future studies should focus on more intensive investigation of those individuals with very high or low ATRA initial systemic exposure in the hope of expanding our understanding of ATRA's clinical pharmacology, ultimately leading to improved efficacy.

Authors
Sutton, LM; Warmuth, MA; Petros, WP; Winer, EP
MLA Citation
Sutton, LM, Warmuth, MA, Petros, WP, and Winer, EP. "Pharmacokinetics and clinical impact of all-trans retinoic acid in metastatic breast cancer: a phase II trial." Cancer Chemother Pharmacol 40.4 (1997): 335-341.
PMID
9225952
Source
pubmed
Published In
Cancer Chemotherapy and Pharmacology
Volume
40
Issue
4
Publish Date
1997
Start Page
335
End Page
341
DOI
10.1007/s002800050666

Continuous infusion 5-fluorouracil as first-line therapy for metastatic breast cancer.

Previous phase II studies of continuous infusion Fluorouracil (5-FU) (CI 5-FU) in refractory metastatic breast cancer have shown modest activity with low toxicity. Its activity in a first-line setting has not been formally tested. Patients were eligible if they fulfilled the following criteria: metastatic breast cancer; measurable or evaluable disease, no prior chemotherapy in the metastatic setting; ECOG performance status of 0, 1, or 2: adequate bone marrow and liver function. Patients were treated with 5-FU 250 mg/m2 per day by continuous intravenous infusion for 5 weeks in a 6-week cycle. Treatment was continued until disease progression or unacceptable toxicity. In addition to the traditional endpoints of response, survival, and toxicity, quality of life was assessed with the Functional Living Index-Cancer (FLIC) and the Symptom Distress Scale (SDS). Twenty-one patients were enrolled. Among the 16 patients with measurable disease, the objective response rate was 44% (95% CI 20%, 68%) with CR rate 13% and PR rate 31%. The median duration of response was 37 weeks. Responses were not observed in patients with visceral (lung or liver) disease. Among all 21 patients in the study, the median time to disease progression was 12 weeks, and median overall survival was 64 weeks. Grade 1 or 2 mucosal and cutaneous toxicity were common. Only 4 patients (19%) had toxicity greater than grade 2; three patients had grade 3 mucositis, and 1 patient developed an indwelling catheter infection requiring its removal. Among responding patients, mean FLIC scores improved from 114.3 at baseline to 128.7 at week 8 (p = 0.11). Symptoms reported on the SDS generally improved in responding patients. Continuous infusion 5-FU as a first-line therapy for metastatic breast cancer has moderate activity and low toxicity. Its use should be considered in the first-line setting when toxicity needs to be minimized.

Authors
Chu, L; Sutton, LM; Peterson, BL; Havlin, KA; Winer, EP
MLA Citation
Chu, L, Sutton, LM, Peterson, BL, Havlin, KA, and Winer, EP. "Continuous infusion 5-fluorouracil as first-line therapy for metastatic breast cancer." J Infus Chemother 6.4 (1996): 211-216.
PMID
9229318
Source
pubmed
Published In
The Journal of infusional chemotherapy
Volume
6
Issue
4
Publish Date
1996
Start Page
211
End Page
216

Quality of life after bone marrow transplantation.

Allogeneic and autologous bone marrow transplantation are performed with increasing frequency for a variety of malignancies as well as certain nonmalignant disorders. Physical toxicities associated with treatment are often substantial. Patients may also experience psychological, social, sexual, and vocational difficulties following treatment, which can have an adverse effect on quality of life. This article reviews selected aspects of physical and psychosocial functioning following allogeneic and autologous transplantation and provides recommendations for future quality of life research in the transplant setting.

Authors
Winer, EP; Sutton, LM
MLA Citation
Winer, EP, and Sutton, LM. "Quality of life after bone marrow transplantation." Oncology (Williston Park) 8.1 (January 1994): 19-27. (Review)
PMID
8123445
Source
pubmed
Published In
Oncology
Volume
8
Issue
1
Publish Date
1994
Start Page
19
End Page
27
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