Klein M

Purpose/Rationale: Our Minneapolis VA Healthcare System (MVAHCS) team developed a self-management symptom program using the existing Annie Mobile Messaging System platform that was designed to be userfriendly for Veterans. We are currently determining which patients with advanced cancer might benefit most from the system. Here we describe early results from this program.

Background: Symptom monitoring programs using electronic communications platforms in patients with advanced solid tumors undergoing routine outpatient chemotherapy has resulted in benefits such as improved quality of life, improved survival, and reduced Emergency Room (ER) usage.

Methods: We created a symptom management protocol in conjunction with the Annie Program Team. Patients are sent text messages twice daily Monday through Friday, and they are asked to rate the following symptoms with a severity scale of 0-4 (absent, mild, moderate, severe, or disabling): Nausea/vomiting, mouth sores, fatigue, trouble breathing, appetite, constipation, diarrhea, numbness/tingling, and pain. In addition, patients are asked whether they have had a fever or not. Based on the patient response, the patient receives an automated, corresponding text back. The text may provide positive affirmation that they are doing well, give them education, refer them to an educational hyperlink, ask them to call a direct number to the clinic, or report directly to the ER.

Results: We have currently enrolled 5 patients in the program through screening new patient consults or those referred for chemotherapy education. There have not been any calls to the clinic or visits to the ER to date. Initial evaluation of the program via survey found no technology challenges and patients have been very positive about the program, including ease of use, appreciation of messages that validated when they were doing well, empowerment of self-management, and utilization of the texting advice.

Conclusions: Development and introduction of the MVAHCS Mobile Messaging System for Self-Management of Chemotherapy Symptoms has been completed. Early evaluation has not revealed any major concerns. We will continue to introduce this technology to patients undergoing chemotherapy and will further assess the feasibility and efficacy of this novel VA program.

Purpose/Rationale: Our Minneapolis VA Healthcare System (MVAHCS) team developed a self-management symptom program using the existing Annie Mobile Messaging System platform that was designed to be userfriendly for Veterans. We are currently determining which patients with advanced cancer might benefit most from the system. Here we describe early results from this program.

Background: Symptom monitoring programs using electronic communications platforms in patients with advanced solid tumors undergoing routine outpatient chemotherapy has resulted in benefits such as improved quality of life, improved survival, and reduced Emergency Room (ER) usage.

Methods: We created a symptom management protocol in conjunction with the Annie Program Team. Patients are sent text messages twice daily Monday through Friday, and they are asked to rate the following symptoms with a severity scale of 0-4 (absent, mild, moderate, severe, or disabling): Nausea/vomiting, mouth sores, fatigue, trouble breathing, appetite, constipation, diarrhea, numbness/tingling, and pain. In addition, patients are asked whether they have had a fever or not. Based on the patient response, the patient receives an automated, corresponding text back. The text may provide positive affirmation that they are doing well, give them education, refer them to an educational hyperlink, ask them to call a direct number to the clinic, or report directly to the ER.

Results: We have currently enrolled 5 patients in the program through screening new patient consults or those referred for chemotherapy education. There have not been any calls to the clinic or visits to the ER to date. Initial evaluation of the program via survey found no technology challenges and patients have been very positive about the program, including ease of use, appreciation of messages that validated when they were doing well, empowerment of self-management, and utilization of the texting advice.

Conclusions: Development and introduction of the MVAHCS Mobile Messaging System for Self-Management of Chemotherapy Symptoms has been completed. Early evaluation has not revealed any major concerns. We will continue to introduce this technology to patients undergoing chemotherapy and will further assess the feasibility and efficacy of this novel VA program.

Purpose/Rationale: Our Minneapolis VA Healthcare System (MVAHCS) team developed a self-management symptom program using the existing Annie Mobile Messaging System platform that was designed to be userfriendly for Veterans. We are currently determining which patients with advanced cancer might benefit most from the system. Here we describe early results from this program.

Background: Symptom monitoring programs using electronic communications platforms in patients with advanced solid tumors undergoing routine outpatient chemotherapy has resulted in benefits such as improved quality of life, improved survival, and reduced Emergency Room (ER) usage.

Methods: We created a symptom management protocol in conjunction with the Annie Program Team. Patients are sent text messages twice daily Monday through Friday, and they are asked to rate the following symptoms with a severity scale of 0-4 (absent, mild, moderate, severe, or disabling): Nausea/vomiting, mouth sores, fatigue, trouble breathing, appetite, constipation, diarrhea, numbness/tingling, and pain. In addition, patients are asked whether they have had a fever or not. Based on the patient response, the patient receives an automated, corresponding text back. The text may provide positive affirmation that they are doing well, give them education, refer them to an educational hyperlink, ask them to call a direct number to the clinic, or report directly to the ER.

Results: We have currently enrolled 5 patients in the program through screening new patient consults or those referred for chemotherapy education. There have not been any calls to the clinic or visits to the ER to date. Initial evaluation of the program via survey found no technology challenges and patients have been very positive about the program, including ease of use, appreciation of messages that validated when they were doing well, empowerment of self-management, and utilization of the texting advice.

Conclusions: Development and introduction of the MVAHCS Mobile Messaging System for Self-Management of Chemotherapy Symptoms has been completed. Early evaluation has not revealed any major concerns. We will continue to introduce this technology to patients undergoing chemotherapy and will further assess the feasibility and efficacy of this novel VA program.

Purpose: The purpose of this study is to determine whether CK2 expression may be a biomarker for clinical outcomes in advanced oropharyngeal squamous cell carcinoma.

Background: Elevated protein kinase CK2 protein and activity has correlated with poor clinical outcome in patients with various cancers. CK2 is a serine/threonine kinase that has a broad range of intracellular roles that include regulation of apoptosis and DNA repair. However, the prognostic or predictive value of CK2 has not been studied in HPV-related oropharyngeal squamous cell carcinoma (OPSCC).

Methods: A retrospective cohort study of patients diagnosed with OPSCC from 2005-2015 in the Minneapolis Veterans Affairs Healthcare System was performed. Patient demographic, treatment, and clinical outcome data were collected. Archived tumor tissue blocks were stained for p16 (surrogate for HPV-positivity) and CK2α via immunohistochemistry (IHC). The CK2α IHC stain was scored by two staff pathologists with an ordinal scale of 1 (weak) to 3 (strong).

Data Analysis: X2 test of independence, with the 0.01 level considered significant for observed differences

Results: A total of 116 patients were identified that met inclusion criteria. IHC staining for p16 was positive in 80/116 (69%) patients and negative in 36/116 (31%) patients. Overall survival (OS) and progression-free survival (PFS) at 4 years postdiagnosis for p16-positive tumors (p16+) was 71% and 64%, respectively, while the OS and PFS at 4 years for p16-negative tumors was 36% and 32%, respectively. For CK2 IHC scores 1, 2, and 3, respectively, the OS at 4 years was 31%, 75%, and 65%, respectively, while the PFS for scores 1, 2, and 3 at four years was 32%, 65%, and 53%, respectively. In the CK2 IHC score groups, 1, 2, and 3, respectively, p16 positivity vs. negativity was 26% vs. 74%, 79% vs. 21%, and 89% vs. 11%, respectively.

Implications: High CK2 abundance is associated with higher PFS and OS at 4 years in patients with p16+ OPSCC. Further study is needed better define the relationship between p16 expression and CK2 expression in OPSCC.

Purpose: The purpose of this study is to determine whether CK2 expression may be a biomarker for clinical outcomes in advanced oropharyngeal squamous cell carcinoma.

Background: Elevated protein kinase CK2 protein and activity has correlated with poor clinical outcome in patients with various cancers. CK2 is a serine/threonine kinase that has a broad range of intracellular roles that include regulation of apoptosis and DNA repair. However, the prognostic or predictive value of CK2 has not been studied in HPV-related oropharyngeal squamous cell carcinoma (OPSCC).

Methods: A retrospective cohort study of patients diagnosed with OPSCC from 2005-2015 in the Minneapolis Veterans Affairs Healthcare System was performed. Patient demographic, treatment, and clinical outcome data were collected. Archived tumor tissue blocks were stained for p16 (surrogate for HPV-positivity) and CK2α via immunohistochemistry (IHC). The CK2α IHC stain was scored by two staff pathologists with an ordinal scale of 1 (weak) to 3 (strong).

Data Analysis: X2 test of independence, with the 0.01 level considered significant for observed differences

Results: A total of 116 patients were identified that met inclusion criteria. IHC staining for p16 was positive in 80/116 (69%) patients and negative in 36/116 (31%) patients. Overall survival (OS) and progression-free survival (PFS) at 4 years postdiagnosis for p16-positive tumors (p16+) was 71% and 64%, respectively, while the OS and PFS at 4 years for p16-negative tumors was 36% and 32%, respectively. For CK2 IHC scores 1, 2, and 3, respectively, the OS at 4 years was 31%, 75%, and 65%, respectively, while the PFS for scores 1, 2, and 3 at four years was 32%, 65%, and 53%, respectively. In the CK2 IHC score groups, 1, 2, and 3, respectively, p16 positivity vs. negativity was 26% vs. 74%, 79% vs. 21%, and 89% vs. 11%, respectively.

Implications: High CK2 abundance is associated with higher PFS and OS at 4 years in patients with p16+ OPSCC. Further study is needed better define the relationship between p16 expression and CK2 expression in OPSCC.

Purpose: The purpose of this study is to determine whether CK2 expression may be a biomarker for clinical outcomes in advanced oropharyngeal squamous cell carcinoma.

Background: Elevated protein kinase CK2 protein and activity has correlated with poor clinical outcome in patients with various cancers. CK2 is a serine/threonine kinase that has a broad range of intracellular roles that include regulation of apoptosis and DNA repair. However, the prognostic or predictive value of CK2 has not been studied in HPV-related oropharyngeal squamous cell carcinoma (OPSCC).

Methods: A retrospective cohort study of patients diagnosed with OPSCC from 2005-2015 in the Minneapolis Veterans Affairs Healthcare System was performed. Patient demographic, treatment, and clinical outcome data were collected. Archived tumor tissue blocks were stained for p16 (surrogate for HPV-positivity) and CK2α via immunohistochemistry (IHC). The CK2α IHC stain was scored by two staff pathologists with an ordinal scale of 1 (weak) to 3 (strong).

Data Analysis: X2 test of independence, with the 0.01 level considered significant for observed differences

Results: A total of 116 patients were identified that met inclusion criteria. IHC staining for p16 was positive in 80/116 (69%) patients and negative in 36/116 (31%) patients. Overall survival (OS) and progression-free survival (PFS) at 4 years postdiagnosis for p16-positive tumors (p16+) was 71% and 64%, respectively, while the OS and PFS at 4 years for p16-negative tumors was 36% and 32%, respectively. For CK2 IHC scores 1, 2, and 3, respectively, the OS at 4 years was 31%, 75%, and 65%, respectively, while the PFS for scores 1, 2, and 3 at four years was 32%, 65%, and 53%, respectively. In the CK2 IHC score groups, 1, 2, and 3, respectively, p16 positivity vs. negativity was 26% vs. 74%, 79% vs. 21%, and 89% vs. 11%, respectively.

Implications: High CK2 abundance is associated with higher PFS and OS at 4 years in patients with p16+ OPSCC. Further study is needed better define the relationship between p16 expression and CK2 expression in OPSCC.