The Hammersmith Score Optimises Patient Selection and Predicts for Overall Survival in Early-Phase Cancer Trial Participants Independent of Tumour Burden.

INTRODUCTION: As tumour response rates are increasingly demonstrated in early-phase cancer trials (EPCT), optimal patient selection and accurate prognostication are paramount. Hammersmith Score (HS), a simple prognostic index derived on routine biochemical measures (albumin <35 g/L, lactate dehydrogenase >450 IU/L, sodium <135 mmol/L), is a validated predictor of response and survival in EPCT participants. HS has not been validated in the cancer immunotherapy era. METHODS: We retrospectively analysed characteristics and outcomes of unselected referrals to our early-phase unit (12/2019-12/2022). Independent predictors for overall survival (OS) were identified from univariable and multivariable models. HS was calculated for 66 eligible trial participants and compared with the Royal Marsden Score (RMS) to predict OS. Multivariable logistic regression and C-index was used to compare predictive ability of prognostic models. RESULTS: Of 212 referrals, 147 patients were screened and 82 patients treated in EPCT. Prognostic stratification by HS identifies significant difference in median OS, and HS was confirmed as a multivariable predictor for OS (HR: HS 1 vs. 0 2.51, 95% CI: 1.01-6.24, p = 0.049; HS 2/3 vs. 0: 10.32, 95% CI: 2.15-49.62, p = 0.004; C-index 0.771) with superior multivariable predictive ability than RMS (HR: RMS 2 vs. 0/1 5.46, 95% CI: 1.12-26.57, p = 0.036; RMS 3 vs. 0/1 6.83, 95% CI: 1.15-40.53, p < 0.001; C-index 0.743). CONCLUSIONS: HS is a validated prognostic index for patients with advanced cancer treated in the context of modern EPCTs, independent of tumour burden. HS is a simple, inexpensive prognostic tool to optimise referral for EPCT.

Interaction between mode of learning and subjective experience: translation effects in long-term memory.

It has been suggested that writing auditorily presented words at encoding involves distinctive translation processes between visual and auditory domains, leading to the formation of distinctive memory traces at retrieval. This translation effect leads to higher levels of recognition than the writing of visually presented words, a non-translation effect. The present research investigated whether writing and the other translation effect of vocalisation (vocalising visually presented words) would be present in tests of recall, recognition memory and whether these effects are based on the subjective experience of remembering or knowing. Experiment 1 found a translation effect in the auditory domain in recall, as the translation effect of writing yielded higher recall than both non-translation effects of vocalisation and silently hearing. Experiment 2 found a translation effect in the visual domain in recognition, as the translation effect of vocalisation yielded higher recognition than both non-translation effects of writing and silently reading. This translation effect was attributable to the subjective experience of remembering rather than knowing. The present research therefore demonstrates the beneficial effect of translation in both recall and recognition, with the effect of vocalisation in recognition being based on rich episodic remembering.

Differential facilitative effects of glucose administration on Stroop task conditions.

Previous research has demonstrated that glucose administration improves memory performance. These glucose facilitation effects have been most reliably demonstrated in medial temporal lobe tasks with the greatest effects found for cognitively demanding tasks. The aim of the proposed research was to first explore whether such effects might be demonstrated in a frontal lobe task. A second aim was to investigate whether any beneficial effects of glucose may arise more prominently under tasks of increasing cognitive demand. To achieve these aims, the Stroop Task was administered to participants and effects of a drink of glucose (25 g) were compared with an aspartame-sweetened control drink on performance in young adults. Results demonstrated that glucose ingestion significantly reduced RTs in the congruent and incongruent conditions. No effect on error rates was observed. Of most importance was the finding that this glucose facilitative effect was significantly greatest in the most cognitively demanding task, that is, the incongruent condition. The present results support the contention that the glucose facilitation effect is most robust under conditions of enhanced task difficulty and demonstrate that such benefits extend to frontal lobe function.