Interventions that may reduce depressive symptoms among prostate cancer patients: a systematic review and meta-analysis.

OBJECTIVE: Prostate cancer patients are at increased risk of depression yet there is no standard intervention to address this. The purpose of this meta-analysis is to examine the efficacy of interventions in reducing depressive symptoms in men with prostate cancer. METHODS: Searches for studies were conducted in four databases and by hand. Randomized controlled trials of any intervention relative to control for depression in prostate cancer patients at any stage of their cancer treatment were included. RESULTS: We identified 11 studies that randomized men with prostate cancer to either an intervention meant to improve some aspect of quality of life or control and reported depressive symptoms scores before and after the intervention or control condition. Two of these were not used in our meta-analysis either for concerns about quality or for lack of depression scores. The interventions identified in the remaining nine articles were exercise (four), information (three), psychotherapy or peer support (three), massage therapy (one), and medication (one). Several publications included more than one type of intervention. A meta-analysis of all studies showed that an intervention of some types significantly improved depressive symptom scores relative to the control condition (improvement in depression score by -0.86 unit (95% CI: -1.42, -0.31)). Isolating the peer support/psychotherapy studies also showed significant improvement (improvement in depression score by -1.09 unit (95% CI: -2.05, -0.13)). CONCLUSION: Treatments to improve depressive symptoms in men with prostate cancer may be effective, with the best evidence supporting the use of peer support/psychotherapy.

Feasibility, acceptability and findings from a pilot randomized controlled intervention study on the impact of a book designed to inform patients about cancer clinical trials.

This study was conducted to assess the feasibility, acceptability, and changes in knowledge among cancer patients assigned to receive a 160-page book on experimental cancer therapies and clinical trials. We enrolled 20 patients with cancer who had never participated in a clinical trial and randomly assigned them to receive the book either during week 1 or week 4 of the study. We collected baseline patient demographic and cancer-related information as well as knowledge about cancer clinical trials at week 0. Follow-up surveys were administered at weeks 3 and 6 for both study groups. Comparisons were made within and between groups randomized to receive the book early (at week 1) to those who received it later (at week 4). One hundred percent of data were captured in both groups at baseline, which decreased to 77.8% by week 6. The vast majority of participants found the book moderately or very useful (89% in the Early Group at week 3 and 95.5% in the Late Group at week 6). Within group pairwise comparisons found significant difference between baseline and week 6 in content-specific knowledge scores among participants in the Late Group [79% versus 92.1%, p = 0.01). Global knowledge scores increased significantly for variables reflecting knowledge that promotes decisions to participate in clinical trials. Providing published reading material to patients with cancer is both feasible and acceptable. Offering information to patients about cancer clinical trials, using a book designed for patients with cancer may influence knowledge related to decision to participate in clinical trials.

Novice Instructional Designers' Attitudes towards the Best Possible Self Activity and the Correlation with Personality and Subjective Well-Being.

The effectiveness of positive psychology interventions relies heavily on participants' buy-in and personality traits. The Best Possible Self (BPS) intervention asks participants to envision their ideal future, supposing that everything goes smoothly. The BPS shows salient effects in improving subjective well-being in laboratory settings. In this study, the BPS was integrated into a real-world graduate-level online course as a series of assignments. A convergent mixed method was used to explore the participants' attitudes towards the BPS and the relationship between their personality and subjective well-being. A total of 86 students registered in both the summer and spring semesters of 2020 participated in this study. Pearson correlation results show significant correlations among attitudes, subjective well-being and gains and openness to experience. The results from open-ended questions confirmed participants' positive attitudes towards the BPS. This study contributes to the practical application of BPS in real-world, online, higher education courses.

Effect of Best Possible Self Writing Activities on Preservice Teachers' Attitudes towards Technology Integration.

Preservice teachers' attitudes towards technology integration influence their motivation for and future behavior in teaching, but effective interventions to modify attitudes towards technology integration are scarce in teacher education programs. This quasi-experimental study redesigned and integrated one of the most widely used positive psychology interventions-Best Possible Self (BPS)-for use in a stand-alone technology integration course to measure its effect in improving preservice teachers' attitudes towards technology integration. While results show no statistically significant difference between the control and treatment groups, the treatment group had more positive trends (significant increase in positive attitudes) than the control group (no significant increase in positive attitudes) even under the negative influence of pandemic. The results of this study suggest a need for continued development of and research on this type of activity.

No Impact? Long-Term Effects of Applying the Best Possible Self Intervention in a Real-World Undergraduate Classroom Setting.

Positive psychology interventions (PPIs) improve students' well-being in laboratory settings. Best possible self (BPS) is one of the most widely used PPIs shown in the laboratory to effectively improve participants' well-being in both the short- and long-term, but limited research has been conducted in real-world contexts. This study applied BPS in an undergraduate classroom to examine its long-term effects. Students enrolled in an undergraduate education course were assigned to treatment and control groups. Three writing activities and four tests were integrated into the course as assignments in both groups. Data were analyzed using a 2 × 3 (group and time) mixed ANOVA. The results indicate that BPS did not significantly improve the participants' well-being over time compared with the control group. In fact, the control group performed better than treatment at one month after the intervention. This aligns with recent findings of well-being during COVID-19. Potential implications and areas for future research are discussed.

Phase II Study of Ipilimumab in Men With Metastatic Prostate Cancer With an Incomplete Response to Androgen Deprivation Therapy.

Background: Phase 3 studies of immune checkpoint inhibitors have not shown a survival benefit in prostate cancer, but some patients have a profound anticancer response. Patients and Methods: We evaluated the efficacy of the CTLA-4 targeted agent, ipilimumab, in metastatic prostate cancer patients who had an incomplete biochemical response to initial androgen deprivation therapy (ADT) alone. Ten patients were enrolled, each treated with ipilimumab 10 mg/kg (every 3 weeks for up to 4 doses) with maintenance ipilimumab every 12 weeks for non-progressing patients. The primary endpoint was proportion of patients with an undetectable PSA. The total sample size was 30 patients, but there was an interim analysis planned at 10 for futility. If none of the 10 patients achieved an undetectable PSA, the study would be halted. Results: The study was halted at the interim analysis as none of the 10 patients achieved the primary endpoint, but 30% of patients demonstrated a >50% reduction in PSA, with one patient achieving a >90% reduction in PSA. Peripheral blood mononuclear cells (PBMC) examined by mass cytometry showed that patients with clinical responses had an increase in effector memory T-cell subsets as well as an increase in T-cell expression of T-bet, suggesting induction of a Th1 response. Conclusions: This study provides further evidence that ipilimumab has activity in some patients with prostate cancer and provides further rationale for the development of future studies aimed at identifying a subset of patients with CPRC that are more likely to derive a benefit from treatment with ipilimumab. Implications for Practice: There is insufficient evidence to use ipilimumab in prostate cancer in routine practice. Trial Registration: ClinicalTrials.gov, NCT01498978. Registered 26 December 2011. https://www.clinicaltrials.gov/ct2/show/NCT01498978?term=julie+graff&rank=3.

Androgen receptor amplification is concordant between circulating tumor cells and biopsies from men undergoing treatment for metastatic castration resistant prostate cancer.

Increased AR activity has been shown to be preserved in spatially distinct metastatic tumors from the same patient suggesting the requirement for lineage-specific dependencies for metastatic castration resistant prostate cancer (mCRPC). Amplification of the AR gene is a common mechanism by which mCRPC increase AR activity. To determine whether AR amplification in circulating tumor cells (CTC) could complement metastatic tissue biopsies in men undergoing treatment for mCRPC, we developed a novel two-step assay to isolate CTCs and subsequently analyzed AR amplification status in CTCs and matched biopsy tissue from the same patient by fluorescence in situ hybridization (FISH). AR gene status in CTCs showed strong concordance with AR gene status in matched tissue samples in 24 of 25 patients (Correlation: 96%; Kappa: 0.83; Sensitivity: 100%, Specificity: 83%). Our work demonstrates that AR amplification is conserved between CTCs and biopsies and that CTCs can serve as non-invasive surrogate to document AR amplification in mCRPC.