Grant Number:	4R00CA286967-03 Interpret this number
Primary Investigator:	Harris, Carolyn
Organization:	University Of California, San Francisco
Project Title:	Characterization of the Symptom Experience of Patients with Cutaneous Melanoma Receiving Immune Checkpoint Inhibitor Therapy
Fiscal Year:	2025

PROJECT SUMMARY/ABSTRACT The psychological symptom cluster is a common problem that impacts women receiving breast cancer treatment and is associated with several negative outcomes, including reduced functional status and quality of life. Unfortunately, the mechanism(s) that underlie this cluster are unknown which limits the development of targeted interventions. Mounting evidence suggests that individual (e.g., age, education) and community-level determinants of health (e.g., neighborhood deprivation, pollution) increase psychological symptoms in women with breast cancer. While exercise can improve psychological symptoms in women with breast cancer, it is unknown if individual or community-level factors impact this relationship. Given that exercise, individual, and community-level factors can alter DNA methylation, evaluation of epigenetic regulation may provide new mechanistic insights. Investigation into the epigenomic, individual, and community-level factors associated with a psychological symptom cluster in women with breast cancer within the context of a randomized clinical trial for a moderate-intensity aerobic exercise intervention will clarify these relationships and inform the development of targeted interventions. The overarching goal of this research is to alleviate symptoms in cancer patients, which is a research priority of the NCI’s Division of Cancer Prevention. The aims of the K99 study are to (1) test the hypotheses that epigenomic, individual, and community-level factors are associated with psychological symptom cluster severity profiles in women with breast cancer prior to the start of aromatase inhibitor therapy; and (2) test the hypotheses that epigenomic, individual, and community-level factors are associated with worsening psychological symptom cluster severity profiles following six months of aromatase inhibitor therapy in women with breast cancer, while exercise and epigenomic factors mitigate this effect. The candidate will extend this line of research to immunotherapy, which is rapidly emerging as an adjuvant therapy for breast cancer. The detailed training plan, exceptional team of mentors, and research-intensive environment of the University of Pittsburgh will provide the candidate with the mentored training, support, and research experience needed to conduct this research. Through this training plan, the candidate will develop: proficiency in epigenomics; competency in analysis and bioinformatics of longitudinal epigenomic data; proficiency in the evaluation of social determinants of health in symptom science; expertise in the mechanisms of immunotherapy-related symptoms; and knowledge and skills for professional career development. The aims of the R00 study are to: (1) identify symptom cluster profiles of women with breast cancer receiving immunotherapy over time; and (2) evaluate for epigenomic, individual, interpersonal, community, and societal- level factors associated with symptom cluster severity profiles of women with breast cancer receiving immunotherapy over time. Findings from these projects will provide new knowledge to guide clinical assessment and the development of targeted interventions to mitigate the severity common symptom clusters.




Study Protocol to Characterize Symptom Experience During Immune Checkpoint Inhibitor Therapy for Cutaneous Melanoma.
Authors: Harris C.S. , Tsai K.K. , Liu L. , Oppegaard K.R. , Cooper B.A. , Paul S.M. , Hubbard E.M. , Levine J.D. , Miaskowski C.A. .
Source: Nursing Research, 2026-06-02 00:00:00.0; , .
EPub date: 2026-06-02 00:00:00.0.
PMID: 42228432
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Associations Between Potassium Channel Genes and the Occurrence of Palpitations in Women Prior to Breast Cancer Surgery.
Authors: Sheng Y. , Fleming M.R. , Harris C.J. , Levine J.D. , Paul S.M. , Carpenter J.S. , Conley Y.P. , Shin J. , Oppegaard K. , Hammer M.J. , et al. .
Source: Seminars In Oncology Nursing, 2025 Dec; 41(6), p. 152039.
EPub date: 2025-10-15 00:00:00.0.
PMID: 41102034
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Cytokine-Cytokine Receptor Interaction and Endocytosis are Common Pathways for Symptom Burden and Sickness Behavior Symptoms in Oncology Patients Undergoing Chemotherapy.
Authors: Harris C.S. , Kober K.M. , Shin J. , Morse L. , Oppegaard K.R. , Paul S. , Hammer M.J. , Levine J.D. , Conley Y.P. , Miaskowski C.A. .
Source: Cancer Medicine, 2025 Nov; 14(21), p. e71328.
PMID: 41217992
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Advancing Global Cancer Symptom Science: Insights and Strategies From the Inaugural Cancer Symptom Science Expert Meeting.
Authors: Colomer-Lahiguera S. , Pozzar R.A. , Harris C.S. , Brant J.M. , Conley Y.P. , Cooley M.E. , Eicher M. , Hinds P.S. , Howell D. , Mitchell S.A. , et al. .
Source: Oncology Nursing Forum, 2025-08-18 00:00:00.0; 52(5), p. 331-350.
PMID: 40849926
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Greater Symptom Burden and Poorer Quality of Life Outcomes Are Associated With The Co-Occurrence of Anxiety and Depression During Cancer Chemotherapy.
Authors: Calvo-Schimmel A. , Hammer M.J. , Conley Y.P. , Paul S.M. , Cooper B.A. , Shin J. , Harris C. , Morse L. , Levine J.D. , Miaskowski C. .
Source: Seminars In Oncology Nursing, 2025 Apr; 41(2), p. 151809.
EPub date: 2025-02-13 00:00:00.0.
PMID: 39952817
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Perturbations in the neuroactive ligand-receptor interaction and renin angiotensin system pathways are associated with cancer-related cognitive impairment.
Authors: Chan R.J. , Walker A. , Vardy J. , Chan A. , Oppegaard K. , Conley Y.P. , Paul S.M. , Kober K.M. , Harris C. , Shin J. , et al. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2025-03-06 00:00:00.0; 33(4), p. 254.
EPub date: 2025-03-06 00:00:00.0.
PMID: 40047999
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Self-reported cancer-related cognitive impairment is associated with perturbed neurotransmission pathways.
Authors: Oppegaard K.R. , Conley Y.P. , Paul S. , Cooper B. , Harris C.S. , Shin J. , Morse L. , Levine J.D. , Cartwright F. , Roy R. , et al. .
Source: Journal Of Neural Transmission (vienna, Austria : 1996), 2025 Feb; 132(2), p. 275-286.
EPub date: 2024-09-26 00:00:00.0.
PMID: 39325169
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Impact of Multimorbidity on Symptom Burden and Symptom Clusters in Patients Receiving Chemotherapy.
Authors: Harris C. , Hammer M.J. , Conley Y.P. , Paul S.M. , Cooper B.A. , Shin J. , Oppegaard K. , Morse L. , Levine J.D. , Miaskowski C. .
Source: Cancer Medicine, 2025 Feb; 14(3), p. e70418.
PMID: 39910913
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Associations Between Preoperative Shortness of Breath and Potassium Channels Gene Variations in Women With Breast Cancer.
Authors: Shin J. , Hammer M.J. , Paul S.M. , Conley Y.P. , Harris C. , Oppegaard K. , Morse L. , Cooper B.A. , Levine J.D. , Miaskowski C. .
Source: Biological Research For Nursing, 2025 Jan; 27(1), p. 81-90.
EPub date: 2024-08-13 00:00:00.0.
PMID: 39137431
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Psychological Symptom Cluster Severity Profiles Are Associated With Higher Levels of Stress and Worse Quality of Life in Postmenopausal Women With Breast Cancer.
Authors: Harris C.S. , Conley Y.P. , Rosenzweig M.Q. , Erickson K.I. , Cooper B.A. , Bender C.M. .
Source: Cancer Nursing, 2024-12-02 00:00:00.0; , .
EPub date: 2024-12-02 00:00:00.0.
PMID: 39625825
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