Abstract P6-12-11: Feasibility and biomarker modulation due to high levels of moderate to vigorous physical activity as part of a weight loss intervention in older, sedentary, obese breast cancer survivors

Author(s):  
CJ Fabian ◽  
JR Klemp ◽  
JM Burns ◽  
ED Vidoni ◽  
JL Nydegger ◽  
...  
2016 ◽  
Vol 25 (5) ◽  
pp. 1455-1463 ◽  
Author(s):  
Caroline O Terranova ◽  
Sheleigh P Lawler ◽  
Kym Spathonis ◽  
Elizabeth G Eakin ◽  
Marina M Reeves

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12501-e12501
Author(s):  
Christina Marie Dieli-Conwright ◽  
Maura Harrigan ◽  
Brenda Cartmel ◽  
Anees B. Chagpar ◽  
Yalai Bai ◽  
...  

e12501 Background: Weight loss interventions are effective approaches to reduce body weight and alter serum biomarkers in breast cancer survivors, however the impact on breast tissue biomarkers is unknown. The Lifestyle, Exercise and Nutrition (LEAN) study was a randomized trial designed to test the effect of a weight loss intervention on body composition and breast tissue and serum biomarkers. Methods: Fifity-one women with a BMI ³ 25.0 kg/m2 diagnosed with breast cancer, who had completed chemotherapy and/or radiation therapy were randomized to weight loss intervention or usual care. Breast tissue biopsies from the unaffected breast, fasting serum samples, and body composition were measured at baseline and 6-months. Ki67, insulin receptor (IR), CD68 and CD163 were measured by Automated Quantitative Analysis (AQUA) method. Mean baseline to 6-month changes were compared using ANCOVA adjusting for baseline values. Results: Pre- and post-intervention biopsies were conducted in 49 and 42 women respectively, with both pre- and post- epithelial tissue available from 25 women; epithelial tissue was unavailable in the remaining 66 women. Women were 56.8 ± 8.9 years old, diagnosed 3.3 + 3.8 years prior, primarily Stage I breast cancer (54%), with a BMI of 32.8 ± 6.0 kg/m2. At baseline, breast tissue levels of IR were inversely associated with both percent body fat (r = -0.47, p = .03) and serum insulin levels (r = -0.45, p = .04); serum insulin levels were inversely associated with CD68 (r = -0.47, p = .03). Significant between-group biomarker changes are presented in Table 1. At month 6, loss in percent body fat was associated with increased IR (r = -0.42, p = .05). Increased CD68 breast tissue expression was associated with reductions in serum levels of CRP (r = -0.49, p=0.02). There was no significant effect of the intervention on IR expression or Ki67 (p>0.10). Conclusions: Breast tissue biopsies are feasible to collect in a clinical research setting among breast cancer survivors. A 6-month weight loss intervention led to decreased levels of CD163 in breast tissue and serum levels of leptin, and increased serum levels of adiponectin among breast cancer survivors. At baseline and month 6, changes in breast tissue biomarkers were favorably associated with serum biomarkers and body composition. Future confirmation is required to confirm the added benefit of tissue biomarkers beyond serum as an endpoint for lifestyle interventions among breast cancer survivors. Clinical trial information: NCT02110641. [Table: see text]


2018 ◽  
Vol 52 (12) ◽  
pp. 999-1009 ◽  
Author(s):  
Kelly M Kenzik ◽  
Wendy Demark-Wahnefried ◽  
Patricia A Ganz ◽  
Graham Colditz ◽  
Cheryl L Rock ◽  
...  

AbstractBackgroundBreast cancer survivors rank fatigue (e.g., decreased vitality) as their number one concern affecting quality of life. Excess adiposity is associated with decreased vitality in breast cancer survivors, yet weight loss intervention trials report inconsistent effects on this parameter.MethodsThis is a secondary analysis of the Exercise and Nutrition to Enhance Recovery and Good Health for You trial, in which 692 overweight or obese breast cancer survivors ≤5 years from diagnosis, initiated weight loss interventions, and completed assessments semi-annually for 2 years. Assessments included the Godin Leisure-Time Exercise Questionnaire and the SF-36 MOS vitality subscale as an inverse measure of fatigue. Multilevel structural equation models estimated the direct effects of physical activity on vitality and indirect effects through body mass index (BMI) changes.ResultsWithin-person findings show that at assessments with greater physical activity, BMI was significantly lower (B = −0.07, p < 0.001) and vitality was higher (B = 0.22, p < 0.001). However, there was no direct relationship between lower BMI and higher vitality (B = −0.11, p = 0.262) after controlling for the relationship of physical activity with BMI and physical activity with vitality. The between-person indirect effect of physical activity change through BMI change to vitality was significant (B = 0.03, p < 0.001). Participants whose physical activity was above the mean (B = 0.37, p < 0.001) and whose BMI was below the mean (B = −1.05, p < 0.001) were more likely to report greater vitality.ConclusionImprovements in vitality are primarily associated with increases in physical activity rather than BMI changes in this trial. Vitality was lower among survivors with higher BMI, although within-individual changes in BMI had no effect on vitality. Physical activity and weight loss share mechanistic links to vitality with physical activity potentially increasing (e.g., in an additive or synergistic manner) the effect of BMI reduction on vitality.


2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 200-200
Author(s):  
Wilma Kuijpers ◽  
Wim G Groen ◽  
Hester SA Oldenburg ◽  
Michel W.J.M. Wouters ◽  
Neil K Aaronson ◽  
...  

200 Background: MijnAVL is an interactive portal that includes patient education, an overview of appointments, access to the electronic medical record (EMR), patient-reported outcomes plus feedback and physical activity support. The aim of this feasibility study was to evaluate use, satisfaction and preliminary effects among breast cancer survivors. Methods: We included women currently or recently treated for breast cancer with curative intent. At baseline, they completed a questionnaire on sociodemographics, expectations of MijnAVL and three effect measures: patient activation (PAM), quality of life (SF-36), and physical activity (IPAQ). MijnAVL could be used noncommittally for 4 months. Log data were collected retrospectively and participants completed questions on satisfaction and effect measures. This process was conducted twice, to be able to improve MijnAVL iteratively. Results: We included 92 women (mean age 49.5 years, 59% on-treatment). Mean number of logins was 8.7 and mean duration 13.1 minutes. Overview of appointments (80% of participants) and access to the EMR (90%) were most frequently used and most appreciated. Website user satisfaction was rated 3.8 on a 1-5 scale on average and participants were primarily positive about the accessibility of information. We did not find an effect on the PAM. For the SF-36, we found significant improvements on the role functioning – emotional (65.3 to 78.5, p< .01), mental health (69.8 to 76.5, p< .01) and social functioning (71.2 to 80.5, p< .01) domains. Median vigorous physical activity significantly increased from 0 to 360 MET-minutes per week (p< .05); levels of walking and moderate physical activity did not change significantly over time. These effects were not related to the intensity of use of MijnAVL. Conclusions: This study showed that user experiences were positive and that exposure to MijnAVL resulted in improvements on three quality of life domains and vigorous physical activity. More tailored, interactive features might be needed to substantially change empowerment, quality of life and physical activity. Research with a controlled design and possibly a more sensitive measure for patient empowerment are needed to substantiate our findings.


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