Impact of taxanes on weight gain during neoadjuvant chemotherapy (Ctx) for breast cancer (BC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10606-10606
Author(s):  
M. E. Melisko ◽  
C. A. Millerick ◽  
P. Maniar ◽  
D. Moore ◽  
M. Rosenwein ◽  
...  
Keyword(s):  
Weight Gain ◽  
Weight Change ◽  
Cox Regression ◽  
Menopausal Status ◽  
Baseline Body Mass Index ◽  
Risk Of Recurrence ◽  
Increased Risk ◽  
Taxane Chemotherapy ◽  
The Impact

10606 Background: Weight gain after the diagnosis of BC has been associated with increased risk of recurrence and mortality. Previous studies have documented weight gain after cyclophosphamide, methotrexate, and 5-fluoruracil (CMF) and adriamycin and cyclophosphamide (AC) chemotherapy, but the impact of taxane chemotherapy has not been described. Methods: We reviewed the charts of 119 patients (pts) who completed neoadjuvant Ctx between 1997–2005. Age, baseline body mass index (BMI), tumor size, nodal status, hormone receptor status, menopausal status, co-morbid illnesses and anti-depressant use were collected. Weight was recorded at each Ctx visit and at follow-up visits for two years. Results: 22 pts received AC only. 97 pts received AC followed by a taxane - 58 docetaxel (D), 39 paclitaxel (P). Median f/u time was 26.3 months. 66/119 (55%) of pts gained weight during Ctx, with a median change of + 1 pound (range -28 to +19.5 pounds) at the end of Ctx. 49/119 (41%) of pts gained weight during AC and 76/97 (78%) of pts gained weight during the taxane. Mean weight change after AC was -1.8 pounds compared to +3.2 pounds after the taxane (p < 0.001). Age, baseline BMI, and menopausal status prior to Ctx did not predict weight gain. There was no difference in weight gain between pts who received D vs. P (p = 0.19). 8/22 (36%) patients who received AC alone recurred, and 13/95 (14%) who received both AC and T recurred; however this was not statistically significant (p = 0.23). Total weight change during neoadjuvant Ctx did not predict recurrence; however weight gain during the AC portion was associated with a higher risk of recurrence when adjusted for weight gain during taxane Ctx (p = 0.035, Cox regression). Each one pound gained was associated with an 11% increase in risk of recurrence. Conclusions: Weight gain is common during neoadjuvant Ctx for BC, particulary during treatment with taxanes. Further follow up is required to establish if weight gain is maintained over time and to determine the impact of weight change on BC outcomes and health. No significant financial relationships to disclose.

scholarly journals Weight change and risk of cardiovascular disease among adults with type 2 diabetes: more than 14 years of follow-up in the Tehran Lipid and Glucose Study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Seyyed Saeed Moazzeni ◽  
Reyhane Hizomi Arani ◽  
Niloofar Deravi ◽  
Mitra Hasheminia ◽  
Davood Khalili ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Weight Gain ◽  
Weight Change ◽  
P Value ◽  
Increased Risk ◽  
History Of ◽  
The Impact

Abstract Background To examine the impact of weight change on incident cardiovascular disease and coronary heart disease (CVD/CHD) among an Iranian population with type 2 diabetes mellitus (T2DM). Methods The study population included 763 participants with T2DM aged ≥ 30 years without a history of CVD and cancer at baseline. Two weight measurements done at baseline and about 3 years later. Based on their weight change, they categorized into: > 5% loss, 3–5% loss, stable (± < 3%), 3–5% gain, > 5% gain. Participants were then followed for incident CVD/CHD annually up to 20 March 2018. Multivariable Cox proportional hazard models, adjusted for age, sex, body mass index, educational level, current smoking, glucose-lowering drug use, family history of CVD, hypertension, hypercholesterolemia, chronic kidney disease, and fasting plasma glucose (FPG) were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of weight change categories for incident CVD/CHD, considering stable weight as reference. Results After the weight change measurement, during a median follow-up of 14.4 years, 258 CVD and 214 CHD occurred. Over 5% weight gain was associated with reduced risks of CVD and CHD development by the HRs of 0.70 [95% CI 0.48–1.01; P-value: 0.058] and 0.61 [0.40–0.93], respectively, in multivariable analysis. After further adjustment for FPG change, the HRs of weight gain > 5% were attenuated to 0.75 [0.51–1.10; P-value: 0.138] and 0.66 [043–1.01; P-value: 0.053] for incident CVD and CHD, respectively. The effect of weight loss > 5% was in opposite direction among those older versus younger than 60 years; with suggestive increased risk (not statistically significant) of incident CHD/CVD for the older group. Moreover, weight gain > 5% significantly reduced the risk of CHD only among those older than 60 years (P-value for interaction < 0.2). Furthermore, weight gain > 5% had an association with lower risk of CVD and CHD among sulfonylurea users (0.56 [0.32–0.98] for CVD and 0.54 [0.29–0.99] for CHD). Conclusions Our results with a long-term follow-up showed that weight gain > 5% was associated with better CVD/CHD outcomes among Iranian participants with T2DM, especially older ones. Moreover, we did not find an unfavorable impact on incident CVD/CHD for sulfonylurea-induced weight gain.

scholarly journals The Risks of Cardiovascular Disease and Mortality Following Weight Change in Adults with Diabetes: Results from ADVANCE

2019 ◽  
Vol 105 (1) ◽  
pp. 152-162 ◽  
Author(s):  
Alexandra K Lee ◽  
Mark Woodward ◽  
Dan Wang ◽  
Toshiaki Ohkuma ◽  
Bethany Warren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Change ◽  
Cox Regression ◽  
Lifestyle Changes ◽  
Baseline Body Mass Index ◽  
Diabetes Medication ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Context Weight loss is strongly recommended for overweight and obese adults with type 2 diabetes. Unintentional weight loss is associated with increased risk of all-cause mortality, but few studies have examined its association with cardiovascular outcomes in patients with diabetes. Objective To evaluate 2-year weight change and subsequent risk of cardiovascular events and mortality in established type 2 diabetes. Design and Setting The Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation was an international, multisite 2×2 factorial trial of intensive glucose control and blood pressure control. We examined 5 categories of 2-year weight change: &gt;10% loss, 4% to 10% loss, stable (±&lt;4%), 4% to 10% gain, and &gt;10% gain. We used Cox regression with follow-up time starting at 2 years, adjusting for intervention arm, demographics, cardiovascular risk factors, and diabetes medication use from the 2-year visit. Results Among 10 081 participants with valid weight measurements, average age was 66 years. By the 2-year examination, 4.3% had &gt;10% weight loss, 18.4% had 4% to 10% weight loss, and 5.3% had &gt;10% weight gain. Over the following 3 years of the trial, &gt;10% weight loss was strongly associated with major macrovascular events (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.26-2.44), cardiovascular mortality (HR, 2.76; 95% CI, 1.87-4.09), all-cause mortality (HR, 2.79; 95% CI, 2.10-3.71), but not major microvascular events (HR, 0.91; 95% CI, 0.61-1.36), compared with stable weight. There was no evidence of effect modification by baseline body mass index, age, or type of diabetes medication. Conclusions In the absence of substantial lifestyle changes, weight loss may be a warning sign of poor health meriting further workup in patients with type 2 diabetes.

scholarly journals The Impact of a Long-Term Rivastigmine and Donepezil Treatment on All-Cause Mortality in Patients With Alzheimer’s Disease

2018 ◽  
Vol 33 (6) ◽  
pp. 385-393 ◽  
Author(s):  
Jakub Kazmierski ◽  
Chaido Messini-Zachou ◽  
Mara Gkioka ◽  
Magda Tsolaki
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cox Regression ◽  
Symptomatic Treatment ◽  
Risk Of Death ◽  
Increased Risk ◽  
Functional Assessments ◽  
The Impact

Cholinesterase inhibitors (ChEIs) are the mainstays of symptomatic treatment of Alzheimer’s disease (AD); however, their efficacy is limited, and their use was associated with deaths in some groups of patients. The aim of the current study was to assess the impact of the long-term use of ChEIs on mortality in patients with AD. This observational, longitudinal study included 1171 adult patients with a diagnosis of AD treated with donepezil or rivastigmine. Each patient was observed for 24 months or until death. The cognitive and functional assessments, the use of ChEIs, memantine, antipsychotics, antidepressants, and anxiolytics were recorded. The total number of deaths at the end of the observational period was 99 (8.45%). The patients who had received rivastigmine treatment were at an increased risk of death in the follow-up period. The higher risk of death in the rivastigmine group remained significant in multivariate Cox regression models.

The weight change impact on metabolic syndrome: a 17-year follow-up study

Open Medicine ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. 788-794 ◽  
Author(s):  
Magdalena Kwaśniewska ◽  
Dorota Kaleta ◽  
Anna Jegier ◽  
Tomasz Kostka ◽  
Elżbieta Dziankowska-Zaborszczyk ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Metabolic Risk ◽  
Adjusted Relative Risk ◽  
Prospective Longitudinal ◽  
The Impact

AbstractIntroduction: Data on long-term patterns of weight change in relation to the development of metabolic syndrome (MetS) are scarce. The aim of the study was to evaluate the impact of weight change on the risk of MetS in men. Material and Methods: Prospective longitudinal observation (17.9 ± 8.1 years) of apparently healthy 324 men aged 18–64 years. Metabolic risk was assessed in weight gain (⩾ 2.5 kg), stable weight (> −2.5 kg and < 2.5 kg) and weight loss (⩽ −2.5 kg) groups. Adjusted relative risk (RR) of MetS was analyzed using multivariate logistic regression. Results: The prevalence of MetS over follow-up was 22.5%. There was a strong relationship between weight gain and worsening of MetS components among baseline overweight men. Long-term increase in weight was most strongly related with the risk of abdominal obesity (RR=7.26; 95% CI 2.98–18.98), regardless of baseline body mass index (BMI). Weight loss was protective against most metabolic disorders. Leisure-time physical activity (LTPA) with energy expenditure > 2000 metabolic equivalent/min/week was associated with a significantly lower risk of MetS. Conclusions: Reducing weight among overweight and maintaining stable weight among normal-weight men lower the risk of MetS. High LTPA level may additionally decrease the metabolic risk regardless of BMI.

scholarly journals Anemia and the use of antihypertensive medications in hemodialysis patients: multicenter retrospective observational study

2019 ◽  
pp. 29-38
Author(s):  
N. Stepanova ◽  
V. Novakivskyy ◽  
L. Snisar ◽  
M. Kutsenko
Keyword(s):  
Observational Study ◽  
Cox Regression ◽  
Erythropoietin Receptor ◽  
Retrospective Observational Study ◽  
Antihypertensive Medications ◽  
Increased Risk ◽  
Interest Statement ◽  
The Impact ◽  
Anemia Treatment

Abstract. We hypothesized that the use of antihypertensive medications in patients treated by hemodialysis (HD) may interfere with the activity of erythropoietin and leads to an increase in the dose of erythropoiesis stimulating agents (ESAs). The aim of our study was to analyze the impact of antihypertensive medications on the effectiveness of anemia treatment. Methods. We conducted a multicenter retrospective observational study. The archival medical data from 379 patients treated by HD or hemodiafiltration (HDF) were used. The medical records of 142 patients were excluded from the study. The study group consisted of 237 patients: 108 (45.6%) women and 129 (54.4%) men, with an average age of 54 [41-62.5] years. Results. The analysis of the mean hemoglobin (Hb) stratified by the administration of antihypertensive medications in the dynamics of dialysis treatment demonstrated a significant impact of angiotensin-converting enzyme (ACE) inhibitors (F = 3.97; p = 0.048) and amlodipine (F = 6.9; p = 0.01) on the effectiveness of anemia correction. The significant effect of amlodipine on the need to increase the dosage of iron-containing medications (OR = 3.9; 95% CI (1.27-12.06), p = 0.002; RR = 1.9 95% CI (1.27-2.9) and continuous erythropoietin receptor activator (CERA) (OR = 5.2, 95% CI (1.2-24.4), p = 0.03; RR = 1.3 95% CI (1, 08-1.6), p = 0.006) weas showed by logistic regression analysis. The increased risk of failure to achieve of the target Hb level in HD patients received amlodipine was confirmed by Cox regression model (HR = 2.7 (95% CI 1.5-4.7)). Conclusions: The results of our study demonstrated a significant increase in the frequency of appointment and amount of anti-anemia therapy in HD patients when amlodipine is co-administered. Follow-up studies to determine the effect of amlodipine mechanism for anemia will avoid unreasonable prescriptions for the treatment of НD patients. Conflict of interest statement: the authors declared no competing interests.

scholarly journals Hospitalizations in patients with idiopathic pulmonary fibrosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hyun J. Kim ◽  
Laurie D. Snyder ◽  
Ayodeji Adegunsoye ◽  
Megan L. Neely ◽  
Shaun Bender ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cox Regression ◽  
Ventilatory Support ◽  
Patient Characteristics ◽  
Risk Of Mortality ◽  
Point Increase ◽  
Increased Risk ◽  
The Impact

Abstract Background Hospitalizations are common among patients with idiopathic pulmonary fibrosis (IPF). We investigated the impact of hospitalizations on outcomes in patients with IPF. Methods The IPF-PRO Registry is an observational US registry that enrolled patients with IPF that was diagnosed or confirmed at the enrolling center in the previous 6 months. Associations between patient characteristics and hospitalization, and between hospitalization and mortality, were analyzed using Cox regression models. Results A total of 1002 patients with IPF were enrolled into the IPF-PRO Registry. Over a median follow-up time of 23.7 months (maximum: 67.0 months), 568 patients (56.7%) had at least one hospitalization. Of these patients, 319 (56.2%) had at least one respiratory-related hospitalization and 120 (21.1%) had at least one hospitalization with ventilatory support. Younger age (HR 0.68 [95% CI 0.55, 0.84] per 5-year increase for patients < 62 years), lower BMI (0.96 [0.93, 0.98] per 1-point increase), lower FVC % predicted (0.90 [0.83, 0.97] per 10% increase), oxygen use at rest (2.85 [2.18, 3.72]) and history of pulmonary hypertension (2.02 [1.37, 2.96]) at enrollment were associated with an increased risk of respiratory-related hospitalization during follow-up. In a multivariable model, there was an eightfold increase in the risk of mortality during hospitalization or within 90 days of discharge compared with outside of this period. The risk of mortality associated with a respiratory hospitalization or a hospitalization with ventilatory support was even greater. Conclusions Data from the IPF-PRO Registry demonstrate that hospitalizations are common among patients with IPF. The risk of mortality during hospitalization or within 90 days of discharge was high, particularly among patients who were hospitalized for a respiratory cause or received ventilatory support. Trial registration ClinicalTrials.gov, NCT01915511. Registered 5 August 2013, https://clinicaltrials.gov/ct2/show/NCT01915511

The tumor microenvironment in EGFR-driven loco-regional lung adenocarcinoma can predict higher risk of recurrence.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8521-8521
Author(s):  
Maya Khalil ◽  
Ahmed Elkhanany ◽  
Yuanquan Yang ◽  
Sean Glenn ◽  
Antonios Papanicolau-Sengos ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Lung Adenocarcinoma ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Egfr Mutations ◽  
Risk Of Recurrence ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact ◽  
Egfr Mutated

8521 Background: The role of EGFR tyrosine kinase inhibitors (TKIs) as adjuvant therapy in EGFR-mutated NSCLC is still controversial. Identifying biomarkers associated with increased risk of recurrence may help stratify pts & guide adjuvant therapy. We hypothesized that tumor immune microenvironment (TME) alterations could predict disease-free survival (DFS) in these pts. Methods: The Cancer Genome Atlas (TCGA) lung Adenocarcinoma (LUAD) data at Genomic Data Common (GDC) was accessed for pt phenotype, updated outcome & normalized gene expression profile (RNA seq). Immune landscape data was obtained from PANCAN. We chose to focus on 54 key TME genes, identified from a commercially available immune report card from OmniSeq (Inc.). Pt groups were divided via K-mean clustering. Group comparison was done via Likelihood Ratio (LR, categorical), Mann Whitney (continuous), log-rank (survival) & Cox regression (outcome). Bonferroni correction was used to correct for multiple comparisons. Results: 877 pts with LUAD were identified, 32 of whom had EGFR mutations and were at stages I to III. The mutations were mostly in the TK domain, involving exons 18 (12%), 19 (27%), 20 (6%), & 21 (33%). Only 3% harbored the T790M mutation. None of the pts received adjuvant TKI. Analysis of the impact of individual genes on DFS yielded a group of 8 genes whose high expression was associated with improved DFS: IL10 (HR 0.58, p 0.029), BTLA (HR 0.66, p 0.07), CD8A (HR 0.6252, p 0.099), CD39 (HR 0.454, p 0.037), CCR2 (HR 0.729, p 0.039), CSF1R (HR 0.70, p 0.087), ICOS (HR 0.66, p 0.062), & CD4 (HR 0.67, p 0.059). K-mean clustering of the pts using these genes demonstrated 2 groups with distinct immune profiles. Group 1 was characterized by higher leukocyte and stromal fractions, lymphocyte infiltration score, macrophage regulation, TGF-ß response, & T cell richness with less proliferation, pointing towards a more “inflamed” phenotype. Significant difference between the two groups in the immune subtypes was found (LR 10, p = 0.039). 90% of pts in the inflamed group had tumors with IFN-γ dominant, inflammatory, and TGF-ß dominant subtypes, while 45% of the “non-inflamed” group had lymphocyte depleted & wound healing signatures. DFS was significantly longer in the inflamed group (median DFS 1480 vs 772 days, p = 0.002). Conclusions: In pts with resected EGFR-mutated LUAD, an inflamed TME is associated with prolonged DFS. Identifying these pts may help select those who would benefit from adjuvant therapy.

The impact of diabetes and obesity on endometrial cancer outcomes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5523-5523
Author(s):  
Emily Meichun Ko ◽  
Paige Walter ◽  
Leslie Horn Clark ◽  
Amanda Lynn Jackson ◽  
Jason Franasiak ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Cox Regression ◽  
Clear Cell ◽  
Obese Women ◽  
Cancer Outcomes ◽  
Risk Of Recurrence ◽  
Similar Clinical Outcome ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

5523 Background: Diabetes (DM) is a known risk factor for endometrial cancer (EC), yet its effect on cancer outcomes remains unclear. We sought to investigate of the relationship between DM, obesity, and anti-diabetic medication on EC recurrence and survival. Methods: An IRB approved multi-institution retrospective study included all EC patients diagnosed with carcinosarcoma as well as endometrioid, serous, and clear cell cancers between January 2005 to December 2010. Demographics, comorbidities, and medications were captured at the time of cancer diagnosis. Cohorts for comparison included women with and without DM; and diabetics treated with metformin-only (METFO) were compared to those not treated with METFO. Cox regression models were used to evaluate the effect of selected covariates on PFS and OS. Results: Of 1495 EC patients, 364 (24%) had DM. Diabetics were more likely to be African American (30 v 16%, p<0.0001) and have higher BMIs (median 37.0 v 31.2, p < 0.001). After adjusting for age, race, stage, and BMI, women with DM had a worse OS (HR 1.40, 95CI 1.03-1.79), but similar recurrence risk (HR 1.16, 95CI 0.91-1.48) to non-diabetics. In a subset analysis of women with endometrioid EC (n = 1144), those with DM were 1.6 times more likely to recur (95CI 1.01-1.89, p = 0.04) and 2.4 times more likely to die (95CI 1.6-3.46, p < 0.0001). METFO use was associated with a decreased risk of recurrence (PFS HR 0.54, 95CI 0.3-0.96, p = 0.04), and death (OS HR 0.43, 95CI 0.22-0.83, p = 0.01) compared to no METFO use. METFO users had a similar clinical outcome compared to non-diabetics (PFS HR 1.05, p = 0.82; OS HR 1.3, p = 0.46). Obese women with DM who were treated with non-METFO regimens had a 1.8-fold increased risk of recurrence (95CI 0.94-3.7, p = 0.07) and 2.7-fold increased risk of death (95CI 1.2-5.9, p = 0.01). No survival differences were seen in women with serous, clear cell, or carcinosarcoma. Conclusions: Our data demonstrates worse clinical outcomes for EC patients with DM and improved outcomes for METFO users, suggesting a link between tumor pathogenesis and insulin growth factor and mTOR pathways. Future investigation is required to elucidate the complex relationship between diabetes, anti-hyperglycemic agents, and cancer outcomes.

The impact of weight change during treatment with targeted therapy in patients with metastatic renal cell carcinoma (mRCC).

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 557-557
Author(s):  
Laurence Albiges ◽  
Rana R. McKay ◽  
Xun Lin ◽  
Guillermo de Velasco ◽  
Ronit Simantov ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Weight Change ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Baseline Body Mass Index ◽  
Free Survival ◽  
Management Measures ◽  
Kaplan Meier ◽  
The Impact

557 Background: A growing body of evidence suggests a relationship between baseline body mass index and outcomes in patients (pts) with mRCC. However, the role of weight loss (WL) during treatment in pts with mRCC is poorly characterized. The aim of this study was to investigate the impact of weight change in mRCC pts treated with targeted agents. Methods: We conducted an analysis of mRCC pts treated on phase II-III clinical trials sponsored by Pfizer from 2003-2013. Weight change was defined as WL (≥ 5% weight reduction from baseline), stable weight (SW) or weight gain (WG, ≥2 % weight increase). We assessed the impact of weight change on overall survival (OS) (primary endpoint), progression-free survival (PFS) and overall response rate (ORR) at week (wk) 12. Statistical analyses were performed using Cox regression and Kaplan-Meier method. Multivariate analysis was adjusted for known prognostic factors for mRCC, including IMDC criteria. Results: Among 3,311 pts, 1,916 (58 %) had SW, 936 (28 %) had WL and 459 (14%) had WG at wk 12. Overall, pts with WL demonstrated both reduced OS and PFS compared to SW (median OS: 18.68 vs. 26.94 vs. 23.03 months in WL, SW and WG respectively; median PFS: 7.17 vs. 10.12 vs. 9.93 months in WL, SW and WG), and were consistent when considering 2 other time points (table). WL at wk 12 was associated with worse ORR (23.4 vs. 32.1 vs. 35.9% in WL, SW, WG; adjusted odd ratio 0.715, 95% CI 0.590-0.867, p=0.03). Discontinuation rate due to adverse events was similar between groups. Conclusions: We demonstrated that WL during therapy for mRCC is strongly associated with worse clinical outcomes. This observation remains valid for WL at 6, 12 and 24 weeks. Weight change may be an early prognostic factor and guide physician in clinical management. Measures to avoid WL during therapy may lead to better outcomes from targeted therapy. [Table: see text]

Body weight changes in young breast cancer survivors and associated predictors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11574-11574
Author(s):  
Tal Sella ◽  
Zhenying Tan-Wasielewski ◽  
Shoshana M. Rosenberg ◽  
Philip Daniel Poorvu ◽  
Kathryn Jean Ruddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Prospective Cohort ◽  
Menopausal Status ◽  
Weight Changes ◽  
Young Breast Cancer ◽  
The Impact

11574 Background: Weight gain after cancer diagnosis is common in cancer survivors and has been linked to increased treatment toxicity, poor quality of life, and increased risk of second cancers and overall mortality. Young breast cancer (BC) survivors may be especially susceptible to weight changes given the impact of treatments such as chemotherapy and hormonal therapy on menopausal status. Methods: We identified women with Stage 0-III breast cancer diagnosed at ≤40 years (y) between 2006-2016 from a multi-center prospective cohort study. Clinical data including self-reported pre-diagnosis and follow-up weights were obtained using baseline and follow-up patient surveys. Participants missing baseline weight, pregnant at diagnosis/within 1y of diagnosis or with BC recurrence within 1y were excluded; those pregnant or with BC recurrence between 1-3y from diagnosis were excluded from the 3y analysis. Menopausal status at baseline and treatment-related amenorrhea (TRA) in follow-up were defined by self-reported last menstrual period. Factors associated with weight gain (>5%) were evaluated using univariate two-sided Fisher's exact test. Results: At baseline, 1y and 3y post diagnosis, 956, 899 and 687 women were eligible for analysis respectively. Median age at diagnosis was 37y (17 - 40), 65% received endocrine therapy and 74% chemotherapy. Premenopausal status was verified in 94% at baseline. Mean BMI at baseline was 24.4 (SD 5.3) kg/m2; 20% (187/956) were overweight and 12% (116/956) obese. At 1y and 3y, mean BMI increased modestly to 24.7 (SD 5.6) and 24.9 (SD 5.2), respectively with weight gain (>5%) observed in 18% (164/899) and 13% (87/687) respectively. 37% (300/804) and 32% (196/615) of eligible premenopausal subjects experienced TRA at 1y and 3y, respectively. Receipt of chemotherapy, receipt of endocrine therapy and TRA were not associated with weight gain at any timepoint. Conclusions: In this large prospective cohort of young BC survivors, mean BMI increased only modestly over time. Self-reported weight gain was not associated with treatment and not exacerbated by TRA. Further analysis to understand the effects of physical activity and other predictors of weight gain in this population are ongoing.

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