Test of weight gain prevention intervention in stage II and III breast cancer patients receiving neoadjuvant chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20523-e20523 ◽  
Author(s):  
K. Basen-Engquist ◽  
H. Y. Perkins ◽  
C. L. Carmack Taylor ◽  
D. C. Hughes ◽  
J. L. Jovanovic ◽  
...  

e20523 Background: Weight gain is common in women with breast cancer and is worrisome, as may affect prognosis and risk of other chronic diseases. This randomized study pilot tested a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy. Methods: Breast cancer patients receiving neoadjuvant chemotherapy were randomized to a weight gain prevention intervention or a usual care control arm. The intervention used a body acceptance approach, which emphasized changes in diet (low energy density food) and exercise behavior (resistance training) rather than focusing on weight loss. It was administered in weekly sessions delivered in-person and by telephone. Assessments were done at baseline, mid-chemotherapy, pre-surgery, after surgical recovery, after a 9 week post-surgical booster intervention, and 6 months after surgery. The data on weight changes from baseline (T0) to mid-chemotherapy (T1) and presurgery (T2) is presented. Results: 33 participants were randomized the intervention (n=16) or usual care (n=17). Three control participants withdrew before assessments were done. Of the 30 remaining women, 70% had stage II and 30% had stage III breast cancer. Their mean age was 49.7 (SD=12.2), and half were premenopausal. Mean BMI was 29.3 (SD=6.1) and 70% were physically inactive. The sample was diverse with regard to self-reported ethnicity (57% white, 27% African-American, 7% Hispanic, 10% other). Change in weight from T0 to T1 was -0.9 kg in the intervention group and +1.4 kg in the usual care group (n=27, p=0.126); from T0 to T2 the change was -2.0 kg in the intervention group and +0.8 kg in the usual care group (n=20, p=0.056). When weights from a chart review were used for patients with missing assessments the T0 to T2 changes were -2.9 kg for the intervention group and 0 kg for the usual care group (n=30, p=0.065). Conclusions: Based on a preliminary analysis, there was a trend approaching statistical significance for weight loss from a diet and exercise intervention based on the body acceptance approach compared to a usual care control group. These results indicate this intervention should be tested in a larger randomized controlled trial. No significant financial relationships to disclose.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11090-e11090
Author(s):  
Karen Basen-Engquist ◽  
James L. Murray ◽  
George Baum ◽  
Angelica M. Gutierrez-Barrera ◽  
Banu Arun

e11090 Background: Weight gain is a common problem after breast cancer diagnosis and treatment, particularly for women who receive chemotherapy. The weight gain has negative effects on quality of life, increases risk for chronic disease, and may increase risk of breast cancer recurrence. This pilot study tested a behavioral weight gain prevention intervention on weight, IGF-I, and IGFBP-3. Methods: Thirty-nine breast cancer patients receiving neoadjuvant chemotherapy were randomized to the weight gain prevention intervention or usual care. The intervention focused on exercise (resistance training, aerobic) and eating a low energy dense diet. Participants received 20 sessions during chemotherapy (14 in person and 6 by telephone) and 9 sessions after surgery (3 in person, 6 by telephone). They completed weight and other assessments at baseline (t0), mid-chemotherapy (T1), post-chemotherapy (t2), post surgical recovery (T3), after the post-surgical intervention (T4) and long term follow-up 6-9 months post surgery (T5). Serum was collected at T0, T2, T3, and T5 and analyzed for IGF-I and IGFBP-3. Results: Controlling for baseline weight, the intervention group weighed less than the control group at T1-T4, a result which approached significance (p=.08) in the intent to treat analysis. There was also a significant obesity x treatment group interaction, indicating that the intervention was most effective for patients who were obese at baseline (p=0.03). The groups did not differ in weight at the post-intervention follow-up (p=0.839). There was no significant difference between the groups in IGF-I or IGFBP-3. Conclusions: A diet and exercise intervention delivered during and after chemotherapy can promote weight loss in breast cancer patients, but the results may not be sustained after the intervention ends. [caption]Participants’ weights in kilograms, adjusted for baseline weight (least squares means).[caption] [Table: see text]


2021 ◽  
Author(s):  
Danbee Kang ◽  
Nayeon Kim ◽  
Young Hyuck Im ◽  
Yeon Hee Park ◽  
Ji Yeon Kim ◽  
...  

Abstract Introduction: While up to 60% of breast cancer patients undergoing chemotherapy experience skin side effects reducing quality of life, it was unclear which individual product was beneficial. To evaluate the effectiveness of a tailored moisturizer with a high content (1.5%) of pseudo-ceramides on skin dryness due to chemotherapy in breast cancer patients. Methods: Randomized controlled trial conducted from February 2015 to October 2018. 204 breast cancer patients experiencing skin dryness after 1 cycle of chemotherapy were randomly assigned to 3 groups (tailored moisturizer with high pseudo-ceramide content; general moisturizer; and usual care). Skin dryness, dullness, quality of life, and changes in sebum level were assessed at baseline, 3 weeks, and 1 month after completion of chemotherapy. The primary objective of the trial was to compare the tailored moisturizer group to usual care.Results: At 1 month after completion of chemotherapy, the tailored moisturizer group was significantly less likely to report severe skin dryness compared to the usual care group (8.5 vs. 27.9%, respectively, P < 0.01). The tailored moisturizer group reported significantly lower levels of skin dullness and lower levels of impairment of dermatological quality of life compared with the other two groups. Conclusions: A tailored moisturizer with a high content of pseudo-ceramides improved skin dryness, dullness and dermatological quality of life compared to usual care in breast cancer patients undergoing chemotherapy.


2021 ◽  
pp. 1-10
Author(s):  
Yu Wang ◽  
Han Zhao ◽  
Ping Zhao ◽  
Xingang Wang

BACKGROUND: Pyruvate kinase M2 (PKM2) was overexpressed in many cancers, and high PKM2 expression was related with poor prognosis and chemoresistance. OBJECTIVE: We investigated the expression of PKM2 in breast cancer and analyzed the relation of PKM2 expression with chemotherapy resistance to the neoadjuvant chemotherapy (NAC). We also investigated whether PKM2 could reverse chemoresistance in breast cancer cells in vitro and in vivo. METHODS: Immunohistochemistry (IHC) was performed in 130 surgical resected breast cancer tissues. 78 core needle biopsies were collected from breast cancer patients before neoadjuvant chemotherapy. The relation of PKM2 expression and multi-drug resistance to NAC was compared. The effect of PKM2 silencing or overexpression on Doxorubicin (DOX) sensitivity in the MCF-7 cells in vitro and in vivo was compared. RESULTS: PKM2 was intensively expressed in breast cancer tissues compared to adjacent normal tissues. In addition, high expression of PKM2 was associated with poor prognosis in breast cancer patients. The NAC patients with high PKM2 expression had short survival. PKM2 was an independent prognostic predictor for surgical resected breast cancer and NAC patients. High PKM2 expression was correlated with neoadjuvant treatment resistance. High PKM2 expression significantly distinguished chemoresistant patients from chemosensitive patients. In vitro and in vivo knockdown of PKM2 expression decreases the resistance to DOX in breast cancer cells in vitro and tumors in vivo. CONCLUSION: PKM2 expression was associated with chemoresistance of breast cancers, and could be used to predict the chemosensitivity. Furthermore, targeting PKM2 could reverse chemoresistance, which provides an effective treatment methods for patients with breast cancer.


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