Association between lifestyle factors and completion of neoadjuvant chemotherapy for breast cancer.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 91-91
Author(s):  
Ilana M Usiskin ◽  
Fangyong Li ◽  
Melinda L Irwin ◽  
Brenda Cartmel ◽  
Tara Beth Sanft

91 Background: Completion of chemotherapy has been associated with improved breast cancer outcomes. We evaluated whether lifestyle factors, such as physical activity and diet, may contribute to neoadjuvant chemotherapy completion in breast cancer. Methods: We conducted a retrospective study of women treated with neoadjuvant chemotherapy for early stage (I-III) breast cancer. A medical record review recorded BMI, blood pressure, diabetes and hypertension medication, and chemotherapy completion. Completers received full doses of all prescribed chemotherapy, with or without cycle delays. We conducted a telephone survey about exercise and fruit/vegetable intake (>5 servings/day) during the year prior to cancer diagnosis. Exercisers completed at least 7.5 MET-hours/week (i.e., 150 minutes of moderate-intensity exercise). Multi-variable adjusted analyses were conducted to identify factors associated with chemotherapy completion. Results: Sixty-seven patients (45%) answered the survey. Chemotherapy completers were on average 11 years younger than non-completers (p<0.001), more likely premenopausal (p=0.02), and less likely on diabetes medication (p=0.05). Exercisers were more likely to complete chemotherapy than non-exercisers (p=0.002). After controlling for age, diastolic blood pressure, menopausal status, and diabetes medication, the adjusted odds ratio for exercise on chemotherapy completion was 4.1 (95% CI 1.1 – 15.3) (p=0.04). Conclusions: Women who reported exercising at recommended levels in the year prior to breast cancer diagnosis were more likely to complete neoadjuvant chemotherapy regimens, suggesting a potentially important role for lifestyle factors in chemotherapy completion. Factors associated with chemotherapy completion [Table: see text]

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12076-12076
Author(s):  
Anna-Carson Rimer Uhelski ◽  
David Lim ◽  
Amanda L. Blackford ◽  
Jennifer Y. Sheng ◽  
Claire Frances Snyder ◽  
...  

12076 Background: Weight gain is common after a breast cancer diagnosis. The incidence of and risk factors for weight gain during adjuvant endocrine therapy (ET) are poorly described. Limited data support an association between emergent symptoms and weight gain after a breast cancer diagnosis. Methods: We enrolled women with stage 0-III breast cancer initiating ET in a prospective clinic-based cohort. We assessed symptoms with the FACT-ES and PROMIS pain interference, depression, anxiety, fatigue, sleep disturbance and physical function measures at baseline (BL), 3, 6, 12, 24, 36, 48 and 60 months (mo). We defined emergent symptoms at 3 and/or 6 mo as worsening of 4 points from BL on PROMIS measures and 5 points from BL on the FACT-ES. We abstracted weight and menopausal status from charts. The primary outcome of this secondary analysis was weight gain (dichotomized as ≥5% vs < 5% of body weight compared to BL) through 60 mo. We evaluated the association between weight gain during ET and menopausal status. We also evaluated the associations between clinicodemographic factors and emergent symptoms with weight gain and if these associations differed by menopausal status. We performed logistic regression modeling with GEE to account for the longitudinal design. We identified a multivariable model for the set of factors associated with weight gain among pre-menopausal women taking ET. Results: 309 of 321 participants with BL and ≥1 follow-up (FU) weight were included. 263 (85%) had stage I-II disease, 99 (32%) were pre-menopausal, 259 (84%) were White and 32 (10%) were Black. Prior to ET, 45% had mastectomy, 66% had radiation, and 28% received chemotherapy. 4% of pre- and 82% of post-menopausal participants initiated an aromatase inhibitor (AI); all others initiated tamoxifen (Tam). 17% of pre-menopausal participants received ovarian suppression. At BL, 75% of Black and 59% of White participants were overweight/obese. With a median FU of 56 mo, 51% of pre- and 34% of post-menopausal participants gained ≥5% body weight (OR 1.09, 95% CI 1.07-1.13, p < 0.001). For each PRO measure, > 20% of participants had emergent symptoms. Worsening of physical function and pain interference scores at 3 and/or 6 mo were differentially associated with weight gain according to menopausal status (interaction p-values ≤0.05). On multivariate analysis, factors associated with weight gain among pre-menopausal participants were ET (AI vs Tam) (OR 2.8, 95% CI 0.90- 8.77, p = 0.08), prior mastectomy (OR 2.06, 95% CI 0.89-4.77, p = 0.09), emergent pain interference (OR 2.49, 95% CI 0.99-6.24, p = 0.05) and race (White vs other) (OR 7.13, 95% CI 1.29-39.4], p = 0.02). Conclusions: Weight gain during ET for breast cancer is more frequent among pre-menopausal than post-menopausal women. Worsening pain soon after ET initiation, receipt of AI, prior mastectomy and race may identify pre-menopausal women at risk for weight gain for whom prevention strategies are a priority.


Lab on a Chip ◽  
2021 ◽  
Author(s):  
Wenwen Chen ◽  
Rongkai Cao ◽  
Wentao Su ◽  
xu zhang ◽  
Yuhai Xu ◽  
...  

Tumor-derived exosomes have been recognized as promising biomarkers for early-stage cancer diagnosis, tumor prognosis monitoring and individual medical treatment. However, separating exosomes from trace biological samples is a huge challenge...


2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A347-A347
Author(s):  
Shipra Gandhi ◽  
Mateusz Opyrchal ◽  
Cayla Ford ◽  
Victoria Fitzpatrick ◽  
Melissa Grimm ◽  
...  

BackgroundNeoadjuvant chemotherapy (NAC) with taxanes is the standard of care in triple negative breast cancer (TNBC). Intratumoral prevalence of CD8+ cytotoxic T-lymphocytes (CTLs) is associated with an improvement in relapse-free survival (RFS) and overall survival (OS), while regulatory T-cells (Treg) and myeloid derived suppressor cells (MDSC) are associated with poor survival. Higher ratio of CTL/Treg is associated with higher probability of obtaining pathological complete response (pCR), a surrogate marker for RFS. Intratumoral production of CCL5, CXCL9, CXCL10 and CXCL11 is critical for local infiltration with CTLs, while CCL22 is responsible for Treg attraction. Previous studies have shown that CXCL9 expression in the pre-treatment breast tissue is associated with a three-fold higher rate of achieving pCR. Our preclinical data show that Chemokine modulating (CKM) regimen, combining rintatolimod (TLR3 agonist), interferon (IFN)-α2b, and celecoxib (COX-2 inhibitor) increases CTL-attracting, and decreases MDSC-, Treg-favoring chemokines, increasing CTL/Treg ratio in tumor microenvironment, with preferential tumor tissue activation than adjacent healthy tissues. We hypothesize that the combination of CKM with paclitaxel will result in infiltration of TNBC with CTLs, and along with doxorubicin/cyclophosphamide (AC), result in higher pCR, translating into improved RFS and OS.MethodsIn this phase I study NCT04081389, eligibility includes age ≥18 years, confirmed resectable TNBC, radiographically measurable disease ≥1 cm, ECOG PS ≤ 2, adequate organ and marrow function. Patients with autoimmune disease, serious mood disorders, invasive carcinoma within 3 years, history of peptic ulcers or hypersensitivity to NSAIDs will be excluded. We plan to treat three patients with early stage TNBC with paclitaxel 80 mg/m2 IV weekly for 12 weeks, rintatolimod 200 mg IV, celecoxib 200 mg oral twice daily, and accelerated titration of IFN-α2b at doses 0, 5, or 10 million units (MU)/m2 [Dose Levels (DL) 1, 2 and 3 respectively] on days 1–3 (no intra-patient dose escalation) in weeks 1–3. Dose-limiting toxicity (DLT) is defined as grade 3 or higher toxicities within the first 3 weeks. Any DLT will mandate recruitment per the 3+3 model. If no DLT, three patients will be enrolled at DL 4 at 20 MU/m2 IFN- α2b. This will be followed by standard dose-dense AC, and then surgery. The primary endpoint is safety and tolerability of combination and to identify the appropriate DL of CKM and paclitaxel for extended efficacy study. The secondary endpoints include investigation of efficacy (pCR and breast MRI response), along with RFS and OS. Intratumoral biomarkers will be analyzed in an exploratory manner.ResultsN/AConclusionsN/ATrial RegistrationNCT04081389Ethics ApprovalThe study was approved by Roswell Park Comprehensive Cancer Center Institution’s Ethics Board, approval number I-73718.


2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986527 ◽  
Author(s):  
Thang Vu Hong ◽  
Duc Nguyen Ba ◽  
Lambert Skoog ◽  
Van Ta Thanh ◽  
Edneia Tani

Little is known about breast cancer in Vietnamese women. Previous studies have reported the frequencies of prognostic factors of breast cancer in this population. The aim of this study was to examine the prognostic factors associated with the survival rates of patients with breast cancer treated at the National Cancer Hospital, Hanoi, Vietnam. We recruited 248 women with operable breast cancer treated with surgery and adjuvant therapy. Tumor tissue samples were stained by many immunohistochemical approaches and analyzed for estrogen receptor, progesterone receptor, and HER2 gene amplification status. A Cox model was used to determine the relationship between survival and the prognostic factors. The disease-free survival rate, overall survival rate, and cancer-specific survival rate were 75.8%, 80.6%, and 86.4%, respectively, at 5 years and 62.3%, 68.1%, and 78.9%, respectively, at 10 years. The lung was the most common metastatic site. Women with factors associated with a poor prognosis (eg, advanced clinical stage, high tumor grade, progesterone receptor [PR] negativity, HER2 amplification) had significantly lower survival rates. Patients with PR-negative breast cancer had significantly worse survival rates compared to those who were PR positive, according to multivariate analysis (hazard ratio = 1.77, 95% confidence interval: 1.01-3.11, P = .045); however, there was only a statistically significant difference in postmenopausal patients. The PR was a prognostic factor in postmenopausal women with breast cancer, but not in premenopausal women.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Liew JK ◽  
Cheong XP ◽  
Law L ◽  
Teo WH ◽  
Eng SS ◽  
...  

Introduction: Evidence has shown an increase in paediatric hypertension globally and this could give rise to increase prevalence of adult hypertension. The purpose of this paper was to determine the prevalence of hypertension among adolescents in Malaysia as well as the association between hypertension and lifestyle factors selected based on published literature. Methods: Adolescents aged 13-17 years old were selected randomly from two secondary schools to have their blood pressure measured. Their lifestyle information was obtained through completed bilingual questionnaires based on validated instruments, as well as anthropometry measurements. The relationship between hypertension and lifestyle factors was determined through statistical analysis. Results: A total of 273 students were included in the study with 120 (44%) males and 153 (56%) females. The prevalence of hypertension was 24.5% among the respondents with the highest being recorded among Malays (28.7%). Generally, hypertension was associated with an increased Body Mass Index (BMI) (AOR=4.053, 95%CI=1.677-9.795, p=0.002) and waist circumference (WC) (AOR=2.918, 95%CI=1.171-7.269, p=0.021) in all respondents. Similar associations were noted in females (BMI: AOR=7.707, 95%CI=2.043-29.072, p=0.003; WC: AOR=3.690, 95%CI=1.011-13.464, p=0.048) but not in males. Conclusion: Hypertension recorded high prevalence among Malaysian adolescents in our study. The strong association between elevated body weight, BMI and WC with hypertension may require further study to evaluate the need for screening


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