Prospective study of the energy balance disruption during adjuvant chemotherapy in post-menopausal early-stage breast cancer patient

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Effectiveness of a Global Multidisciplinary Supportive and Educational Intervention in Thermal Resort on Anthropometric and Biological Parameters, and the Disease-Free Survival after Breast Cancer Treatment Completion (PACThe)

International audienceA growing knowledge highlights the strong benefit of regular physical activity in the management of breast cancer patients, but few studies have considered biological parameters in their outcomes. In the prospective randomised trial after breast cancer treatment completion "PACThe," we determined the effects of physical activity and nutritional intervention on the biological and anthropometric status of patients after one year of follow-up, and clarified the link between biomarkers at allocation and disease-free survival. 113 patients from the population of the "PACThe" study (n = 251) were analysed for biological parameters. Patients were randomized after chemotherapy in two arms: the intervention "SPA" receiving a 2-week session of physical training, dietary education, and physiotherapy (n = 57), and the control "CTR" (n = 56). Diet questionnaire, anthropometric measures, and blood parameters were determined at allocation and one year later. Survival and recurrence were checked over 7 years. Data were considered as a function of BMI, i.e., ≤25 for normal, 25-30 for overweight, and >30 for obese patients. At allocation, the large standard deviation for nutrient-intake values reflected an unbalanced diet for some patients in the three groups. At one-year follow-up, we noticed an increase in glucose (p 30 groups. Using the Cox model, we demonstrated that the highest testosterone plasma values were linked to an increase of the recurrence risk (HR [CI-95%] = 5.06 [1.66-15.41]; p=0.004). One-year after a global multidisciplinary supportive and educational intervention, we found few anthropometric and biological changes, mainly related to the patient's initial BMI. We highlighted the importance of plasma testosterone in the evaluation of patient's recurrence risk. Future studies would help better understand the mechanisms by which such multidisciplinary interventions could interact with breast cancer recurrence and define the most effective modalities

Improvement in adherence to Capecitabine and Lapatinib by way of a therapeutic education program

International audienceA patient non-adherence with oral anticancer agents is a well-recognized barrier to effective treatment. The aim of this prospective study was to evaluate the efficacy of a therapeutic education program among non-adherent patients treated with Capecitabine alone or associated with Lapatinib

Long-term improvement of breast cancer survivors’ quality of life by a 2-week group physical and educational intervention: 5-year update of the ‘PACThe’ trial

The trial was financed by AFRETH (French association for hydrothermal research). Auvergne Regional Council, Clermont-Communauté, League Against Cancer (Puy de Dôme committee CD63).International audienceBackground: The advantages of adapted physical activity and nutritional education (APANE) on breast cancer prognosis and quality of life (QoL) are well known, but long-term results are lacking.Methods: A randomised controlled trial testing a 2-week intervention in hydrothermal centres including APANE enrolled 251 patients ost-chemotherapy. QoL and weight control were significantly improved at 12 months. A 5-year follow-up was performed to evaluate the persistence of improvements.Results: QoL increase (SF36) was persistent: effect-size at 2, 3, 4 and 5 years equalled respectively 0.27 (-0.01; 0.56), 0.28 (-0.02; 0.58),0.41 (0.02; 0.81) and 0.45 (0.11; 0.80).Weight control observed after intervention lasted 2 years: 2.7% decrease at 1 year (P=0.0085), 2.5%at 2 years (P=0.025); and respectively for waist -2.4% (-3.6; -1.1) (P=0.000014) and -1.3% (-2.5; -0.1) (P=0.0072).Conclusions: A 2-week intervention in hydrothermal centres performed shortly after chemotherapy can durably improve breast cancer patients’ QoL and reduce weight

Prospective Study on Body Composition, Energy Balance and Biological Factors Changes in Post-menopausal Women with Breast Cancer Receiving Adjuvant Chemotherapy Including Taxanes

International audienceIn breast cancer patients, weight and fat mass changes observed after chemotherapy have been related to poor prognosis but some recent works using modern chemotherapy failed to find this correlation with weight gain. In this study, the extent of changes in weight and body composition (DEXA, impedance) was characterized until six months after current chemotherapy, in 50 post-menopausal women with breast cancer. The evolution of factors contributing to the energy balance and some biological factors were also described. During chemotherapy, 20% of women lost weight due to both fat (-13.1% ± 10.3) and lean soft tissue mass loss (-3.6% ± 4.6). Twenty percent of women gained weight. No significant fat mass gain was observed in these women but significant water gain was highlighted. Six months later, women who gained weight presented a gain in fat mass (15.4% ± 19.0), especially in the abdominal region. Age and initial BMI were negatively correlated with fat mass in multivariate analyzes (r = 0.486, P = 0.0030). No significant variation of the glucose homeostasis, triglycerides, and HDL-Cholesterol was found six months after chemotherapy. These results do not suggest major adverse metabolic disturbances six months after modern chemotherapy and only a mild fat mass gain was observed in women who gained weight

Weight Evolution During Endocrine Therapy for Breast Cancer in Postmenopausal Patients: Effect of Initial Fat Mass Percentage and Previous Adjuvant Treatments

International audiencePurpose: Weight change during adjuvant treatment for early breast cancer is associated with poor prognosis. The long-term evolution of body composition during adjuvant treatment for breast cancer, particularly endocrine therapy, is not well known and new data on this topic is required. The present study assesses the evolution of weight and body composition among 33 postmenopausal breast cancer patients currently treated with endocrine therapy after standard adjuvant chemotherapy including Taxanes.Patients and Methods: Dual-Energy X-ray Absorptiometry (DXA) was used to measure fat and lean body mass. Body water was assessed by multifrequency bioelectrical impedance analysis. The HAD questionnaire and the short version of the IPAQ were also administered.Results: During endocrine therapy, 15.2% (n=5) of the population lost weight and 36.4% (n=12) gained weight. The overall average gain was 2.0kg ±5.5 (p= 0.04). During this period, fat mass, lean body mass and body water increased. Factors linked to fat mass gain are excess fat mass (≥36%) before treatment and weight loss during chemotherapy. In the overall period of adjuvant cancer treatment, 30% of the population gained more than 5% of their initial weight. The average gain was the same as during the endocrine therapy period (2.0kg ±5.4; p=0.031) and was characterized by an increase in total lean body mass, mainly localized in the trunk region.Conclusion: Endocrine therapy appears as a pivotal period in weight and body composition management. Overfat/obese patients and those who lose weight during chemotherapy are more subject to weight and fat mass gain during endocrine therapy

Multicenter randomized phase II study comparing docetaxel plus curcumin versus docetaxel plus placebo in first‐line treatment of metastatic castration‐resistant prostate cancer

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