In the LEANer study, reported in the Journal of Clinical Oncology by Tara Sanft, MD, and colleagues, researchers found that an exercise and nutrition intervention did not improve relative dose intensity (RDI) among patients receiving neoadjuvant or adjuvant chemotherapy for breast cancer, but did improve pathologic complete response rate among those receiving neoadjuvant chemotherapy.
Tara Sanft, MD
Study Details
In the study, 173 patients with stage I to III disease who were initiating neoadjuvant or adjuvant chemotherapy were recruited between February 2018 and July 2021 from the Smilow Cancer Hospital Network at Yale and Dana-Farber Cancer Institute. Patients were randomly assigned to receive usual care (n = 86) or a home-based exercise and nutrition intervention with counseling sessions delivered by oncology-certified registered dietitians (n = 87). The intervention included 4 weekly sessions in the first month, 2 biweekly sessions in months 2 and 3, and monthly sessions thereafter. A total of 72 patients (40 in the intervention group and 32 in the usual-care group) were starting neoadjuvant chemotherapy.
Key Findings
Patients in the intervention group had significantly greater improvements from baseline to end of chemotherapy in several exercise and diet quality measures vs the usual-care group.
RDI was 92.9% ± 12.1% in the intervention group vs 93.6% ± 11.1% in the usual-care group (P = .69). RDI of ≥ 85% was achieved in 81% vs 85% of patients (P = .44). Proportions of patients with at least one dose reduction or delay were 38% vs 36% (P = .80).
Among the patients who received neoadjuvant chemotherapy, pathologic complete response was achieved in 53% of those in the intervention group vs 28% of those in the usual-care group (P = .037). Pathologic complete response was achieved in 3 of 10 vs 0 of 12 patients with hormone receptor–positive, HER2-negative disease, and in 11 of 16 vs 3 of 10 patients with triple-negative disease.
The investigators concluded, “Although a diet and exercise intervention did not affect RDI, the intervention was associated with a higher pathologic complete response in patients with hormone receptor–positive/HER2-negative and triple-negative breast cancer undergoing neoadjuvant chemotherapy.”
Melinda L. Irwin, PhD, MPH, of Yale School of Public Health, Yale University, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Institute. For full disclosures of the study authors, visit ascopubs.org.
