Tara B. Sanft, MD, on How Diet and Exercise May Affect Completion of Chemotherapy for Breast Cancer
2022 ASCO Annual Meeting
Tara B. Sanft, MD, of Yale University, discusses the results of the LEANer study (Lifestyle, Exercise, and Nutrition Early After Diagnosis) in women with breast cancer. It showed that patients with newly diagnosed disease who were just starting chemotherapy could improve physical activity and diet quality. While both groups had high rates of treatment completion, women in the intervention who exercised at or above the recommended levels did better in terms of treatment completion, with fewer dose reductions and delays (Abstract 12007).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
We know completing chemotherapy as prescribed is important for cancer outcomes. We also know that adopting healthy diet and exercise is important, both for cancer prevention and, in certain cancers, can improve cancer-related survival. The healthy diet and exercise guidelines include eating a predominantly plant-based diet and exercising with moderate intensity exercise at least 150 minutes per week, and performing two strength training sessions per week. Our study, the Lifestyle, Exercise, and Nutrition Study, randomized women who were not meeting these guidelines to a healthy diet and exercise intervention based on the Diabetes Prevention Protocol and adapted using the cancer-related guidelines as well versus usual care, which is referral to our survivorship clinic and dieticians and exercise programs at request by the patient. Our primary outcome was looking at the relative dose intensity, or the actual amount of chemotherapy received compared to that which was prescribed. The intervention group received a year-long intervention of 16 sessions administered by a registered dietician who was certified, specialized in oncology, and also had exercise counseling training. The control group were followed at baseline post-chemotherapy. What we found was that both groups completed chemotherapy at very high rates, with both groups approaching about 93% completion rates. This is higher than what we had found in the literature before. We also found that the number of dose delays and reductions were similar between the two groups. When we looked at the intervention group, in particular, and we looked at if they were meeting the actual recommendations, that is 150 minutes per week and a high consumption of fruits and vegetables, we found that women who were able to meet these guidelines or exceeded them, did have higher completion rates compared to those who didn't quite make those guidelines. So in summary, the women who made the highest number of changes or adhered the best did have better relative dose intensity and fewer dose reductions and delays. But when we took the entire intervention group and compared them to usual care, we did not find a statistically significant difference. In summary, both groups completed their chemotherapy as prescribed most of the time, and the intervention group significantly improved both their diet and physical activity during the course of the intervention. Those who were able to adopt the exercise and diet recommendations the best did have significant improvements in their completion rates and fewer dose reductions and delays compared to those who didn't adopt it as well.
The ASCO Post Staff
Etienne Brain, MD, PhD, of the Institut Curie, discusses phase III findings from the Unicancer ASTER 70s trial, in which patients aged 70 or older with estrogen receptor–positive, HER2-negative breast cancer and a high genomic grade index received adjuvant endocrine therapy with or without chemotherapy. The data did not find a statistically significant overall survival benefit with this treatment after surgery (Abstract 500).
The ASCO Post Staff
Rami Manochakian, MD, of Mayo Clinic Florida, discusses the phase II findings of the NADIM II trial, which confirmed that, in terms of pathologic complete response as well as the feasibility of surgery, combining nivolumab and chemotherapy was superior to chemotherapy alone as a neoadjuvant treatment for locally advanced, resectable stage IIIA non–small cell lung cancer (Abstract 8501).
The ASCO Post Staff
Richard Finn, MD, of the Geffen School of Medicine at UCLA and the Jonsson Comprehensive Cancer Center, discusses analyses from the PALOMA-2 trial on overall survival with first-line palbociclib plus letrozole vs placebo plus letrozole in women with ER-positive/HER2-negative advanced breast cancer. The study met its primary endpoint of improving progression-free survival but not the secondary endpoint of overall survival. Although patients receiving palbociclib plus letrozole had numerically longer overall survival than those receiving placebo plus letrozole, the results were not statistically significant (Abstract LBA1003).
The ASCO Post Staff
Stephen M. Ansell, PhD, MD, of Mayo Clinic, discusses updated data from the ECHELON-1 trial, which showed that, when administered to patients with stage III or IV classical Hodgkin lymphoma, the combination of brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine resulted in a 41% reduction in the risk of death. These outcomes, says Dr. Ansell, confirm A+AVD as a preferred option for previously untreated disease (Abstract 7503).
The ASCO Post Staff
Sriram Yennu, MD, of The University of Texas MD Anderson Cancer Center, discusses the placebo response in patients with advanced cancer and cancer-related fatigue. His latest findings show that open-labeled placebo was efficacious in reducing cancer-related fatigue and improving quality of life in fatigued patients with advanced cancer at the end of 1 week. The improvement in fatigue was maintained for 4 weeks (Abstract 12006).