BMI, lifestyle factors and taxane-induced neuropathy in breast cancer patients: The pathways study

Heather Greenlee, Dawn L. Hershman, Zaixing Shi, Marilyn L. Kwan, Isaac J. Ergas, Janise M. Roh, Lawrence H. Kushi

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Abstract

Background: Lifestyle factors may be associated with chemotherapy-induced peripheral neuropathy (CIPN). We examined associations between body mass index (BMI) and lifestyle factors with CIPN in the Pathways Study, a prospective cohort of women with invasive breast cancer. Methods: Analyses included 1237 women who received taxane treatment and provided data on neurotoxicity symptoms. Baseline interviews assessed BMI (normal: <25 kg/m2; overweight: 25-29.9kg/m2; obese: ≥30 kg/m2), moderate-to-vigorous physical activity (MVPA) (low: <2.5; medium: 2.5-5; high: >5 hours/week) and fruit/vegetable intake (low: <35 servings/week; high: ≥35 servings/week). Baseline and six-month interviews assessed antioxidant supplement use (nonuser, discontinued, continued user, initiator). CIPN was assessed at baseline, six months, and 24 months using the Functional Assessment of Cancer Therapy-Taxane Neurotoxicity (FACT-NTX); a 10% decrease was considered clinically meaningful. Results: At baseline, 65.6% of patients in the sample were overweight or obese, 29.9% had low MVPA, 57.5% had low fruit/ vegetable intake, and 9.5% reported antioxidant supplement use during treatment. In multivariable analyses, increased CIPN was more likely to occur in overweight (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.19 to 4.88) and obese patients (OR=3.21, 95% CI=1.52 to 7.02) compared with normal weight patients at 24 months and less likely to occur in patients with high MVPA compared with those with low MVPA at six (OR=0.56, 95% CI=0.34 to 0.94) and 24 months (OR=0.43, 95% CI=0.21 to 0.87). Compared with nonusers, patients who initiated antioxidant use during treatment were more likely to report increased CIPN at six months (OR=3.81, 95% CI=1.82 to 8.04). Conclusions: Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.

Original languageEnglish (US)
JournalJournal of the National Cancer Institute
Volume109
Issue number2
DOIs
StatePublished - 2017
Externally publishedYes

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Peripheral Nervous System Diseases
Life Style
Body Mass Index
Breast Neoplasms
Drug Therapy
Odds Ratio
Confidence Intervals
Antioxidants
Vegetables
Fruit
Interviews
Therapeutics
taxane
Obesity
Prospective Studies
Weights and Measures
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

BMI, lifestyle factors and taxane-induced neuropathy in breast cancer patients : The pathways study. / Greenlee, Heather; Hershman, Dawn L.; Shi, Zaixing; Kwan, Marilyn L.; Ergas, Isaac J.; Roh, Janise M.; Kushi, Lawrence H.

In: Journal of the National Cancer Institute, Vol. 109, No. 2, 2017.

Research output: Contribution to journalArticle

Greenlee, Heather ; Hershman, Dawn L. ; Shi, Zaixing ; Kwan, Marilyn L. ; Ergas, Isaac J. ; Roh, Janise M. ; Kushi, Lawrence H. / BMI, lifestyle factors and taxane-induced neuropathy in breast cancer patients : The pathways study. In: Journal of the National Cancer Institute. 2017 ; Vol. 109, No. 2.
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abstract = "Background: Lifestyle factors may be associated with chemotherapy-induced peripheral neuropathy (CIPN). We examined associations between body mass index (BMI) and lifestyle factors with CIPN in the Pathways Study, a prospective cohort of women with invasive breast cancer. Methods: Analyses included 1237 women who received taxane treatment and provided data on neurotoxicity symptoms. Baseline interviews assessed BMI (normal: <25 kg/m2; overweight: 25-29.9kg/m2; obese: ≥30 kg/m2), moderate-to-vigorous physical activity (MVPA) (low: <2.5; medium: 2.5-5; high: >5 hours/week) and fruit/vegetable intake (low: <35 servings/week; high: ≥35 servings/week). Baseline and six-month interviews assessed antioxidant supplement use (nonuser, discontinued, continued user, initiator). CIPN was assessed at baseline, six months, and 24 months using the Functional Assessment of Cancer Therapy-Taxane Neurotoxicity (FACT-NTX); a 10{\%} decrease was considered clinically meaningful. Results: At baseline, 65.6{\%} of patients in the sample were overweight or obese, 29.9{\%} had low MVPA, 57.5{\%} had low fruit/ vegetable intake, and 9.5{\%} reported antioxidant supplement use during treatment. In multivariable analyses, increased CIPN was more likely to occur in overweight (odds ratio [OR] = 2.37, 95{\%} confidence interval [CI] = 1.19 to 4.88) and obese patients (OR=3.21, 95{\%} CI=1.52 to 7.02) compared with normal weight patients at 24 months and less likely to occur in patients with high MVPA compared with those with low MVPA at six (OR=0.56, 95{\%} CI=0.34 to 0.94) and 24 months (OR=0.43, 95{\%} CI=0.21 to 0.87). Compared with nonusers, patients who initiated antioxidant use during treatment were more likely to report increased CIPN at six months (OR=3.81, 95{\%} CI=1.82 to 8.04). Conclusions: Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.",
author = "Heather Greenlee and Hershman, {Dawn L.} and Zaixing Shi and Kwan, {Marilyn L.} and Ergas, {Isaac J.} and Roh, {Janise M.} and Kushi, {Lawrence H.}",
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T1 - BMI, lifestyle factors and taxane-induced neuropathy in breast cancer patients

T2 - The pathways study

AU - Greenlee, Heather

AU - Hershman, Dawn L.

AU - Shi, Zaixing

AU - Kwan, Marilyn L.

AU - Ergas, Isaac J.

AU - Roh, Janise M.

AU - Kushi, Lawrence H.

PY - 2017

Y1 - 2017

N2 - Background: Lifestyle factors may be associated with chemotherapy-induced peripheral neuropathy (CIPN). We examined associations between body mass index (BMI) and lifestyle factors with CIPN in the Pathways Study, a prospective cohort of women with invasive breast cancer. Methods: Analyses included 1237 women who received taxane treatment and provided data on neurotoxicity symptoms. Baseline interviews assessed BMI (normal: <25 kg/m2; overweight: 25-29.9kg/m2; obese: ≥30 kg/m2), moderate-to-vigorous physical activity (MVPA) (low: <2.5; medium: 2.5-5; high: >5 hours/week) and fruit/vegetable intake (low: <35 servings/week; high: ≥35 servings/week). Baseline and six-month interviews assessed antioxidant supplement use (nonuser, discontinued, continued user, initiator). CIPN was assessed at baseline, six months, and 24 months using the Functional Assessment of Cancer Therapy-Taxane Neurotoxicity (FACT-NTX); a 10% decrease was considered clinically meaningful. Results: At baseline, 65.6% of patients in the sample were overweight or obese, 29.9% had low MVPA, 57.5% had low fruit/ vegetable intake, and 9.5% reported antioxidant supplement use during treatment. In multivariable analyses, increased CIPN was more likely to occur in overweight (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.19 to 4.88) and obese patients (OR=3.21, 95% CI=1.52 to 7.02) compared with normal weight patients at 24 months and less likely to occur in patients with high MVPA compared with those with low MVPA at six (OR=0.56, 95% CI=0.34 to 0.94) and 24 months (OR=0.43, 95% CI=0.21 to 0.87). Compared with nonusers, patients who initiated antioxidant use during treatment were more likely to report increased CIPN at six months (OR=3.81, 95% CI=1.82 to 8.04). Conclusions: Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.

AB - Background: Lifestyle factors may be associated with chemotherapy-induced peripheral neuropathy (CIPN). We examined associations between body mass index (BMI) and lifestyle factors with CIPN in the Pathways Study, a prospective cohort of women with invasive breast cancer. Methods: Analyses included 1237 women who received taxane treatment and provided data on neurotoxicity symptoms. Baseline interviews assessed BMI (normal: <25 kg/m2; overweight: 25-29.9kg/m2; obese: ≥30 kg/m2), moderate-to-vigorous physical activity (MVPA) (low: <2.5; medium: 2.5-5; high: >5 hours/week) and fruit/vegetable intake (low: <35 servings/week; high: ≥35 servings/week). Baseline and six-month interviews assessed antioxidant supplement use (nonuser, discontinued, continued user, initiator). CIPN was assessed at baseline, six months, and 24 months using the Functional Assessment of Cancer Therapy-Taxane Neurotoxicity (FACT-NTX); a 10% decrease was considered clinically meaningful. Results: At baseline, 65.6% of patients in the sample were overweight or obese, 29.9% had low MVPA, 57.5% had low fruit/ vegetable intake, and 9.5% reported antioxidant supplement use during treatment. In multivariable analyses, increased CIPN was more likely to occur in overweight (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.19 to 4.88) and obese patients (OR=3.21, 95% CI=1.52 to 7.02) compared with normal weight patients at 24 months and less likely to occur in patients with high MVPA compared with those with low MVPA at six (OR=0.56, 95% CI=0.34 to 0.94) and 24 months (OR=0.43, 95% CI=0.21 to 0.87). Compared with nonusers, patients who initiated antioxidant use during treatment were more likely to report increased CIPN at six months (OR=3.81, 95% CI=1.82 to 8.04). Conclusions: Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.

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