Effect of weight loss intervention on inflammatory and metabolic markers in breast cancer survivors: The lifestyle, exercise, and nutrition (LEAN) study.

Cancer Prevention/Epidemiology
Session Type and Session Title: 
Oral Abstract Session, Cancer Prevention/Epidemiology
Abstract Number: 
J Clin Oncol 32:5s, 2014 (suppl; abstr 1505)
Erikka Loftfield, Maura Harrigan, Fangyong Li, Brenda Cartmel, Yang Zhou, Mary Playdon, Lingeng Lu, Tara Beth Sanft, Melinda Irwin; Yale School of Public Health, New Haven, CT; Yale Cancer Center, New Haven, CT; Yale Center for Analytical Sciences, New Haven, CT; Yale School of Medicine, New Haven, CT; Yale Cancer Center, Yale School of Medicine, New Haven, CT; Yale University, New Haven, CT

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures


Background: Obesity and physical inactivity are associated with poorer prognosis among breast cancer survivors. Inflammatory and metabolic pathways may explain these associations. We hypothesized that diet- and exercise-induced weight loss would decrease insulin, glucose, IGF-I, C-reactive protein (CRP), TNF-α, IL-6 and leptin, but increase adiponectin in breast cancer survivors. Methods: Ninety-seven overweight or obese breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and randomized to usual care (n=33) or weight loss counseling by a registered dietitian (n=64) for 6 months. The usual care group was provided with AICR nutrition and physical activity brochures. Weight was measured and fasting blood samples were drawn at baseline and 6-months by trained staff. We conducted analyses using the intention-to-treat procedure with baseline values imputed for missing 6-month values (n=16). We used analysis of covariance, adjusted for baseline biomarker levels, to evaluate mean biomarker changes across groups. In secondary analyses, we evaluated the effect of weight loss on biomarkers among women randomized to intervention. Results: On average, women randomized to intervention and usual care groups lost 6% and 2% body weight (p=0.0003), respectively. Women in the intervention group experienced decreases in insulin, glucose, CRP, leptin and TNF-α and increases in adiponectin and IGF-I. CRP decreased by 30% in the intervention group and 1% in the usual care group (-1.05 mg/L vs. -0.06 mg/L, p=0.05). Compared to intervention women who lost <5% body weight, those who lost ≥5% body weight had larger decreases in CRP (-1.58 mg/L vs. -0.54 mg/L, p=0.02), insulin (-3.21 μU/mL vs. -0.59 μU/mL, p=0.048), leptin (11.08 ng/mL vs. -0.76 ng/mL, p=0.002) and IL-6 (-0.20 pg/mg vs. +0.59 pg/mg, p=0.02) but an increase in IGF-I (+9.19 ng/L vs. -11.11 ng/L, p=0.01). Conclusions: Weight loss resulting from a 6-month, 11-session counseling program had favorable effects on some inflammatory and metabolic biomarkers associated with breast cancer survival. IGF-I may not be a mechanism through which weight loss improves breast cancer survival.