TY - JOUR
T1 - The Effects of a remote-based weight loss program on adipocytokines, metabolic markers, and telomere length in breast cancer survivors
T2 - The POWER-remote trial
AU - Santa-Maria, Cesar A.
AU - Coughlin, Janelle W.
AU - Sharma, Dipali
AU - Armanios, Mary
AU - Blackford, Amanda L.
AU - Schreyer, Colleen
AU - Dalcin, Arlene
AU - Carpenter, Ashley
AU - Jerome, Gerald J.
AU - Armstrong, Deborah K.
AU - Chaudhry, Madhu
AU - Cohen, Gary I.
AU - Connolly, Roisin M.
AU - Fetting, John
AU - Miller, Robert S.
AU - Smith, Karen L.
AU - Snyder, Claire
AU - Wolfe, Andrew
AU - Wolff, Antonio C.
AU - Huang, Chiung Yu
AU - Appel, Lawrence J.
AU - Stearns, Vered
N1 - Publisher Copyright:
© 2020 American Association for Cancer Research.
PY - 2020/6/15
Y1 - 2020/6/15
N2 - Purpose: We initiated a clinical trial to determine the proportion of breast cancer survivors achieving ≥5% weight loss using a remotely delivered weight loss intervention (POWER-remote) or a self-directed approach, and to determine the effects of the intervention on biomarkers of cancer risk including metabolism, inflammation, and telomere length. Experimental Design: Women with stage 0-III breast cancer, who completed local therapy and chemotherapy, with a body mass index ≥25 kg/m2 were randomized to a 12-month intervention (POWER-remote) versus a self-directed approach. The primary objective was to determine the number of women who achieved at least 5% weight loss at 6 months. We assessed baseline and 6-month change in a panel of adipocytokines (adiponectin, leptin, resistin, HGF, NGF, PAI1, TNFa, MCP1, IL1b, IL6, and IL8), metabolic factors (insulin, glucose, lipids, hsCRP), and telomere length in peripheral blood mononuclear cells. Results: From 2013 to 2015, 96 women were enrolled, and 87 were evaluable for the primary analysis; 45 to POWER-remote and 42 to self-directed. At 6 months, 51% of women randomized to POWER-remote lost ≥5% of their baseline body weight, compared with 12% in the self-directed arm [OR, 7.9; 95% confidence interval (CI), 2.6-23.9; P ¼ 0.0003]; proportion were similar at 12 months (51% vs 17%, respectively, P ¼ 0.003). Weight loss correlated with significant decreases in leptin, and favorable modulation of inflammatory cytokines and lipid profiles. There was no significant change in telomere length at 6 months. Conclusions: A remotely delivered weight loss intervention resulted in significant weight loss in breast cancer survivors, and favorable effects on several biomarkers.
AB - Purpose: We initiated a clinical trial to determine the proportion of breast cancer survivors achieving ≥5% weight loss using a remotely delivered weight loss intervention (POWER-remote) or a self-directed approach, and to determine the effects of the intervention on biomarkers of cancer risk including metabolism, inflammation, and telomere length. Experimental Design: Women with stage 0-III breast cancer, who completed local therapy and chemotherapy, with a body mass index ≥25 kg/m2 were randomized to a 12-month intervention (POWER-remote) versus a self-directed approach. The primary objective was to determine the number of women who achieved at least 5% weight loss at 6 months. We assessed baseline and 6-month change in a panel of adipocytokines (adiponectin, leptin, resistin, HGF, NGF, PAI1, TNFa, MCP1, IL1b, IL6, and IL8), metabolic factors (insulin, glucose, lipids, hsCRP), and telomere length in peripheral blood mononuclear cells. Results: From 2013 to 2015, 96 women were enrolled, and 87 were evaluable for the primary analysis; 45 to POWER-remote and 42 to self-directed. At 6 months, 51% of women randomized to POWER-remote lost ≥5% of their baseline body weight, compared with 12% in the self-directed arm [OR, 7.9; 95% confidence interval (CI), 2.6-23.9; P ¼ 0.0003]; proportion were similar at 12 months (51% vs 17%, respectively, P ¼ 0.003). Weight loss correlated with significant decreases in leptin, and favorable modulation of inflammatory cytokines and lipid profiles. There was no significant change in telomere length at 6 months. Conclusions: A remotely delivered weight loss intervention resulted in significant weight loss in breast cancer survivors, and favorable effects on several biomarkers.
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U2 - 10.1158/1078-0432.CCR-19-2935
DO - 10.1158/1078-0432.CCR-19-2935
M3 - Article
C2 - 32071117
AN - SCOPUS:85086524024
SN - 1078-0432
VL - 26
SP - 3024
EP - 3034
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 12
ER -