Hyperglycemic Complications Associated with Adjuvant Chemotherapy of Breast Cancer A Cancer and Leukemia Group B (CALGB) Study

Ellis, Mark; Weiss, Raymond B.; Korzun, Ann H.; Rice, Mary; Norton, Larry; Perloff, Marjorie; Lesnick, Gerson; Wood, William C.

doi:10.1097/00000421-198612000-00013

Cited by 11 publications

(8 citation statements)

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“…In a retrospective work which dates back to 1986, nearly 2.4% of women treated with adjuvant chemotherapy for breast cancer along with prednisone developed severe hyperglycemia, which led to death in 2 cases. 24 More recently, the study by Weiser et al 5 identified a correlation between hyperglycemia and duration of remission in patients treated with hyper-CVAD regimen (hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternated with methotrexate and cytarabine) as induction therapy for ALL. Patients developing hyperglycemia during chemotherapy showed reduced complete remission duration and a shorter median survival, together with a higher risk of complicated infections and sepsis compared with patients without hyperglycemia.…”

Section: Resultsmentioning

confidence: 99%

Hyperglycemia During Chemotherapy for Hematologic and Solid Tumors Is Correlated With Increased Toxicity

Brunello¹,

Kapoor²,

Extermann³

2011

American Journal of Clinical Oncology

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Section: Resultsmentioning

confidence: 99%

Hyperglycemia During Chemotherapy for Hematologic and Solid Tumors Is Correlated With Increased Toxicity

Brunello¹,

Kapoor²,

Extermann³

2011

American Journal of Clinical Oncology

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“…Oestrogen suppression as a result of chemotherapy may further promote diabetes; however, this factor may be less of an issue within the postmenopausal population [8,9,19]. In addition, to reduce nausea associated with chemotherapy, glucocorticoids are often simultaneously used [20] and this has been associated with acute hyperglycaemia, although no long-term impact on diabetes risk has been shown [20][21][22][23]. The transient nature of diabetes resulting from the glucocorticoids [18,21] may account for the higher odds initially following breast cancer diagnosis and its subsequent decrease, due to a depletion of susceptible individuals from the at-risk population [24].…”

Section: Discussionmentioning

confidence: 99%

Incidence of diabetes among postmenopausal breast cancer survivors

et al. 2012

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Aims/hypothesis Evidence is emerging of an association between breast cancer and diabetes; however, it is uncertain whether diabetes incidence is increased in postmenopausal breast cancer survivors compared with women without breast cancer. The objective of this study was to determine whether postmenopausal women who develop breast cancer have a higher incidence of diabetes than those who do not develop breast cancer. Methods We used population-based data from Ontario, Canada to compare the incidence of diabetes among women with breast cancer, aged 55 years or older, from 1996 to 2008, with that of age-matched women without breast cancer. We used Cox proportional hazard models to estimate the effect of breast cancer on the cause-specific hazard of developing diabetes overall and in the subgroup of women who received adjuvant chemotherapy. Results Of 24,976 breast cancer survivors and 124,880 controls, 9.7% developed diabetes over a mean follow-up of 5.8 years. The risk of diabetes among breast cancer survivors compared with women without breast cancer began to increase 2 years after diagnosis (HR 1.07 [95% CI, 1.02, 1.12]), and rose to an HR of 1.21 (95% CI, 1.09, 1.35) after 10 years. Among those who received adjuvant chemotherapy (n04,404), risk was highest in the first 2 years after diagnosis (HR 1.24 [95% CI 1.12, 1.38]) and then declined. Conclusions/interpretation We found a modest increase in the incidence of diabetes among postmenopausal breast cancer survivors that varied over time. In most women the risk began to increase 2 years after cancer diagnosis but the highest risk was in the first 2 years in those who received adjuvant therapy. Our study suggests that greater diabetes screening and prevention strategies among breast cancer survivors may be warranted.

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“…Glucocorticoids are often used in conjunction with chemotherapy in the treatment of breast cancer, and these drugs may cause acute hyperglycemia in predisposed individuals. 14 However, this effect is believed to be acute, transient, and reversible, and steroids have not been shown to impact on glycemic control in the long term.…”

Section: Discussionmentioning

confidence: 99%

Diabetes and breast cancer among women with BRCA1 and BRCA2 mutations

Bordeleau

Lipscombe

Lubiński

et al. 2010

Cancer

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BACKGROUND Hyperinsulinemia and the metabolic syndrome are both risk factors for breast cancer. It is not clear if diabetes is associated with the risk of breast cancer in women with a BRCA1 or BRCA2 mutation. METHODS The authors reviewed the medical histories of 6052 women with a BRCA1 or BRCA2 mutation, half of whom had been diagnosed with breast cancer. They estimated the odds ratio for breast cancer, given a self-report of diabetes. They then estimated the hazard ratio for a new diagnosis of diabetes associated with a history of breast cancer. RESULTS There was no excess of diabetes in the period before the diagnosis of breast cancer, compared with controls with no diagnosis of breast cancer. The risk of diabetes was doubled among BRCA carriers in the 15-year period after the diagnosis of breast cancer (relative risk, 2.0; 95% confidence interval [CI], 1.4–2.8; P = .0001), compared with carriers without cancer. The risk was particularly high for women with a body mass index (BMI) >25.0 kg/m2 (odds ratio, 5.8; 95% CI, 4.0–8.6; P = .0001). CONCLUSIONS After a diagnosis of breast cancer, women with a BRCA1 or BRCA2 mutation face a 2-fold increase in the risk of diabetes, which is exacerbated by a high BMI.

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Hyperglycemic Complications Associated with Adjuvant Chemotherapy of Breast Cancer A Cancer and Leukemia Group B (CALGB) Study

Cited by 11 publications

References 0 publications

Hyperglycemia During Chemotherapy for Hematologic and Solid Tumors Is Correlated With Increased Toxicity

Hyperglycemia During Chemotherapy for Hematologic and Solid Tumors Is Correlated With Increased Toxicity

Incidence of diabetes among postmenopausal breast cancer survivors

Diabetes and breast cancer among women with BRCA1 and BRCA2 mutations

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