Muscle mass loss in patients with metastatic breast cancer

Solomayer, Erich‐Franz; Braun, Eva-Marie; Zimmermann, Julia; Radosa, Julia Caroline; Stroeder, Jonas; Endrikat, Jan; Gerlinger, Christoph

doi:10.1007/s00404-019-05168-y

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…Although emerging evidence suggests that pretreatment SMI is a prognostic marker for patients with breast cancer [ 8 , 10 , 13 , 14 , 34 – 37 ], the clinical significance of changes in SMI during treatment in an individual patient remains unknown. In this regard, our results provide a novel finding that a decrease in SMI during NAC might have a negative effect on prognosis in patients with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Skeletal muscle loss during neoadjuvant chemotherapy predicts poor prognosis in patients with breast cancer

et al. 2022

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Background The skeletal muscle index (SMI), which is calculated as the ratio of skeletal muscle area at the third lumbar vertebral level divided by height squared, has been considered a prognostic factor in patients with breast cancer. However, the prognostic impact of changes in SMI during treatment remains unclear. This study aimed to evaluate the influence of SMI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods We reviewed patients with breast cancer who underwent NAC and subsequent surgery for breast cancer between 2010 and 2017. The rate of SMI change during NAC was calculated, and the association between SMI changes and prognosis was retrospectively analyzed. Results In total, 141 patients were evaluated. 48 (34.0%), 53 (37.6%), and 40 (28.4%) patients exhibited increased (≥ 3%), maintained (− 3% <, < 3%), and decreased (− 3% ≥) SMI during NAC, respectively. The decreased SMI group showed significantly poorer disease-free survival than the maintained and increased SMI groups (hazard ratio [HR] 8.29, p < 0.001 for the decreased vs. increased SMI groups; HR 3.49, p < 0.001 for the decreased vs. maintained SMI groups). Moreover, decreased SMI was an independent risk factor for disease-free survival in multivariate analysis (HR 3.68, p < 0.01). Conclusions Skeletal muscle loss during NAC predicts poor prognosis. Our results underscore the importance of monitoring and maintaining skeletal muscle mass during NAC.

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Section: Discussionmentioning

confidence: 99%

Skeletal muscle loss during neoadjuvant chemotherapy predicts poor prognosis in patients with breast cancer

et al. 2022

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“…Conversely, during the ABLE Trial the prevalence of sarcopenia and the skeletal muscle parameters remained constant at 3 and 6 months which suggests that even regular walking could preserve muscle mass. The reduction (by 5.0 ± 2.5 cm 2 per year) of muscle mass or muscle quality observed in patients with a metastatic breast cancer [ 73 , 74 ] underlines the potential importance of the suggested benefit of the six-month physical activity intervention of the ABLE Trial to mitigate treatment and disease induced sarcopenia in advanced breast cancer. There is increasing evidence that physical inactivity contributes to increase the prevalence of sarcopenia, particularly in the elderly [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia and serum biomarkers of oxidative stress after a 6-month physical activity intervention in women with metastatic breast cancer: results from the ABLE feasibility trial

Delrieu

Martin

Touillaud

et al. 2021

Breast Cancer Res Treat

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Purpose Sarcopenia has been identified as an important prognostic factor for patients with cancer. This study aimed at exploring the potential associations between a 6-month physical activity intervention and muscle characteristics, sarcopenia, oxidative stress and toxicities in patients with metastatic breast cancer. Methods Women newly diagnosed with metastatic breast cancer (N = 49) participated in an unsupervised, personalized, 6-month physical activity intervention with activity tracker. Computerized tomography images at the third lumbar vertebra were analysed at baseline, three months and six months to assess sarcopenia (muscle mass index < 40 cm2/m2) and muscle quality (poor if muscle attenuation < 37.8 Hounsfield Units). Oxidative markers included plasma antioxidant enzymes (catalase, glutathione peroxidase and superoxide dismutase activities), prooxidant enzymes (NADPH oxidase and myeloperoxidase activities) and oxidative stress damage markers (advanced oxidation protein products, malondialdehyde (MDA) and DNA oxidation. Results At baseline 53% (mean age 55 years (SD 10.41)) were sarcopenic and 75% had poor muscle quality. Muscle cross sectional area, skeletal muscle radiodensity, lean body mass remained constant over the six months (p = 0.75, p = 0.07 and p = 0.75 respectively), but differed significantly between sarcopenic and non-sarcopenic patients at baseline and 6-months. Sarcopenic patients at baseline were more likely to have an increase of MDA (p = 0.02) at 6 months. Being sarcopenic during at least one moment during the 6-month study was associated with a higher risk of developing severe toxicities (grade > 2) (p = 0.02). Conclusions This study suggests potential benefits of physical activity for maintenance of muscle mass. Sarcopenia can alter many parameters and disturb the pro and antioxidant balance.

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“…With regard to the known limitations of bioimpedance analysis and plicometry, we will compare the intra-individual relative changes over time instead of absolute values ( 107 ). In addition, we will further extend the data by estimating the body composition from the routine CT scans of the study patients ( 56 ). The BEGYN study is an observational study, thus potential causal relationships must be interpreted carefully.…”

Section: Discussionmentioning

confidence: 99%

“…Bioimpedance analysis is routinely used in the context of nutritional advice and sports medicine, but it can also shed light into disease processes, such as hemodialysis patients ( 55 ) ( Table 4 ). When accessible, the body composition will also be estimated by using routine CT scans of the study patients as previously published ( 56 ).…”

Section: Methodsmentioning

confidence: 99%

Longitudinal Assessment of Physical Activity, Fitness, Body Composition, Immunological Biomarkers, and Psychological Parameters During the First Year After Diagnosis in Women With Non-Metastatic Breast Cancer: The BEGYN Study Protocol

et al. 2021

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BackgroundModerate physical activity is associated with an improved prognosis and psychosocial outcome in breast cancer patients. Although exercise and physical activity are associated with multiple physiological and psychological effects, many of the underlying mechanisms remain obscure. The BEGYN study (Influence of physical activity in breast cancer patients on physiological and psychological parameters and on biomarkers) aims at identifying potential associations between the extent of physical activity, fitness, body composition, immunological biomarkers, psycho-emotional parameters, and the course of treatment during the first year after diagnosis of breast cancer.MethodsThe prospective observational BEGYN study will include 110 non-metastatic breast cancer patients. The patients will be assessed during a base line visit prior to the initiation of the antineoplastic therapy and after 3, 6, 9 and 12 months. The physical activity will be measured using a fitness tracker and a self-assessment diary during the entire study. Each visit will include the assessment of (i) cardiorespiratory fitness measured by spiroergometry, (ii) body composition, (iii) psycho-emotional parameters (quality of life, mental health, fatigue, depression, distress, anxiety, well-being), and (iv) extensive blood tests including routine laboratory, vitamin D, selenium and immunologically relevant biomarkers (e.g., leukocyte subpopulations and cytokine profiles).DiscussionWhereas most studies investigating the influence of physical activity in breast cancer patients focus on specific activities for three months or less, the BEGYN study will quantify the daily physical activity and cardiorespiratory fitness of breast cancer patients based on objective measurements in the context of the oncological therapy for 12 months after diagnosis. The study will reveal potential associations between exercise, immune status and physical as well as psycho-emotional outcome and the clinical course of the disease. Moreover, complementary therapies such as Vit D and Selenium supplementation and parameters investigating the motivation of the patients are part of the study. Due to this holistic approach, the BEGYN study will guide towards confirmatory studies on the role of physical activity in breast cancer patients to develop individualized counselling regarding the recommended type and extent of exercise.Trial RegistrationThis study has been registered at the German Clinical Trials Register DRKS00024829.

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Muscle mass loss in patients with metastatic breast cancer

Cited by 9 publications

References 24 publications

Skeletal muscle loss during neoadjuvant chemotherapy predicts poor prognosis in patients with breast cancer

Skeletal muscle loss during neoadjuvant chemotherapy predicts poor prognosis in patients with breast cancer

Sarcopenia and serum biomarkers of oxidative stress after a 6-month physical activity intervention in women with metastatic breast cancer: results from the ABLE feasibility trial

Longitudinal Assessment of Physical Activity, Fitness, Body Composition, Immunological Biomarkers, and Psychological Parameters During the First Year After Diagnosis in Women With Non-Metastatic Breast Cancer: The BEGYN Study Protocol

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