Every Day Counts: A Lifestyle Program for Women with Metastatic Breast Cancer

每一天都很重要：针对转移性乳腺癌女性的生活方式计划

• 批准号: 9371470
• 负责人: Patricia Maureen Sheean
• 金额: $ 20.6万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-29 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9371470
• 关键词: Address; Adherence; Adipose tissue; Adopted; Adverse effects; African American; Age; American Cancer Society; Behavior; Behavioral; Biological; Biological Markers; Body Composition; Body Weight decreased; Breast Cancer Patient; Breast Cancer Treatment; Breast Cancer survivor; C-reactive protein; Cancer Prognosis; Cancer Survivor; Cancer Survivorship; Clinical; Cognitive; Communities; Complement; Consensus; Data; Development; Diagnosis; Dietary Intervention; Disease; Dual-Energy X-Ray Absorptiometry; Eating; Eligibility Determination; Exercise; Fatigue; Future; Glucose; Guidelines; Health; Incidence; Inflammation; Insulin; Insulin Resistance; Interleukin-6; Intervention; Intervention Trial; Lead; Leptin; Life Style; Measures; Menopausal Status; Metastatic breast cancer; Methodology; Mitochondria; Not Hispanic or Latino; Obesity; Outcome; Patient Outcomes Assessments; Pattern; Physical activity; Population; Production; Quality of life; Randomized; Recurrent disease; Relapse; Reporting; Research; Resources; Scientist; Serum; Skeletal Muscle; Social support; Survivors; Symptoms; TNF gene; Technology; Testing; Thinness; Toxicity due to chemotherapy; Woman; Work; adipokines; adiponectin; base; behavior influence; candidate marker; carcinogenesis; evidence base; functional status; healthy lifestyle; improved; inflammatory marker; innovation; interest; intervention effect; lean body mass; lifestyle intervention; malignant breast neoplasm; multidisciplinary; novel therapeutics; nutrition; oncology; outcome forecast; physiologic model; programs; randomized trial; reduce symptoms; soft tissue; survivorship; targeted treatment; tumor progression; young woman

Abstract The community of women with metastatic breast cancer (MBC) is growing due to increases in incidence and improved treatments for women diagnosed at earlier stages who relapse. Research that addresses this burgeoning and underserved survivor group is needed. Breast cancer (BC) treatment is associated with adverse body composition changes including increases in adiposity and decreases in lean body mass (LBM). These changes contribute to insulin resistance and inflammation which are theorized to contribute to tumor progression. Low levels of LBM are also associated with treatment side-effects and decreased cellular energy production due to mitochondrial dysfuntion which lead to fatigue, symptom burden and compromised quality of life (QOL). Lifestyle interventions with early stage BC survivors that promote positive changes in body composition changes result in enhanced QOL, reduced fatigue, and improved biomarkers of BC prognosis. To date, women with MBC have been largely excluded from these trials. Our formative work supports that women with MBC are interested in and capable of participating in a lifestyle intervention trial. Thus, based on current cancer survivorship guidelines, we propose a randomized pilot (n=40) in women with MBC to: (1) examine the feasibility and acceptability of “Every Day Counts” - a 12 week cognitive-behavioral lifestyle intervention; (2) examine the impact of Every Day Counts on body composition changes and the associations with serum biomarkers of prognosis and survival, and patient reported outcomes; and (3) explore the effect of the lifestyle intervention on mitochondrial function and its association with symptom burden. Our multidisciplinary study applies an innovative, highly integrated physiologic model to provide a biologic basis for the impact of lifestyle behaviors on outcomes, integrating support and technology to promote intervention adherence. This study reflects ‘a first step’ in a research trajectory to help discern how lifestyle behaviors influence quality of life, prognosis and help make every day count for women with MBC.

抽象的 由于发病率的增加，患有转移性乳腺癌 (MBC) 的女性群体正在不断增长 并改善了早期诊断出复发的女性的治疗方法。解决这个问题的研究 需要新兴且服务不足的幸存者群体。乳腺癌（BC）治疗与不良反应相关 身体成分发生变化，包括肥胖增加和去脂体重 (LBM) 减少。这些 变化会导致胰岛素抵抗和炎症，理论上这会导致肿瘤进展。 LBM 水平低也与治疗副作用和细胞能量产生减少有关 线粒体功能障碍，导致疲劳、症状负担和生活质量 (QOL) 下降。 对早期 BC 幸存者进行生活方式干预，促进身体成分变化的积极变化 从而提高生活质量、减少疲劳并改善 BC 预后的生物标志物。迄今为止，患有 MBC 的女性 基本上被排除在这些试验之外。我们的形成性工作表明患有 MBC 的女性对此感兴趣 正在并有能力参加生活方式干预试验。因此，根据目前的癌症生存率 指南中，我们建议对患有 MBC 的女性进行随机试验（n=40），以：（1）检查可行性并 “每一天都很重要”的可接受性——为期 12 周的认知行为生活方式干预； (2) 检查 每日计数对身体成分变化的影响以及与血清生物标志物的关联 预后和生存以及患者报告的结果； (3)探讨生活方式干预对 线粒体功能及其与症状负担的关系。我们的多学科研究应用了 创新的、高度集成的生理模型，为生活方式行为对健康的影响提供生物学基础 成果，整合支持和技术以促进干预依从性。这项研究反映了“第一步” 在研究轨迹中帮助了解生活方式行为如何影响生活质量、预后并帮助 对于 MBC 女性来说，每一天都很重要。