A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients

Abstract

Background: A decrease in thermogenesis is suspected to be implicated in the energy expenditure reduction during breast cancer treatment. This study aimed to investigate the impact of chemotherapy on the metabolic activity of brown adipose tissue (BAT) and the link with weight variation.Methods: This was an ancillary analysis of a multicentre trial involving 109 HER2+ breast cancer patients treated with neoadjuvant chemotherapy. A centralised review of 18 F-FDG uptake intensity (SUV max ) in specific BAT regions (cervical and supraclavicular) was conducted on two PET-CT scans for each patient (before and after the first course of chemotherapy). Results: Overall, after one course of chemotherapy a significant decrease of 4.4% in 18 F-FDG-uptake intensity was observed. It was not correlated to initial BMI, age or season. During chemotherapy, 10.1% (n = 11) of the patients lost weight (− 7.7 kg ± 3.8 kg; ie, − 9.4% ± 3.7%) and 29.4% (n = 32) gained weight (+ 5.1 kg ± 1.7 kg; ie, + 8.5% ± 2.6%). Among these subgroups, only the patients who had gained weight underwent a significant decrease (13.42%) in 18 F-FDG uptake intensity (p = 0.042). Conclusion:This study is the first to highlight in a large cohort of patients the negative impact of chemotherapy on brown adipose tissue activity. Weight gain during chemotherapy could thus potentially be explained in part by a decrease in brown adipose tissue activity.

Therapeutic Potentials of Selected Antihypertensive Agents and Their Fixed-Dose Combinations Against Trastuzumab-Mediated Cardiotoxicity

“…Repeated TZM treatment was associated with profound weight loss. Again, this finding is in tandem with previous studies that have reported similar weight loss in patients on TZM treatment ( Hajjaji et al, 2014 ) although the TZM has been reported to have variable effects of body weight pattern in cancer patients on TZM treatment ( Winkels et al, 2014 ; Reijers and Burggraaf, 2015 ; Ginzac et al, 2020 ). However, oral pretreatment with ADP, LSP, VAL and their fixed-dose combinations further induced weight reduction in the face of TZM chemotherapy highlighting the weight loss potential of these antihypertensive drugs and their fixed-dose combinations which were probably mediated via plasma norepinephrine, insulin, and leptin inhibitions, and these were previously reported in the obese hypertensive patients on prolonged amlodipine, lisinopril, valsartan and fixed-dose amlodipine–valsartan combination use ( Masuo et al, 2001 ; Villecco et al, 2004 ).…”

Brown adipose tissue is associated with cardiometabolic health

“…3b). Current data concerning the association between cancer therapy and BAT are controversial, as some studies indicate that chemotherapy is associated with lower BAT prevalence or activity, while another study reported that the antimetabolite cytarabine may actually have an activating effect 10,[15][16][17] . To assess potential effects of treatment, cancer therapies were grouped into ten categories (Supplementary Table 5); only patients who had their first scan designated as the index scan were compared.…”

Biological Support to Obesity Paradox in Renal Cell Carcinoma: A Review

“…As noted above, increased expression of the BAT-associated protein UCP-1 in PAT is negatively associated with RCC prognosis [46]. Previously, studies have associated decreased BAT and UCP-1 activity with weight gain in breast cancer patients and high-fat-fed murine models, respectively [77, 78]. Thus, it will be interesting to further elicit the role of brown fat in the RCC-associated obesity paradox.…”