Effectiveness of a Global Multidisciplinary Supportive and Educational Intervention in Thermal Resort on Anthropometric and Biological Parameters, and the Disease-Free Survival after Breast Cancer Treatment Completion (PACThe)

Abstract

A growing knowledge highlights the strong benefit of regular physical activity in the management of breast cancer patients, but few studies have considered biological parameters in their outcomes. In the prospective randomised trial after breast cancer treatment completion “PACThe,” we determined the effects of physical activity and nutritional intervention on the biological and anthropometric status of patients after one year of follow-up, and clarified the link between biomarkers at allocation and disease-free survival. 113 patients from the population of the “PACThe” study (n = 251) were analysed for biological parameters. Patients were randomized after chemotherapy in two arms: the intervention “SPA” receiving a 2-week session of physical training, dietary education, and physiotherapy (n = 57), and the control “CTR” (n = 56). Diet questionnaire, anthropometric measures, and blood parameters were determined at allocation and one year later. Survival and recurrence were checked over 7 years. Data were considered as a function of BMI, i.e., ≤25 for normal, 25–30 for overweight, and >30 for obese patients. At allocation, the large standard deviation for nutrient-intake values reflected an unbalanced diet for some patients in the three groups. At one-year follow-up, we noticed an increase in glucose (p<10−6), insulin (p<10−7), and adiponectin (p<0.022) plasma levels for both intervention arms, which were more accentuated for the >30 groups. Using the Cox model, we demonstrated that the highest testosterone plasma values were linked to an increase of the recurrence risk (HR [CI–95%] = 5.06 [1.66–15.41]; p=0.004). One-year after a global multidisciplinary supportive and educational intervention, we found few anthropometric and biological changes, mainly related to the patient’s initial BMI. We highlighted the importance of plasma testosterone in the evaluation of patient’s recurrence risk. Future studies would help better understand the mechanisms by which such multidisciplinary interventions could interact with breast cancer recurrence and define the most effective modalities.

Associations between circulating obesity-related biomarkers and prognosis in female breast cancer survivors: a systematic review of observational data in women enrolled in lifestyle intervention trials

“…Several biomarkers were investigated in the DIANA-5 study by Berrino and colleagues [23]. Vasson and colleagues [24] reported baseline biomarker data from the PACThe study. The WHEL study reported on circulating biomarkers in Emond et al [25], Al-Delaimy et al [26] and Villaseñor et al [27].…”

“…A complete list of studies with their main characteristics and investigated biomarkers is provided in Table 3. DIANA-2 [20][21][22] and WHEL [25][26][27] consisted of healthy diet interventions, while DIANA-5 [23], and PACThe [24] included both diet and exercise programs. Biomarkers in these studies were measured before lifestyle interventions were implemented.…”

“…Biomarkers in these studies were measured before lifestyle interventions were implemented. DIANA-2 [20][21][22], DIANA-5 [23] and PACThe [24] were conducted in Europe, while WHEL [25][26][27] took place in the United States. Sample sizes ranged from 107 to 2919 women.…”

“…All studies included a range of estrogen receptor (ER) and progesterone receptor (PR) breast cancer subtypes [20][21][22][23][24][25][26][27]. DIANA-5 [23] and PACThe [24] recruited women with HER2+ breast cancer, while WHEL included women with HER2+ and HER2-subtypes [27].…”

“…All studies included a range of estrogen receptor (ER) and progesterone receptor (PR) breast cancer subtypes [20][21][22][23][24][25][26][27]. DIANA-5 [23] and PACThe [24] recruited women with HER2+ breast cancer, while WHEL included women with HER2+ and HER2-subtypes [27]. DIANA-2 [20][21][22], DIANA-5 [23], and WHEL [26] analyzed blood biomarkers related to glucose, glucose metabolism and insulin resistance.…”