Body composition and chemotherapy toxicity in women with early breast cancer: The Cando-3 study


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Ramsey Cutress1
1Faculty of Medicine, University of Southampton

Abstract

Background

Chemotherapy dosing is traditionally based on body surface area but there are additional challenges in  overweight and obese patients. The extent to which variations in the proportions of body Fat Mass (FM) and Fat Free Mass (FFM) at the outset of treatment influence the risk of chemotoxicity needs to be determined. Bioelectrical Impedance analysis can be used to measure body composition and other impedance values at routine clinic appointments for women receiving standard neo/adjuvant chemotherapy for early breast cancer.

 Hypothesis: Differences in impedance measures of resistance, reactance and phase angle, and/or derived estimates of elevated FM index and low FFM index can be individually and/or jointly predictive of chemotherapy toxicity. Primary Objective: To determine if higher FMi is associated with increased grade 3 chemotherapy toxicity in women receiving neo/adjuvant chemotherapy for early breast cancer Secondary objectives: To determine whether EBC patients with different body composition patterns receive intended chemotherapy dose intensity; to determine the relationship between sBIA-measured physical properties e.g. phase angle and reactance and grade 3 or higher chemotherapy toxicity.

 

Method

This WCRF-funded, observational cohort study will recruit 300 women (aged >18-<80) diagnosed with EBC, undergoing standard neo/adjuvant chemotherapy over a period of 18 months, across seven UK hospital centres. Phase-adjusted sBIA using the Seca 515 mBCA will be performed prior to each chemotherapy cycle and at 3-weeks and 3-months post final cycle. Chemotherapy related toxicities for each treatment will be recorded using the standard Common Terminology Criteria for Adverse Events (v5.0). All chemotherapy doses prescribed will be captured, including any dose delays or reductions; intended and delivered chemotherapy dose density will be calculated.   Primary analyses in this study will investigate whether measures of sBIA or body composition relate to chemotherapy toxicity and/ or reduced delivered chemotherapy dose intensity, and how these variables change during chemotherapy treatment.

Results

Conclusion