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William J. Gradishar, MD, FACP, FASCO


Impact of Diet and Exercise on Chemotherapy Completion in Patients With Breast Cancer

By: Julia Fiederlein
Posted: Friday, July 8, 2022

Tara B. Sanft, MD, of the Yale School of Medicine, New Haven, Connecticut, and colleagues conducted a study to determine the impact of a diet and physical activity intervention on relative dose intensity, an integrated measure used to describe chemotherapy dose delays and reductions, in patients with newly diagnosed breast cancer undergoing chemotherapy. The results of the LEANer trial were presented during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 12007).

“A primarily telephone-based diet and physical activity intervention led to improved diet and physical activity,” the investigators commented. “[However, the intervention] did not improve relative dose intensity compared with usual care.”

Women with stage I to III breast cancer were randomly assigned to receive usual care (n = 86) or a year-long, 16-session, in-person or telephone-based diet and physical activity intervention (n = 87). Patients who received intervention completed 94% of counseling sessions during chemotherapy and were found to experience significant improvements in physical activity and diet. According to the investigators, the average continuous relative dose intensity was unexpectedly high in both groups (P = .92); however, 17% and 15% of the patients who received intervention and usual care, respectively, had a relative dose intensity of less than 85% (P = .70). More than one-third experienced at least one toxicity-associated dose reduction and/or delay lasting longer than 7 days with at least one chemotherapy drug (39% vs. 37%, respectively; P = .80).

Post hoc analyses demonstrated a benefit in neoadjuvant chemotherapy completion with intervention compared with usual care (relative dose intensity: 95% vs. 90%; P = .05). A dose-response effect was observed in patients who received intervention and achieved Healthy Eating Index scores above the median for physical activity and diet quality; this population experienced a higher relative dose intensity than those with scores below the median (97% vs. 90%; P = .05).

Disclosure: For full disclosures of the study authors, visit

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