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Breast CancerCHANGENCT03210441

Evaluation of Eating Habits and Dysgeusia During Chemotherapy Treatment in Patients Affected by Breast Cancer

An observational study of Breast Cancer and Dysgeusia, run by Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In post-menopause women affected by breast cancer and treated with chemotherapy, overweight and obesity are considered both a risk factors as well as a negative prognostic factors since they increase the risk of early relapse and death. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Breast Cancer, Dysgeusia, Eating Behavior
How many people
204 participants
Where
1 siteItaly
Study dates
6 May 2014to 6 May 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients affected by invasive breast cancer

Who may be able to join

  • Pre- and post-menopause women with histologic diagnosis of invasive breast cancer surgically treated (all pT and all pN)
  • Patients must provide written informed consent to be enrolled in the study

Who cannot join

  • Locally extended or metastatic (M1) disease;
  • Previous surgical or radio therapeutic treatment (up to one year before the selection) in oral or nasal region;
  • Other serious medical conditions that can limit patient capability to participate in this study.

Trial locations and contacts

1 site in 1 country.

Lucia Vassalli, MD contact

lucia.vassalli@libero.it

Italy1 site, 1 recruiting
  • Azienda Ospedaliera Spedali Civili di Brescia

    Brescia, 25123

    Lucia Vassalli, MD, lucia.vassalli@libero.it

    Recruiting

Other trials in Italy

About this study

Official title: Evaluation of Eating Habits and Dysgeusia During Chemotherapy Treatment: a Prospective Cohort Study on Patients Affected by Breast Cancer

In post-menopause women affected by breast cancer and treated with chemotherapy, overweight and obesity are considered both a risk factors as well as a negative prognostic factors since they increase the risk of early relapse and death. Furthermore, a decrease in weight may also occur during chemotherapy and is associated to a reduced quality of life and survival. Also, the majority of patients under chemotherapy refer dysgeusia, an alteration in taste that can determine food aversion, selection of hypercaloric food or reduced food introduction up to malnutrition. Our aim is to evaluate eating habits changes in patients affected by breast cancer and under chemotherapy treatment and to better understand how this alterations influence the quality of life, anxiety, depression and insomnia of patients as well as overall survival.

Read the detailed description

INTRODUCTION

Overweight and obesity represent a risk factor for hormone dependent cancers such as breast, endometrium, ovarian, uterine and gastrointestinal cancer.

In particular, overweight and obesity are risk factors for breast cancer in post-menopause women since they are associated to higher level of circulating estrogens, insulin, insulin-like growth factor levels, leptin, adiponectin, growth factors (such as hepatocyte growth factor) and inflammatory cytokines (TNFα and Interleukin-6 (IL-6)). Moreover, they reduce sex hormone binding globulin (SHBG) plasma levels. Overweight and obesity are also negative prognostic factors for breast cancer in post-menopause women since they increase the risk of early relapse and death. An increased weight (2.5-6.2 Kg) is commonly reported during chemotherapy treatment in post-menopause women. This is due to increased appetite, hyperphagia and hydric retention associated with reduced metabolism and physic activities. However, the weight gain during therapy is still not recognised as a negative prognostic factor.

Furthermore, a decrease in weight may also occur during chemotherapy. This is mainly due to lower appetite and early satiety, dysgeusia, nausea and vomiting or intolerance to certain foods. Decreasing weight can determine less efficacy and tolerance in therapy, more complications/infections, more and longer hospitalisations and, as a consequence, a reduced quality of life and survival.

Dysgeusia is an alteration in taste that can determine food aversion, selection of hypercaloric food or reduced food introduction up to malnutrition. More than 75% of patients under chemotherapy refer dysgeusia; this is related to drugs (such as folic acid competitors, cyclophosphamide cisplatin and taxanes) and can last for weeks. ln particular, taxanes determine a peripheral nerves degeneration. The results are a metallic taste and an alteration in salted perception. In addition, they determine a dose-dependent chemotherapy-induced peripheral neuropathy (CIPN) with painful paraesthesia, total areflexia and muscular extremities weakness. Dysgeusia is an underestimated problem. Instrumental examinations and laboratory tests can be useful but they cannot replace a detailed medical history and a close physical examination associated with international validate questionnaires.

At the moment, no agreement was found on chemotherapy-induced dysgeusia prevention and therapy. Patients resolve this problems with cold food, candies before meals and sugary drinks and these behaviours lead to increasing in weight.

STUDY DESIGN

This is a prospective cohort study for the evaluation of eating habits changes and dysgeusia in patients with breast cancer during chemotherapy treatment. It will explore also the potential relations with anxiety, depression, insomnia and quality of life. These evaluations will be actuated using internationally validate questionnaires.

METHODS

This study is based on the collection of data with international validate questionnaires:

  • Food frequency questionnaire (FFQ) and photography atlas
  • Chemotherapy-induced taste alteration scale (CiTAS): evaluation of changes in taste.
  • Functional assessment of cancer therapy (FACT_B): evaluation of quality of life for physical health, social and familiar health, emotional health, functional health and health in relation with the pathology.
  • Beck depression inventory (BDI) and HADS: evaluation of depression presence and its intensity.
  • Pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI): evaluation of sleep quality.
  • State and trait anxiety inventory (STAI-Y): evaluation of anxiety presence and its intensity.

STATISTICAL CONSIDERATIONS

Based on the proportion of the women in overweight before chemotherapy is 30% and the proportion of the women in overweight after chemotherapy is 50% (with a 5% α error and an 80% strength), the established number of patients to include in the study is 186. In prevision of a 10% loss of patients in follow-up, 204 patients will be included in the study.

Medical subject headings
Breast Neoplasms, Dysgeusia, Feeding Behavior

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT03210441
Study groupRoleWhat they receive
Group 1Patients affected by breast cancer and potentially treated with taxane chemotherapy
Group 2Patients affected by breast cancer and not potentially treated without taxane chemotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. To evaluate eating habits changes in patients affected by breast cancer during chemotherapy treatment

    Appearence of dysgeusia, asthenia, diarrhoea, decreased or increased appetite, mucositis, nausea, stypsis, vomiting and meteorism will be evaluated throught Food frequency questionaire (FFQ) compared to baseline (nefore chemotherapy)

    Measured: From basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

Secondary outcomes (7)
  1. Evaluation of dysgeusia

    Presence of changes in food taste (sweet, salt, bitter) and food smell compared to baseline in patients treated with taxanes throught the evaluation of a food questionnaire

    Measured: From basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

  2. Evaluation of weight alterations

    Evaluation of the correlation between eating habits changes and dysgeusia with changes in weight through weight/height measurement and BMI calculation to evaluate the influence of eating habits changes and changes in weight on outcome in patients (relapse free interval (RFI) and overall survival (OS))

    Measured: From basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

  3. Evaluation of eating habits changes

    Food frequency questionnaire (FFQ), chemotherapy-induced taste alteration scale questionnaire (CiTAS)

    Measured: from basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

  4. Evaluation of the impact of eating habits changes and dysgeusia on quality of life

    functional assessment of cancer therapy questionnaire (FACT_B)

    Measured: from basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

  5. Evaluation of the impact of eating habits changes and dysgeusia on depression

    beck depression inventory (BDI) and HADS test

    Measured: from basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

  6. Evaluation of the impact of eating habits changes and dysgeusia on insomnia

    pittsburgh sleep quality index (PSQI) and insomnia severity index (ISI)

    Measured: from basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

  7. Evaluation of the impact of eating habits changes and dysgeusia on anxiety, depression

    state and trait anxiety inventory (STAI-Y) will be administered to patients

    Measured: from basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jul 2017
  2. Study start6 May 2014
  3. Primary completion6 May 2018 (estimated)
  4. Study completion6 May 2018 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
204 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03210441
Sponsor's protocol ID
NP2488
Acronym
CHANGE
Status last verified
Jul 2017
First submitted
15 Jun 2017
Last updated
7 Jul 2017
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sinicrope FA, Dannenberg AJ. Obesity and breast cancer prognosis: weight of the evidence. J Clin Oncol. 2011 Jan 1;29(1):4-7. doi: 10.1200/JCO.2010.32.1752. Epub 2010 Nov 29. No abstract available.

    PubMed 21115867
  • Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002 Feb 15;20(4):1128-43. doi: 10.1200/JCO.2002.20.4.1128.

    PubMed 11844838
  • Goodwin PJ, Boyd NF. Body size and breast cancer prognosis: a critical review of the evidence. Breast Cancer Res Treat. 1990 Oct;16(3):205-14. doi: 10.1007/BF01806329.

    PubMed 2085672
  • Obermair A, Kurz C, Hanzal E, Bancher-Todesca D, Thoma M, Bodisch A, Kubista E, Kyral E, Kaider A, Sevelda P, et al. The influence of obesity on the disease-free survival in primary breast cancer. Anticancer Res. 1995 Sep-Oct;15(5B):2265-9.

    PubMed 8572635
  • Litton JK, Gonzalez-Angulo AM, Warneke CL, Buzdar AU, Kau SW, Bondy M, Mahabir S, Hortobagyi GN, Brewster AM. Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer. J Clin Oncol. 2008 Sep 1;26(25):4072-7. doi: 10.1200/JCO.2007.14.4527.

    PubMed 18757321
  • Rosner GL, Hargis JB, Hollis DR, Budman DR, Weiss RB, Henderson IC, Schilsky RL. Relationship between toxicity and obesity in women receiving adjuvant chemotherapy for breast cancer: results from cancer and leukemia group B study 8541. J Clin Oncol. 1996 Nov;14(11):3000-8. doi: 10.1200/JCO.1996.14.11.3000.

    PubMed 8918498
  • Tredan O, Bajard A, Meunier A, Roux P, Fiorletta I, Gargi T, Bachelot T, Guastalla JP, Lallemand Y, Faure C, Perol D, Bachmann P. Body weight change in women receiving adjuvant chemotherapy for breast cancer: a French prospective study. Clin Nutr. 2010 Apr;29(2):187-91. doi: 10.1016/j.clnu.2009.08.003. Epub 2009 Aug 26.

    PubMed 19713014
  • Saquib N, Flatt SW, Natarajan L, Thomson CA, Bardwell WA, Caan B, Rock CL, Pierce JP. Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women's healthy eating and living (WHEL) study. Breast Cancer Res Treat. 2007 Oct;105(2):177-86. doi: 10.1007/s10549-006-9442-2. Epub 2006 Nov 23.

    PubMed 17123151
  • Harvie MN, Campbell IT, Baildam A, Howell A. Energy balance in early breast cancer patients receiving adjuvant chemotherapy. Breast Cancer Res Treat. 2004 Feb;83(3):201-10. doi: 10.1023/B:BREA.0000014037.48744.fa.

    PubMed 14758090
  • Goodwin PJ, Ennis M, Pritchard KI, McCready D, Koo J, Sidlofsky S, Trudeau M, Hood N, Redwood S. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol. 1999 Jan;17(1):120-9. doi: 10.1200/JCO.1999.17.1.120.

    PubMed 10458225
  • Demark-Wahnefried W, Rimer BK, Winer EP. Weight gain in women diagnosed with breast cancer. J Am Diet Assoc. 1997 May;97(5):519-26, 529; quiz 527-8. doi: 10.1016/s0002-8223(97)00133-8.

    PubMed 9145091
  • Demark-Wahnefried W, Winer EP, Rimer BK. Why women gain weight with adjuvant chemotherapy for breast cancer. J Clin Oncol. 1993 Jul;11(7):1418-29. doi: 10.1200/JCO.1993.11.7.1418.

    PubMed 8315439
  • Demark-Wahnefried W, Hars V, Conaway MR, Havlin K, Rimer BK, McElveen G, Winer EP. Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. Am J Clin Nutr. 1997 May;65(5):1495-501. doi: 10.1093/ajcn/65.5.1495.

    PubMed 9129482
  • Camoriano JK, Loprinzi CL, Ingle JN, Therneau TM, Krook JE, Veeder MH. Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol. 1990 Aug;8(8):1327-34. doi: 10.1200/JCO.1990.8.8.1327.

    PubMed 2199619
  • Chlebowski RT, Weiner JM, Reynolds R, Luce J, Bulcavage L, Bateman JR. Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy. Breast Cancer Res Treat. 1986;7(1):23-30. doi: 10.1007/BF01886732.

    PubMed 3516262

Questions about this trial

What is this clinical trial studying?

An observational study of Breast Cancer and Dysgeusia, run by Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 7 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Lucia Vassalli, MD (lucia.vassalli@libero.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To evaluate eating habits changes in patients affected by breast cancer during chemotherapy treatment (time frame: From basal visit and after every 3 months (during and post-chemotherapy) up to 12 months post- chemotherapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03210441, which also lists 38 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Jul 2017.

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