title: Randomized trial of a telephone-based weight loss intervention in postmenopausal women with breast cancer receiving letrozole: the LISA trial.
abstract: OBJECTIVE
  Obesity is associated with poor outcomes in women with operable breast cancer. Lifestyle interventions (LIs) that help women reduce their weight may improve outcomes.
  
  
  METHODS
  We conducted a multicenter randomized trial comparing mail-based delivery of general health information alone or combined with a 24-month standardized, telephone-based LI that included diet (500 to 1,000 kcal per day deficit) and physical activity (150 to 200 minutes of moderate-intensity physical activity per week) goals to achieve weight loss (up to 10%). Women receiving adjuvant letrozole for T1-3N0-3M0 breast cancer with a body mass index (BMI) ≥ 24 kg/m(2) were eligible. Weight was measured in the clinic, and self-report physical activity, quality-of-life (QOL), and diet questionnaires were completed. The primary outcome was disease-free survival. Accrual was terminated at 338 of 2,150 planned patients because of loss of funding.
  
  
  RESULTS
  Mean weight loss was significantly (P < .001) greater in the LI arm versus the comparison arm (4.3 v 0.6 kg or 5.3% v 0.7% at 6 months and 3.1 v 0.3 kg or 3.6% v 0.4% at 24 months) and occurred consistently across strata (BMI 24 to < 30 v ≥ 30 kg/m(2); prior v no prior adjuvant chemotherapy). Weight loss was greatest in those with higher baseline levels of moderate-intensity physical activity or improvement in QOL. Hospitalization rates and medical events were similar.
  
  
  CONCLUSIONS
  A telephone-based LI led to significant weight loss that was still evident at 24 months, without adverse effects on QOL, hospitalizations, or medical events. Adequately powered randomized trials with cancer end points are needed.
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA. pgoodwin@mtsinai.on.ca.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Goodwin
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Roanne J
authors.initials: RJ
authors.lastname: Segal
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Michael
authors.initials: M
authors.lastname: Vallis
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Ligibel
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Pond
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: André
authors.initials: A
authors.lastname: Robidoux
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Brian
authors.initials: B
authors.lastname: Findlay
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Gralow
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Som
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Mark
authors.initials: M
authors.lastname: Levine
authors.affiliation: Pamela J. Goodwin, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and Princess Margaret Hospital; Kathleen I. Pritchard, Sunnybrook Odette Cancer Center; Pamela J. Goodwin and Kathleen I. Pritchard, University of Toronto, Toronto; Roanne J. Segal, Ottawa Hospital Regional Cancer Center, University of Ottawa, Ottawa; Gregory R. Pond, Som Mukherjee, and Mark Levine, Juravinski Hospital and Cancer Center; Brian Findlay, Niagara Health System, Walker Family Cancer Center; Gregory R. Pond, Mark Levine, Brian Findlay, and Som Mukherjee, McMaster University, Hamilton, Ontario; Michael Vallis, Dalhousie University, Halifax, Nova Scotia; André Robidoux, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada; Jennifer A. Ligibel, Dana-Farber Cancer Institute; George L. Blackburn, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel and George L. Blackburn, Harvard Medical School, Boston, MA; and Julie R. Gralow, University of Washington, Seattle, WA.
authors.forename: Kathleen I
authors.initials: KI
authors.lastname: Pritchard
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077289:Letrozole; D008019:Life Style; D008875:Middle Aged; D009367:Neoplasm Staging; D009570:Nitriles / Q000627:therapeutic use*; D009765:Obesity / Q000517:prevention & control; D017698:Postmenopause; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013689:Telephone; D014230:Triazoles / Q000627:therapeutic use*; D015431:Weight Loss
chemical_list: D000970:Antineoplastic Agents; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole