title: BMI, Lifestyle Factors and Taxane-Induced Neuropathy in Breast Cancer Patients: The Pathways Study.
abstract: Lifestyle factors may be associated with chemotherapy-induced peripheral neuropathy (CIPN). We examined associations between body mass index (BMI) and lifestyle factors with CIPN in the Pathways Study, a prospective cohort of women with invasive breast cancer.
  
  
  
  Analyses included 1237 women who received taxane treatment and provided data on neurotoxicity symptoms. Baseline interviews assessed BMI (normal: <25 kg/m2; overweight: 25-29.9 kg/m2; obese: ≥30 kg/m2), moderate-to-vigorous physical activity (MVPA) (low: <2.5; medium: 2.5-5; high: >5 hours/week) and fruit/vegetable intake (low: <35 servings/week; high: ≥35 servings/week). Baseline and six-month interviews assessed antioxidant supplement use (nonuser, discontinued, continued user, initiator). CIPN was assessed at baseline, six months, and 24 months using the Functional Assessment of Cancer Therapy-Taxane Neurotoxicity (FACT-NTX); a 10% decrease was considered clinically meaningful.
  
  
  
  At baseline, 65.6% of patients in the sample were overweight or obese, 29.9% had low MVPA, 57.5% had low fruit/vegetable intake, and 9.5% reported antioxidant supplement use during treatment. In multivariable analyses, increased CIPN was more likely to occur in overweight (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.19 to 4.88) and obese patients (OR = 3.21, 95% CI = 1.52 to 7.02) compared with normal weight patients at 24 months and less likely to occur in patients with high MVPA compared with those with low MVPA at six (OR = 0.56, 95% CI = 0.34 to 0.94) and 24 months (OR = 0.43, 95% CI = 0.21 to 0.87). Compared with nonusers, patients who initiated antioxidant use during treatment were more likely to report increased CIPN at six months (OR = 3.81, 95% CI = 1.82 to 8.04).
  
  
  
  Obesity and low MVPA were associated with CIPN in breast cancer patients who received taxane treatment.
authors: Mailman School of Public Health, Columbia University, New York, NY, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA.
authors: Heather
authors: H
authors: Greenlee
authors: Mailman School of Public Health, Columbia University, New York, NY, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA.|College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors: Dawn L
authors: DL
authors: Hershman
authors: Mailman School of Public Health, Columbia University, New York, NY, USA.
authors: Zaixing
authors: Z
authors: Shi
authors: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors: Marilyn L
authors: ML
authors: Kwan
authors: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors: Isaac J
authors: IJ
authors: Ergas
authors: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors: Janise M
authors: JM
authors: Roh
authors: Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors: Lawrence H
authors: LH
authors: Kushi
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000975:Antioxidants; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy*; D001952:Bridged-Ring Compounds / Q000009:adverse effects*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy*; D004032:Diet; D019587:Dietary Supplements; D015444:Exercise; D005260:Female; D005638:Fruit; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D043823:Taxoids / Q000009:adverse effects*; D014675:Vegetables
chemical_list: D000970:Antineoplastic Agents; D000975:Antioxidants; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane