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Treatments for early breast cancer have side effects that affect quality of life (QoL) and cause deconditioning. Physical exercise might have a supportive and coadjuvant role in the rehabilitation of breast cancer survivors. We aimed to analyse the preliminary results of a community-based supervised exercise training program on QoL and muscle strength in breast cancer survivors. Twenty breast cancer female survivors were recruited to a single-arm clinical trial consisting of sequential 16 weeks (wk) of control phase (CP) and 16 wk intervention phase (IP). Four evaluations were carried out: M1 (8 wk on CP), M2 (immediately previous IP), M3 (8 wk CP) and M4 (16 wk IP). The IP consisted of 3 sessions per week of combined aerobic and strength exercise (60min) at moderate to vigorous exercise (65-85% of maximum heart rate or 6-8 points on OMNI scale). The primary endpoint was QoL, which was evaluated by EORTC QLQ-C30 questionnaire. Secondary endpoints included handgrip strength and sit-to-stand (STS) test. Of the 20 recruited women, 19 initiated and 15 concluded the program, with a mean compliance to the exercise intervention of 63.6%. The median age was 59 years old (39-72). All but 3 were diagnosed with invasive carcinoma. After surgery, 13 (62%) underwent radiotherapy, 15 (71%) chemotherapy and 18 (86%) were under hormonotherapy. During the control phase, no significant differences were observed in the efficacy variables. There was no changes over time for any domain of QoL, except for physical functioning scale (p = 0.038), where it was observed a trend to increase between M2 and M3 (77.3±14.0 to 85.3±10.1, p = 0.051). A significant increase in handgrip strength of non-operated (22.2±3.9 to 25.6±5.3 kg.f, p = 0.004) and operated limb (22.6±4.7 to 26.9±6.6 kg.f, p = 0.001) was shown after exercise training. Similar results were also observed for STS test [12 (11-13.5) to 17 (13-21) repetitions, p = 0.002]. An exercise program appears to be beneficial for QoL, particularly in the physical functioning of breast cancer survivors. Moreover, it seems to have an important role on strength levels. Associação de Investigação e Cuidados de Suporte em Oncologia. Liga Portuguesa Contra o Cancro. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplantation (HSCT) is a potentially curative procedure for a variety of hematologic malignancies, such as leukemia, lymphomas, and myeloma. HSCT patients have decreased physical function and quality of life (QOL) 6-7 weeks after HSCT compared to that before (Morishita S, et al. Psychooncology, 2013). Besides graft-versus-host disease and infections, reduced physical function, and particularly high levels of fatigue, negatively affect patients QOL. HSCT patients may require physical exercise to prevent a decrease in physical function or improve physical function and QOL. Our previous study showed that the proportion of daily activities performed at an intensity >3.0 metabolic equivalents (METs) has been shown to increase significantly after HSCT in 30 patients (Morishita S, et al. Eur J Cancer care, 2017). Daily activity time performed at an intensity of 1.6-2.9 METs significantly correlated only with knee strength. The total number of daily steps and the proportion of activity performed at 1.6-2.9 METs and >3.0 METs were positively correlated with the 6MWT. In addition, physical functioning and general health subscales in health-related QOL were found to be positively correlated with daily activities performed at > 3.0 METs. For HSCT patients, it may be important to assess physical activity before the procedure and to increase levels and intensity of physical activity to prevent reduced physical function thereafter. [ABSTRACT FROM AUTHOR]

Symptom burden and reduced quality of life are considerable hurdles in cancer treatment. The Patient-Reported Outcomes Measurement Information System (PROMIS) assesses physical and psychosocial functional status in clinical and research settings. We use PROMIS scores to establish mean symptom burden within a breast cancer patient population, identifying how subgroups compare to one another, examining potential drivers, and characterizing severe symptom burden between subgroups. New cancer patients at the UCSF Breast Care Center (BCC) receive electronic intake questionnaires assessing demographics, health history, and 8 PROMIS domains: depression, anxiety, fatigue, sleep-related impairment and disturbance, cognitive function, applied cognition and physical function. Patients were separated by age and stage of cancer and mean PROMIS reference values for each group were calculated using the NCI's Health Measures scoring system. We computed enrichment of higher levels of anxiety, sleep impairment, fatigue, physical function impairment, and cognitive decline in metastatic patients versus all other cases. Compared to stage 0-III, BCC stage IV patients had lower mean values for all assessed domains (p < 0.05). Within the stage IV population, high levels of anxiety were uniquely predictive of low functional status in 6 out of the other 7 domains. The stage IV population was significantly enriched for severe symptomatology in all domains except sleep-related impairment and disturbance when compared to the stage 0-III population. PROMIS scores indicate that stage IV patients have impaired quality of life in multiple domains. Reference values for demographic groups provide improved guidance in tailoring supportive care referrals. Anxiety emerged as one of the biggest drivers of impairment of other physical, mental, and social functions and thus increased priority addressing anxiety early will likely correspond with improved symptom burden. Our analysis on quality of life will also help determine appropriate thresholds of intervention to trigger referrals and manage a patient's quality-of-life trajectory more systematically. Athena Breast Health Network. Athena Breast Health Network, University of California, San Francisco. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

In this study we aimed to examine the independent effect of baseline QoL and persistent CRT among pts with early BC. We included data stage I-III BC pts treated with chemotherapy who were included in the CANTO prospective cohort study (NCT-01993498) from 03/2012 to 12/2014. The primary outcome was CRT defined as the presence at 3-6 months after the end of treatment, of any of the following toxicities (NCI-CTC-AE): infection, venous or arterial thrombosis, neurological G2-4, digestive G3-4 or pulmonary toxicities G3-4). Treatment deliver including chemotherapy dose reductions were also examined. The independent variable of this study was baseline Qol defined by the EORTC QLQ-C30 subscales of general global health status (GHS) (< or ≥ 70) and physical functioning PF (< or ≥ 90). The defined cutoffs correspond to the average values in the French general population. Clinical relevant adjustment covariates included stage, age, performance status (PS), body mass index (BMI), HR and HER2 status, baseline lymphopenia, albumin, creatinine clearance, alcohol consumption, and smoking status. Multivariable logistic models were performed. Among 3079 BC pts included in this analysis, 33% received neoadjuvant and 77% adjuvant treatment. Median age at diagnosis was 53 years, median BMI= 25 kg/m2, 94% of patients had a PS = 0 and 83% stage I-II disease. Pts reported on average a good GHS = 68 (±19) and PF = 90 (±14). GHS and PF were higher in women with better performance status PS = 0 vs 1+, (68 vs 60 p < 0.001) and 91 vs 78 p < 0.001) respectively. 952 (31%) BC pts developed ≥1 CRT: 23% had an infection, 7% thrombosis, 0.3% G3-4 diarrhea, nausea or vomiting, 4% G2-4 neurological and 0.2% G3-4 pulmonary toxicities. 16% had chemotherapy dose reduction. Pts with a baseline GHS <70 had 19 % higher odds of CRT vs to those with GHS≥70, OR = 1.19 [95% CI 1.02-1.41] and similarly those with a PF < 90 had a 23% higher odds of CRT when compared to those with PF ≥ 90 (OR = 1.23 [95% CI 1.03-1.49]). Global and physical QoL before BC treatments are independently associated with CRT. QoL should be assessed before any treatment to identify patients at risk CRT. NCT01993498. UNICANCER/Villejuif, France, 94805 Principal Investigator: Fabrice André Gustave Roussy – Villejuif. Has not received any funding. All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]