Abstract 1694P
Background
Nutrition is a major concern for many cancer survivors, who often seek dietary information to improve their clinical outcomes and quality of life (QOL). Recently, the Nurses’ Health Study linked higher post-diagnosis (dx) coffee consumption with better overall and breast-cancer specific survival. Whether excessive CTC can affect QOL is controversial. Some data suggest a positive impact of bioactive compounds in coffee and tea on health outcomes (pain control), but concerns exist that excessive CTC may exacerbate symptoms (insomnia and anxiety).
Methods
We included pts with stage I-III BC from the prospective, multicenter CANTO cohort (NCT01993498) that provided dietary evaluations from year (Y) 1-4 post-dx, including assessments of CTC (cups/day). PROs (EORTC QLQ-C30, HADS) were collected at dx, and Y1, 2, and 4 post-dx. First, group-based trajectory modeling (GBTM) clustered patients according to CTC and logistic regression assessed factors associated with group membership. Then, multivariable mixed models and Cox models examined associations of CTC with PROs and clinical outcomes, respectively.
Results
3788 pts completed a median of 8 CTC evaluations (Q1-Q3, 5-9) and were clustered in 4 groups by GBTM: little (25.8%), moderate (37.6%), high (25.3%), and very high (11.3%) CTC (<1, 2, 3, and ≥4 cups/day, respectively). Within-group CTC was constant over time. Compared to little CTC, pts with very high CTC were more likely to be younger (adjusted OR for 1Y decrease 1.03 [95%CI 1.01-1.05]), smokers (vs not 3.97 [3.08-5.12]), with higher monthly income (vs low 1.4 [1.05-1.85]) and better education (college vs primary 1.39 [1.06-1.82]). PRO (Table) and BC free and overall survival were similar across the 4 CTC groups. Table: 1694P
| Adjusted1 mean score (95% CI) | Adjusted mean difference2 vs ref group (95% CI) | |||
| Little CTC (ref) | Moderate CTC | High CTC | Very High CTC | |
| Overall QOL3 | 76.7 (75.5, 77.9) | +0.48 (-0.6, +1.5) | +0.1 (-1.0, +1.3) | +0.2 (-1.3, +1.7) |
| Insomnia | 44.5 (41.4, 47.7) | -1.5 (-4.3, +1.2) | -0.8 (-3.8, +2.3) | -0.2 (-4.1, +3.6) |
| Fatigue | 38.3 (36.1, 40.5) | -0.9 (-2.9, +0.9) | -0.05 (-2.2, +2.1) | -0.6 (-3.4, +2.2) |
| Pain | 27.4 (25.2-26.9) | +0.6 (-1.5, 2.6) | +1.8 (-0.5, 4.0) | +1.0 (-0.3, 2.8) |
| Anxiety | 7.9 (7.7, 8.3) | -0.1 (-0.3, 0.2) | -0.1 (-0.4, 0.2) | -0.01 (-0.4, +0.4) |
Range: 0-100 for C30, 0-21 for HADS 1for CTC, time, CTC*time, covariates 2Negative = worse for QOL, better for symptoms. CI crossing 0 = no significant difference 3C30 Summary Score
Conclusions
Over one-in-three survivors of BC reported high or very high post-dx CTC. There were no indications of detrimental associations between increased daily CTC and PRO, including overall QOL, insomnia, and anxiety.
Clinical trial identification
NCT01993498.
Editorial acknowledgement
Legal entity responsible for the study
UNICANCER.
Funding
National Research Agency (grant ANR-10-COHO-0004 to Fabrice André for the Cancer Toxicity study).
Disclosure
B. Pistilli: Financial Interests, Personal, Advisory Role: Puma Biotechnology; Financial Interests, Personal, Advisory Role: Novartis; Financial Interests, Personal, Advisory Role: Myriad Genetics; Financial Interests, Personal, Advisory Role: Pierre Fabre; Financial Interests, Personal, Other, meeting and/or travel support: Novartis; Financial Interests, Personal, Other, meeting and/or travel support: AstraZeneca; Financial Interests, Personal, Other, meeting and/or travel support: MSD Oncology; Financial Interests, Personal, Other, meeting and/or travel support: Pfizer; Financial Interests, Personal, Research Grant: Daiichi Sankyo; Financial Interests, Personal, Research Grant: Puma Biotechnology; Financial Interests, Personal, Research Grant: Novartis; Financial Interests, Personal, Research Grant: Merus; Financial Interests, Personal, Research Grant: Pfizer; Financial Interests, Personal, Research Grant: AstraZeneca. L. Del Mastro: Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal and Institutional, Invited Speaker: Novartis; Financial Interests, Personal, Invited Speaker: Eli Lilly; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Ipsen; Financial Interests, Personal, Other, Support for attending meetings and/or travel: Roche; Financial Interests, Personal, Other, Support for attending meetings and/or travel: Pfizer; Financial Interests, Personal, Other, Support for attending meetings and/or travel: Celgene; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Eli Lilly; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Genomic Health; Financial Interests, Personal, Advisory Board: Pierre Fabre; Financial Interests, Personal, Advisory Board: Daiichi Sankyo; Financial Interests, Personal, Advisory Board: Seagen; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Eisai. O. Tredan: Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: MSD Merck; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: Novartis Sandoz; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Invited Speaker: Seagen; Financial Interests, Personal, Invited Speaker: Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: Eisai; Financial Interests, Personal, Invited Speaker: Pierre Fabre; Financial Interests, Personal, Research Grant: Roche; Financial Interests, Personal, Research Grant: MSD Merck; Financial Interests, Personal, Research Grant: BMS. F. André: Financial Interests, Personal, Other, grants or contracts: Novartis; Financial Interests, Personal, Other, grants or contracts: Pfizer; Financial Interests, Personal, Other, grants or contracts: AstraZeneca; Financial Interests, Personal, Other, grants or contracts: Eli Lilly; Financial Interests, Personal, Other, grants or contracts: Daiichi Sankyo; Financial Interests, Personal, Other, grants or contracts: Roche. I. Vaz-Luis: Financial Interests, Personal, Other, Payments or honoraria: Novartis; Financial Interests, Personal, Other, Payments or honoraria: Kephren; Financial Interests, Personal, Other, Payments or honoraria: AstraZeneca; Financial Interests, Personal, Other, Payments or honoraria: Amgen. A. Di Meglio: Financial Interests, Personal, Other, Honoraria: Thermo Fisher Scientific. All other authors have declared no conflicts of interest.