Continuous glucose monitoring to characterize hyperglycemia during chemotherapy for early stage breast cancer.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-06-04 DOI:10.1007/s10549-025-07745-z

Sophie R Ulene, Shikun Wang, Joshua R Cook, Fiona McAuley, Margaux E Wooster, Khadija F Faheem, Andrew Varoli, Julia E McGuinness, Neil Vasan, Meghna S Trivedi, Katherine D Crew, Erik Harden, Cynthia Law, Dawn L Hershman, Melissa K Accordino

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引用次数: 0

Abstract

Purpose: Diabetes (DM) and hyperglycemia during chemotherapy increase the risk of toxicity, yet the prevalence and patterns of hyperglycemia in early-stage breast cancer (ESBC) patients undergoing chemotherapy with concurrent dexamethasone remain poorly understood.

Methods: We conducted a prospective single-arm study using FreeStyle Libre Pro continuous glucose monitoring in patients with ESBC receiving chemotherapy from 12/2020-2/2022. Sensors measured interstitial glucose every 15 min and were reapplied every 2-3 weeks. Primary endpoints were (1) prevalence of hyperglycemia (≥ 1 reading ≥ 140 mg/dL), and (2) for those with hyperglycemia, the proportion of time spent hyperglycemic. Secondary endpoints included baseline glucose tolerance by A1c, changes in glucose-related biomarkers, and changes in patient-reported neuropathy, quality of life, and fatigue. Analysis was stratified by baseline A1c (euglycemic < 5.7%, prediabetes [pre-DM] 5.7-6.4%, diabetes [DM] ≥ 6.5%).

Results: Among 20 evaluable patients (median age: 60, BMI: 29.5 kg/m²), common chemotherapy regimens included docetaxel/cyclophosphamide (25%), paclitaxel/trastuzumab (20%), paclitaxel then doxorubicin/cyclophosphamide (15%), docetaxel/carboplatin/trastuzumab/pertuzumab (15%), and cyclophosphamide/methotrexate/fluorouracil (15%). All patients received Dexamethasone. At baseline, 10 patients were euglycemic, 7 had pre-DM, and 3 had DM. All experienced hyperglycemia. Of 124,165 total glucose readings, 17% were ≥ 140 mg/dL. By cohort, the proportion of time spent hyperglycemic was 3.9% (euglycemic), 10% (pre-DM), and 73.3% (DM) (p < .0001). Mean glucose values were 95.5 mg/dL (euglycemic), 104.5 mg/dL (pre-DM), and 183.0 mg/dL (DM) (p < .0001).

Conclusion: All patients receiving chemotherapy for ESBC experienced hyperglycemia, with time spent hyperglycemic varying significantly by baseline A1c. Future research should explore approaches to and benefits of improving glycemic control during treatment in patients with baseline dysglycemia.

Trial registration: NCT04473378.

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持续血糖监测对早期乳腺癌化疗期间高血糖的特征。

目的：化疗期间糖尿病（DM）和高血糖增加了毒性的风险，然而在化疗同时使用地塞米松的早期乳腺癌（ESBC）患者中高血糖的患病率和模式仍然知之甚少。方法：我们在2020年12月至2022年2月期间接受化疗的ESBC患者中使用FreeStyle Libre Pro持续血糖监测进行了一项前瞻性单臂研究。传感器每15分钟测量间质葡萄糖，每2-3周重新应用。主要终点是：(1)高血糖的患病率（≥1读数≥140 mg/dL），(2)高血糖患者的高血糖时间比例。次要终点包括A1c的基线葡萄糖耐量、葡萄糖相关生物标志物的变化、患者报告的神经病变、生活质量和疲劳的变化。结果：在20例可评估的患者（中位年龄：60，BMI: 29.5 kg/m2）中，常见的化疗方案包括多西紫杉醇/环磷酰胺（25%），紫杉醇/曲妥珠单抗（20%），紫杉醇然后阿霉素/环磷酰胺（15%），多西紫杉醇/卡铂/曲妥珠单抗/帕妥珠单抗（15%），环磷酰胺/甲氨蝶呤/氟尿嘧啶（15%）。所有患者均接受地塞米松治疗。基线时，10例患者血糖正常，7例为糖尿病前期，3例为糖尿病。所有患者均出现高血糖。在124,165个总葡萄糖读数中，17%≥140 mg/dL。在队列中，高血糖持续时间的比例分别为3.9%（正常血糖）、10%（糖尿病前期）和73.3%（糖尿病前期）(p)。结论：所有接受ESBC化疗的患者均出现高血糖，高血糖持续时间随基线A1c的不同而有显著差异。未来的研究应该探索在基线血糖异常患者治疗期间改善血糖控制的方法和益处。试验注册：NCT04473378。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.