Faiza Kalam, Dara L James, Yun Rose Li, Michael F Coleman, Violet A Kiesel, Elizabeth M Cespedes Feliciano, Stephen D Hursting, Dorothy D Sears, Amber S Kleckner
{"title":"Intermittent fasting interventions to leverage metabolic and circadian mechanisms for cancer treatment and supportive care outcomes.","authors":"Faiza Kalam, Dara L James, Yun Rose Li, Michael F Coleman, Violet A Kiesel, Elizabeth M Cespedes Feliciano, Stephen D Hursting, Dorothy D Sears, Amber S Kleckner","doi":"10.1093/jncimonographs/lgad008","DOIUrl":"10.1093/jncimonographs/lgad008","url":null,"abstract":"<p><p>Intermittent fasting entails restricting food intake during specific times of day, days of the week, religious practice, or surrounding clinically important events. Herein, the metabolic and circadian rhythm mechanisms underlying the proposed benefits of intermittent fasting for the cancer population are described. We summarize epidemiological, preclinical, and clinical studies in cancer published between January 2020 and August 2022 and propose avenues for future research. An outstanding concern regarding the use of intermittent fasting among cancer patients is that fasting often results in caloric restriction, which can put patients already prone to malnutrition, cachexia, or sarcopenia at risk. Although clinical trials do not yet provide sufficient data to support the general use of intermittent fasting in clinical practice, this summary may be useful for patients, caregivers, and clinicians who are exploring intermittent fasting as part of their cancer journey for clinical outcomes and symptom management.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary C Playdon, Sheetal Hardikar, Prasoona Karra, Rachel Hoobler, Anna R Ibele, Katherine L Cook, Amanika Kumar, Joseph E Ippolito, Justin C Brown
{"title":"Metabolic and bariatric surgery and obesity pharmacotherapy for cancer prevention: current status and future possibilities.","authors":"Mary C Playdon, Sheetal Hardikar, Prasoona Karra, Rachel Hoobler, Anna R Ibele, Katherine L Cook, Amanika Kumar, Joseph E Ippolito, Justin C Brown","doi":"10.1093/jncimonographs/lgad003","DOIUrl":"10.1093/jncimonographs/lgad003","url":null,"abstract":"<p><p>Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of developing at least 13 types of cancer. This report provides a concise review of the current state of the science regarding metabolic and bariatric surgery and obesity pharmacotherapy related to cancer risk. Meta-analyses of cohort studies report that metabolic and bariatric surgery is independently associated with a lower risk of incident cancer than nonsurgical obesity care. Less is known regarding the cancer-preventive effects of obesity pharmacotherapy. The recent approval and promising pipeline of obesity drugs will provide the opportunity to understand the potential for obesity therapy to emerge as an evidence-based cancer prevention strategy. There are myriad research opportunities to advance our understanding of how metabolic and bariatric surgery and obesity pharmacotherapy may be used for cancer prevention.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Preface: Engaging Older Adults in Cancer Clinical Trials Conducted in the National Cancer Institute Clinical Trials Network: Opportunities to Enhance Accrual.","authors":"","doi":"10.1093/jncimonographs/lgac030","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgac030","url":null,"abstract":"","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157774/pdf/lgac030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ngozi D Akingbesote, Dennis Owusu, Ryan Liu, Brenda Cartmel, Leah M Ferrucci, Michelle Zupa, Maryam B Lustberg, Tara Sanft, Kim R M Blenman, Melinda L Irwin, Rachel J Perry
{"title":"A review of the impact of energy balance on triple-negative breast cancer.","authors":"Ngozi D Akingbesote, Dennis Owusu, Ryan Liu, Brenda Cartmel, Leah M Ferrucci, Michelle Zupa, Maryam B Lustberg, Tara Sanft, Kim R M Blenman, Melinda L Irwin, Rachel J Perry","doi":"10.1093/jncimonographs/lgad011","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgad011","url":null,"abstract":"<p><p>Cancer cells cannot proliferate without sufficient energy to generate biomass for rapid cell division, as well as to fuel their functions at baseline. For this reason, many recent observational and interventional studies have focused on increasing energy expenditure and/or reducing energy intake during and after cancer treatment. The impact of variance in diet composition and in exercise on cancer outcomes has been detailed extensively elsewhere and is not the primary focus of this review. Instead, in this translational, narrative review we examine studies of how energy balance impacts anticancer immune activation and outcomes in triple-negative breast cancer (TNBC). We discuss preclinical, clinical observational, and the few clinical interventional studies on energy balance in TNBC. We advocate for the implementation of clinical studies to examine how optimizing energy balance-through changes in diet and/or exercise-may optimize the response to immunotherapy in people with TNBC. It is our conviction that by taking a holistic approach that includes energy balance as a key factor to be considered during and after treatment, cancer care may be optimized, and the detrimental effects of cancer treatment and recovery on overall health may be minimized.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana P Arteaga, Corina DeKraker, Marguerite Ennis, Nicole Dewey, Emily A Goebel, Stephen Welch, Isabel Pimentel, Joseph E Ippolito, Ana Elisa Lohmann
{"title":"Body composition and endometrial cancer outcomes.","authors":"Diana P Arteaga, Corina DeKraker, Marguerite Ennis, Nicole Dewey, Emily A Goebel, Stephen Welch, Isabel Pimentel, Joseph E Ippolito, Ana Elisa Lohmann","doi":"10.1093/jncimonographs/lgad012","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgad012","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a known risk factor for developing endometrial cancer. However, the association of obesity with endometrial cancer (EC) outcomes has not been clearly established. This study examined how outcomes in women with early stage EC vary with body composition measured via computed tomography (CT).</p><p><strong>Methods: </strong>In this retrospective study, patients diagnosed with EC international Federation of Gynecology and Obstetrics stages I-III and available CT scans were included. Automatica software was used to assess the areas of visceral adipose tissue, subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) and skeletal muscle area.</p><p><strong>Results: </strong>Of 293 patient charts assessed, 199 met eligibility criteria. Median body mass index (BMI) was 32.8 kg/m2 (interquartile range [IQ] = 26.8-38.9); 61.8% had histologic subtype endometrioid carcinoma. Adjusted for age, international Federation of Gynecology and Obstetrics stage, and histologic subtype, a BMI of at least 30 vs less than 30 kg/m2 was associated with lower endometrial cancer-specific survival (ECSS) (hazard ratio [HR] = 2.32, 95% confidence interval [CI] = 1.27 to 4.25) and overall survival (OS) (HR = 2.7, 95% CI = 1.35 to 5.39). Higher IMAT 75th vs 25th percentile and SAT of at least 225.6 vs less than 225.6 cm2 were associated with lower ECSS (HR = 1.53, 95% CI = 1.1 to 2.13, and HR = 2.57, 95% CI = 1.13 to 5.88) and OS (HR = 1.50, 95% CI = 1.11 to 2.02, and HR = 2.46, 95% CI = 1.2 to 5.01), respectively. The association of visceral adipose tissue (75th vs 25th percentile) with ECSS and OS was not statistically significant (HR = 1.42, 95% CI = 0.91 to 2.22, and HR = 1.24, 95% CI = 0.81 to 1.89).</p><p><strong>Conclusion: </strong>Higher BMI, IMAT, and SAT were associated with higher mortality from EC and lower OS. A better understanding of the mechanisms underlying these relationships could inform strategies to improve patient outcomes.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10049104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary A Kennedy, Melanie Potiaumpai, Melissa Maitin-Shepard, Christopher M Wilson, Anna Campbell, Anna L Schwartz, Jessica Gorzelitz, Maxime Caru, Chloe Grimmett, Kathryn H Schmitz
{"title":"Looking back: a review of policy implications for exercise oncology.","authors":"Mary A Kennedy, Melanie Potiaumpai, Melissa Maitin-Shepard, Christopher M Wilson, Anna Campbell, Anna L Schwartz, Jessica Gorzelitz, Maxime Caru, Chloe Grimmett, Kathryn H Schmitz","doi":"10.1093/jncimonographs/lgad002","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgad002","url":null,"abstract":"The evidence to support the benefits of exercise for people living with and beyond cancer is robust. Still, exercise oncology interventions in the United States are only eligible for coverage by third-party payers within the restrictions of cancer rehabilitation settings. Without expanded coverage, access will remain highly inequitable, tending toward the most well-resourced. This article describes the pathway to third-party coverage for 3 programs that address a chronic disease and utilize exercise professionals: the Diabetes Prevention Program, Supervised Exercise Training for Peripheral Artery Disease, and Cancer Rehabilitation. Lessons learned will be applied toward expanding third-party coverage for exercise oncology programming.","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501465/pdf/lgad002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amy M Dennett, Kelly A Hirko, Kathleen J Porter, Kah Poh Loh, Yue Liao, Lin Yang, Hannah Arem, Jasmine S Sukumar, Elizabeth A Salerno
{"title":"Embedding lifestyle interventions into cancer care: has telehealth narrowed the equity gap?","authors":"Amy M Dennett, Kelly A Hirko, Kathleen J Porter, Kah Poh Loh, Yue Liao, Lin Yang, Hannah Arem, Jasmine S Sukumar, Elizabeth A Salerno","doi":"10.1093/jncimonographs/lgac028","DOIUrl":"10.1093/jncimonographs/lgac028","url":null,"abstract":"<p><p>Lifestyle interventions targeting energy balance (ie, diet, exercise) are critical for optimizing the health and well-being of cancer survivors. Despite their benefits, access to these interventions is limited, especially in underserved populations, including older people, minority populations and those living in rural and remote areas. Telehealth has the potential to improve equity and increase access. This article outlines the advantages and challenges of using telehealth to support the integration of lifestyle interventions into cancer care. We describe 2 recent studies, GO-EXCAP and weSurvive, as examples of telehealth lifestyle intervention in underserved populations (older people and rural cancer survivors) and offer practical recommendations for future implementation. Innovative approaches to the use of telehealth-delivered lifestyle intervention during cancer survivorship offer great potential to reduce cancer burden.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hisham Hussan, Mohamed R Ali, Shehnaz K Hussain, Victoria Lyo, Eric McLaughlin, ChienWei Chiang, Henry J Thompson
{"title":"The impact of surgical weight loss procedures on the risk of metachronous colorectal neoplasia: the differential effect of surgery type, sex, and anatomic location.","authors":"Hisham Hussan, Mohamed R Ali, Shehnaz K Hussain, Victoria Lyo, Eric McLaughlin, ChienWei Chiang, Henry J Thompson","doi":"10.1093/jncimonographs/lgac029","DOIUrl":"10.1093/jncimonographs/lgac029","url":null,"abstract":"<p><p>Patients with prior colorectal polyps are at high risk for metachronous colorectal neoplasia, especially in the presence of obesity. We assessed the impact of 2 common bariatric surgeries, vertical sleeve gastrectomy and roux-n-Y gastric bypass, on the risk of colorectal neoplasia recurrence. This nationally representative analysis included 1183 postbariatric adults and 3193 propensity score-matched controls, who all had prior colonoscopy with polyps and polypectomy. Colorectal polyps reoccurred in 63.8% of bariatric surgery patients and 71.7% of controls at a mean follow-up of 53.1 months from prior colonoscopy. There was a reduced odds of colorectal polyp recurrence after bariatric surgery compared with controls (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.58 to 0.83). This effect was most pronounced in men (OR = 0.58, 95% CI = 0.42 to 0.79), and post roux-n-Y gastric bypass (OR = 0.57, 95% CI = 0.41 to 0.79). However, the risk of rectal polyps or colorectal cancer remained consistent between groups. This study is the first to our knowledge to show a reduction in risk of polyp recurrence following bariatric surgery.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delaney K Geitgey, Miyoung Lee, Kirsten A Cottrill, Maya Jaffe, William Pilcher, Swati Bhasin, Jessica Randall, Anthony J Ross, Michelle Salemi, Marisol Castillo-Castrejon, Matthew B Kilgore, Ayjha C Brown, Jeremy M Boss, Rich Johnston, Anne M Fitzpatrick, Melissa L Kemp, Robert English, Eric Weaver, Pritha Bagchi, Ryan Walsh, Christopher D Scharer, Manoj Bhasin, Joshua D Chandler, Karmella A Haynes, Elizabeth A Wellberg, Curtis J Henry
{"title":"The 'omics of obesity in B-cell acute lymphoblastic leukemia.","authors":"Delaney K Geitgey, Miyoung Lee, Kirsten A Cottrill, Maya Jaffe, William Pilcher, Swati Bhasin, Jessica Randall, Anthony J Ross, Michelle Salemi, Marisol Castillo-Castrejon, Matthew B Kilgore, Ayjha C Brown, Jeremy M Boss, Rich Johnston, Anne M Fitzpatrick, Melissa L Kemp, Robert English, Eric Weaver, Pritha Bagchi, Ryan Walsh, Christopher D Scharer, Manoj Bhasin, Joshua D Chandler, Karmella A Haynes, Elizabeth A Wellberg, Curtis J Henry","doi":"10.1093/jncimonographs/lgad014","DOIUrl":"10.1093/jncimonographs/lgad014","url":null,"abstract":"<p><p>The obesity pandemic currently affects more than 70 million Americans and more than 650 million individuals worldwide. In addition to increasing susceptibility to pathogenic infections (eg, SARS-CoV-2), obesity promotes the development of many cancer subtypes and increases mortality rates in most cases. We and others have demonstrated that, in the context of B-cell acute lymphoblastic leukemia (B-ALL), adipocytes promote multidrug chemoresistance. Furthermore, others have demonstrated that B-ALL cells exposed to the adipocyte secretome alter their metabolic states to circumvent chemotherapy-mediated cytotoxicity. To better understand how adipocytes impact the function of human B-ALL cells, we used a multi-omic RNA-sequencing (single-cell and bulk transcriptomic) and mass spectroscopy (metabolomic and proteomic) approaches to define adipocyte-induced changes in normal and malignant B cells. These analyses revealed that the adipocyte secretome directly modulates programs in human B-ALL cells associated with metabolism, protection from oxidative stress, increased survival, B-cell development, and drivers of chemoresistance. Single-cell RNA sequencing analysis of mice on low- and high-fat diets revealed that obesity suppresses an immunologically active B-cell subpopulation and that the loss of this transcriptomic signature in patients with B-ALL is associated with poor survival outcomes. Analyses of sera and plasma samples from healthy donors and those with B-ALL revealed that obesity is associated with higher circulating levels of immunoglobulin-associated proteins, which support observations in obese mice of altered immunological homeostasis. In all, our multi-omics approach increases our understanding of pathways that may promote chemoresistance in human B-ALL and highlight a novel B-cell-specific signature in patients associated with survival outcomes.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Summary Bias Assessment and Meta-Analysis.","authors":"","doi":"10.1093/jncimonographs/lgac027","DOIUrl":"https://doi.org/10.1093/jncimonographs/lgac027","url":null,"abstract":"","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157751/pdf/lgac027.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}