American Society of Clinical Oncology Annual Meeting

Telephone-Based Weight Loss Intervention Successful in Breast Cancer Survivors

Avatar photoJoyce Pagan
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A middle aged woman wearing a head scarf talks on the phone at home and smiles.
Results of the Breast Cancer Weight Loss trial were presented at the 2023 ASCO Annual Meeting.

Telephone- and web-based weight loss intervention (WLI) successfully induced weight loss in patients with breast cancer who had overweight and obesity across demographic and tumor factors, according to a presentation at a premeeting press briefing for the 2023 ASCO Annual Meeting.

“A telephone and web-based weight loss intervention led to significant and clinically meaningful weight loss in breast cancer survivors with overweight and obesity,”  Jennifer Ligibel, MD, FASCO, explained in her presentation. 

Obesity is prognostic of poor outcomes in early breast cancer and is associated with higher risks of all-cause mortality. Additionally, each 5 kg/m2 increase in body mass index (BMI) is linked with a 10% increase in risk of breast cancer-specific mortality and a 14% increase in risk of secondary cancers. However, little is known about the effects of weight loss after breast cancer diagnosis on breast cancer mortality and risk of developing second cancers.

Therefore, researchers sought to evaluate the impact of WLI on invasive disease-free survival (iDFS) in breast cancer survivors with overweight or obesity (BMI 25 kg/m2 or higher).

The Breast Cancer Weight Loss trial (BWEL; ClinicalTrials.gov Identifier: NCT02750826) recruited 3136 participants. Eligibility criteria included a diagnosis of stage II-III hormone receptor-positive (HR+)/HER2− or triple-negative breast cancer (TNBC) within the past 14 months, completion of chemotherapy and radiation therapy (if administered), and a BMI of 27 kg/m2 or higher. 

Patients were randomly assigned 1:1 to WLI or health education alone (control group). Health education comprised nontailored diet and exercise recommendations, a quarterly newsletter, twice yearly webinars, and a health-related magazine. WLI included health education plus a 2-year telephone-based intervention that comprised 42 calls from a health coach supplemented with a workbook and tools based on social cognitive theory. 

Height and weight were measured at baseline, 6 months, and 12 months, with changes in weight compared between the groups. Univariable and multivariable (arm, baseline weight, menopausal status, race/ethnicity, and HR status) regression models were used in analyses.

A total of 3136 women were randomly assigned to the WLI or control group between August 2016 and February 2021. At baseline, mean BMI was 34.5 (±5.74) kg/m2, mean age was 53.4 years (±10.58), and 57% of participants were postmenopausal at the time of diagnosis. At 12 months, 2395 participants were alive and disease-free with follow-up weight available. 

Weight change among participants in WLI was a significant loss compared with those in the control group, both overall and across demographic and tumor factors. 

At 6 months, absolute weight change was −4.4 kg (−4.8%) in patients in WLI and +0.2 kg (+0.3%) in the control group. At 12 months, changes were −4.4 kg (−4.8%) and +0.7 kg (+0.9%), respectively (all P <.0001). 

However, the effect of WLI differed significantly by menopausal status (interaction P value =0.0057) and race/ethnicity (interaction P value =0.019), but not HR status (interaction P value =0.17).

Although the intervention successfully induced weight loss in breast cancer patients with overweight and obesity, patterns of weight change varied by age and race. Additional tailoring of the weight loss intervention could improve WLI outcomes in Black and younger patients. 

Follow-up of patients in BWEL is ongoing to assess the impact of the intervention on iDFS and other outcomes, Dr Ligibel concluded.

Reference

Ligibel JA, Ballman KV, McCall LM, et al. Effect of a telephone-based weight loss intervention (WLI) on weight at 12-months in women with early breast cancer: results from the Breast Cancer Weight Loss (BWEL) trial. ASCO 2023. June 2-6, 2023. Abstract 12001.