Fat Metabolism Following Chemotherapy in Breast Cancer

Sponsor

Texas A&M University (Other)

Overall Status

Terminated

CT.gov ID

NCT01890824

Collaborator

(none)

Enrollment

Location

Duration (Months)

0.2

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Following chemotherapy, breast cancer patients primarily gain fat mass and lose muscle mass. Both depletion of muscle and an increase of fat mass in breast cancer patients are related to short survival, and decreased skeletal muscle mass and function may result in fatigue and inactivity, which contributes to fat mass changes and can be responsible for chemo-toxicity and increased mortality. The purpose of this study is to provide detailed insight in chemotherapy related changes in lipid metabolism and gut digestion and absorption of fat in breast cancer patients compared to matched healthy controls. This will provide required information that is necessary to implement new strategies to develop optimal nutritional regimen in breast cancer patients. The hypothesis is that chemotherapy in breast cancer is related to altered gut function and absorption and to increases in fat synthesis that lead to fat accumulation. In addition, we will examine the effect of cancer, chemotherapy, and gender by comparing fat digestion/absorption and fat metabolism of the breast cancer before and after chemotherapy, to aged matched healthy female and male controls.

Condition or Disease	Intervention/Treatment	Phase
Breast Cancer

Detailed Description

This research study involves 5 visits for the breast cancer subjects and 3 visits for the healthy controls. The first visit includes the informed consent and a screening and the second and third visit for the study days before chemotherapy and the fourth and fifth visit for the study days after chemotherapy. For the first test day, 2 hours of the subjects time will be for urine and blood sample collection, and to ingest the deuterated water. Subjects are allowed to go home after and eat normally. On the second study day, subjects will arrive early that morning and a DXA scan will be performed first. For the duration of the study, subjects have to lie in the bed (except for bathroom privileges). They can watch tv or bring and use a book/tablet. The research nurse or study staff will be present in the human subject area to assist the subject if necessary. Subjects are not allowed to eat or drink during the second test day, except for the test drink (meal) and water. One IV catheter will be placed in a vein of the arm/hand for blood draws. The hand will be placed in a hot box during blood collection. Another IV catheter will be placed in the contra-lateral forearm for a primed and continuous infusion of 2H5-glycerol. Over the two day time period, a total of 100-120 ml of blood will be obtained over approximately 19 samples. Stable isotopes will be ingested on the first test day, added to the test drinks on the second test day after the second hour, and infused on the second day. On the second test day, subjects will fill out questionnaires and perform muscle function tests. After completion of the study, we will provide the subject with a meal.

Study Design

Study Type:

Observational

Actual Enrollment :

5 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

The Effect of Chemotherapy on Fat Metabolism and Digestion and Function in Breast Cancer Patients.

Study Start Date :

Aug 1, 2013

Actual Primary Completion Date :

Oct 1, 2015

Actual Study Completion Date :

Oct 1, 2015

Arms and Interventions

Arm	Intervention/Treatment
Breast Cancer Patients Breast cancer patients to be studied before and after chemotherapy
Healthy Female Controls Healthy female controls will be compared to breast cancer patients before and after chemotherapy and to healthy male controls
Healthy Male Controls Healthy male controls will be compared to healthy female controls to determine gender differences

Outcome Measures

Primary Outcome Measures

Hepatic triglyceride synthesis [Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion]
changes in hepatic triglyceride synthesis before and after a meal
Hepatic de novo lipogenesis [Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion]
changes in hepatic de novo lipogenesis before and after a meal

Secondary Outcome Measures

Adipose tissue triglyceride synthesis [pre and 4 hours post meal]
changes in adipose tissue triglyceride synthesis before and after a meal
Adipose tissue de novo lipogenesis [pre and 4 hours post meal]
changes in adipose tissue de novo lipogenesis before and after a meal
Adipose tissue lipolysis - glycerol rate of appearance [Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion]
changes in adipose tissue lipolysis before and after a meal. plasma enrichment of glycerol.
Fat digestion and absorption [Pre meal ingestion and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 270, and 300 min post meal ingestion]
defining fat digestion and absorption after a meal. Enrichment in palmitic acid and tripalmitin fatty acids in plasma
Skeletal muscle strength and endurance [1 day]
Difference in leg strength and fatigue
Insulin response to feeding [pre and up to 5 hours post meal]
acute changes from postabsorptive state to postprandial state
Body composition [1 day]
body composition will be determined by dual-energy X-ray absorptiometry and by deuterated water dilution technique. Plasma deuterium enrichments will be determined.
Physical activity questionnaire [1 day]
Outcome of physical activity assessment in breast cancer patients and healthy controls in relation to the fat metabolism

Eligibility Criteria

Criteria

Ages Eligible for Study:

30 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion criteria cancer subjects:

Diagnosed with breast cancer
Scheduled for chemotherapy
Ability to sign informed consent
Age 30 years and older
Ability to lie in supine position for 7 hours

Inclusion criteria healthy subjects:

Healthy male & female according to the investigator's or appointed staff's judgment
Age 30 years or older
No diagnosis of cancer

Exclusion Criteria:

Presence of fever within the last 3 days
Untreated metabolic diseases including hepatic or renal disorder
Presence of acute illness or metabolically unstable chronic illness
Use of nutritional supplements within 5 days of first test day
Any other condition according to the PI or nurse that would interfere with the study or safety of the patient
Failure to give informed consent
Possible) pregnancy