TY - JOUR
T1 - Supplement use during an intergroup clinical trial for breast cancer (S0221)
AU - Zirpoli, Gary R.
AU - Brennan, Patrick M.
AU - Hong, Chi Chen
AU - McCann, Susan E.
AU - Ciupak, Gregory
AU - Davis, Warren
AU - Unger, Joseph M.
AU - Thomas Budd, G.
AU - Hershman, Dawn L.
AU - Moore, Halle C.F.
AU - Stewart, James
AU - Isaacs, Claudine
AU - Hobday, Timothy
AU - Salim, Muhammad
AU - Hortobagyi, Gabriel N.
AU - Gralow, Julie R.
AU - Albain, Kathy S.
AU - Ambrosone, Christine B.
N1 - Funding Information:
Conflict of interest This study was supported by NIH R01 CA116395, and the following PHS Cooperative Agreement Grant numbers awarded by the National Cancer Institute, DHHS: CA32102, CA38926, CA63844, CA63845, CA 20319, CA46282, CA46441, CA35261, CA63848, CA67575, CA14028, CA35281, CA128567, CA45560, CA58882, CA13612; CA46368, CA45808, CA58658, CA76447, CA37981, CA04919; CA95860; CA27057, CA42777, CA22433, CA74647, CA86780, CA68183, CA58861, CA45807, CA35192, CA35178, CA58416, CA35176, CA67663, CA35431, CA12644, CA16385, CA11083, CA45377, CA35128, CA35262, CA52654, CA76429, CA58723, CA46113, CA76132, CA45450, CA35119, CA45461, CA21115, CA21076, CA77597, CA25224, CA77202, CCSRI 15469, and in part by Amgen, Inc. Support was also provided by the Fashion Footwear Charitable Foundation of New York/QVC Presents Shoes on Sale TM (DFH), and Drs. Ambrosone, Gralow, Hershman and Hortobagyi are recipients of funding from the Breast Cancer Research Foundation. Dr. Budd serves an advisory at Amgen. Dr. Gralow receives funding from Nevartis, Amgen, Genentech, and Roche. Funding agencies had no involvement in the study design, data collection, analysis and interpretation, or in the writing of the report and submission.
PY - 2013/2
Y1 - 2013/2
N2 - The use of supplements during chemotherapy is controversial, partly due to the potential effect of antioxidants on reduced efficacy of chemotherapy-related cytotoxicity. We examined supplement use among breast cancer patients registered to a clinical trial (SWOG 0221) before diagnosis and during treatment. Patients (n = 1,467) completed questionnaires regarding multivitamin and supplement use at trial registration (baseline) to capture use before diagnosis. Of these patients, 1,249 completed a 6-month followup questionnaire to capture use during treatment. We examined the use of vitamins C, D, E, B6, B12, folic acid, and calcium at these timepoints, as well as physician recommendations regarding supplement use. The use of vitamins C, E, folic acid, and calcium decreased during treatment, while the use of vitamin B6 increased. Five hundred seventy four patients (51 %) received no physician recommendations regarding supplement use. Among the remaining 49, 10 % were advised not to take multivitamins and/or supplements, 7 % were advised to use only multivitamins, and 32 % received recommendations to use multivitamins and/or supplements. Among patients who took vitamin C before diagnosis, those who were advised not to take supplements were >5 times more likely not to use of vitamin C during treatment than those not advised to stop use (OR = 5.27, 95 % CI 1.13-24.6). Previous non-users who were advised to take a multivitamin were nearly 5 times more likely to use multivitamins during treatment compared to those who received no recommendation (OR = 4.66, 95 % CI 2.10-10.3). In this clinical trial for high-risk breast cancer, supplement use generally decreased during treatment. Upon followup from the clinical trial, findings regarding supplement use and survival outcomes will better inform physician recommendations for patients on adjuvant chemotherapy.
AB - The use of supplements during chemotherapy is controversial, partly due to the potential effect of antioxidants on reduced efficacy of chemotherapy-related cytotoxicity. We examined supplement use among breast cancer patients registered to a clinical trial (SWOG 0221) before diagnosis and during treatment. Patients (n = 1,467) completed questionnaires regarding multivitamin and supplement use at trial registration (baseline) to capture use before diagnosis. Of these patients, 1,249 completed a 6-month followup questionnaire to capture use during treatment. We examined the use of vitamins C, D, E, B6, B12, folic acid, and calcium at these timepoints, as well as physician recommendations regarding supplement use. The use of vitamins C, E, folic acid, and calcium decreased during treatment, while the use of vitamin B6 increased. Five hundred seventy four patients (51 %) received no physician recommendations regarding supplement use. Among the remaining 49, 10 % were advised not to take multivitamins and/or supplements, 7 % were advised to use only multivitamins, and 32 % received recommendations to use multivitamins and/or supplements. Among patients who took vitamin C before diagnosis, those who were advised not to take supplements were >5 times more likely not to use of vitamin C during treatment than those not advised to stop use (OR = 5.27, 95 % CI 1.13-24.6). Previous non-users who were advised to take a multivitamin were nearly 5 times more likely to use multivitamins during treatment compared to those who received no recommendation (OR = 4.66, 95 % CI 2.10-10.3). In this clinical trial for high-risk breast cancer, supplement use generally decreased during treatment. Upon followup from the clinical trial, findings regarding supplement use and survival outcomes will better inform physician recommendations for patients on adjuvant chemotherapy.
KW - Antioxidants
KW - Breast cancer
KW - Chemotherapy
KW - Dietary supplements
KW - Epidemiology
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U2 - 10.1007/s10549-012-2400-2
DO - 10.1007/s10549-012-2400-2
M3 - Article
C2 - 23306462
AN - SCOPUS:84879362365
SN - 0167-6806
VL - 137
SP - 903
EP - 913
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 3
ER -