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Omega-3 fatty acid use for obese breast cancer patients with aromatase inhibitor-related arthralgia (SWOG S0927)

  • Clinical trial
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Abstract

Purpose

Although aromatase inhibitors (AIs) prolong survival in post-menopausal breast cancer (BC) patients, AI-associated arthralgia can lead to discontinuation. Obese patients have higher rates of AI arthralgia than non-obese patients, but treatment options are limited. Omega-3 fatty acid (O3-FA) treatment for AI arthralgia has produced mixed results.

Methods

We performed an exploratory analysis of SWOG S0927, a multicenter randomized placebo-controlled trial of O3-FA use for AI arthralgia. Post-menopausal women with stage I–III BC taking an AI were randomized to 24 weeks of O3-FAs or placebo. Brief Pain Inventory (BPI) questionnaires and fasting serum were collected at baseline, 12, and 24 weeks. The BPI assessment included worst pain, average pain, and pain interference scores (range 0–10).

Results

Among the 249 participants, 139 had BMI < 30 kg/m2 (56%) and 110 had BMI ≥ 30 kg/m2 (44%). Among obese patients, O3-FA use was associated with significantly lower BPI worst pain scores at 24 weeks compared with placebo (4.36 vs. 5.70, p = 0.02), whereas among non-obese patients, there was no significant difference in scores between treatment arms (5.27 vs. 4.58, p = 0.28; interaction p = 0.05). Similarly, O3-FA use was associated with lower BPI average pain and pain interference scores at 24 weeks compared with placebo among obese patients, but no significant difference between treatment arms in non-obese patients (interaction p = 0.005 and p = 0.01, respectively).

Conclusions

In obese BC patients, O3-FA use was associated with significantly reduced AI arthralgia compared to placebo.

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Acknowledgements

This study was supported by BCRF, NCI, and SWOG.

Funding

This study was funded by the Breast Cancer Research Foundation; National Cancer Institute, Division of Cancer Prevention, NCORP Research Base grant 1UG1CA189974-01.

Author information

Authors and Affiliations

  1. Columbia University Medical Center, 161 Fort Washington Avenue, 10-1068, New York, NY, 10032, USA

    Sherry Shen, Katherine D. Crew, Heather Greenlee & Dawn L. Hershman

  2. SWOG Statistical Center, Seattle, WA, USA

    Joseph M. Unger & Cathee Till

  3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Joseph M. Unger

  4. Seattle Cancer Care Alliance, Seattle, WA, USA

    Julie Gralow

  5. Cancer Center of Kansas, Wichita, KS, USA

    Shaker R. Dakhil

  6. Community Oncology and Prevention Trials Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA

    Lori M. Minasian

  7. Central Illinois CCOP/Cancer Care Specialists of Central Illinois, Decatur, IL, USA

    James L. Wade III

  8. AIM Specialty Health, Chicago, IL, USA

    Michael J. Fisch

  9. Hunstman Cancer Institute, Salt Lake City, UT, USA

    N. Lynn Henry

Authors
  1. Sherry Shen
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Corresponding author

Correspondence to Dawn L. Hershman.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Shen, S., Unger, J.M., Crew, K.D. et al. Omega-3 fatty acid use for obese breast cancer patients with aromatase inhibitor-related arthralgia (SWOG S0927). Breast Cancer Res Treat 172, 603–610 (2018). https://doi.org/10.1007/s10549-018-4946-0

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  • DOI: https://doi.org/10.1007/s10549-018-4946-0

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