Abstract CN05-03: Energy balance in cancer patients: Are we ready to intervene?
Bibliographic record
Abstract
Abstract There is growing evidence that aspects of energy balance, including overweight/obesity and physical inactivity are associated with poor outcomes in some cancers, notably breast and colorectal. In breast cancer, evidence is strongest for overweight/obesity; recent evidence suggests physical activity may have important independent associations with outcomes. In colorectal cancer, evidence is strongest for physical activity. Clinical mechanisms that have been postulated for these associations include presentation of cancer at a more advanced stage or receipt of less than optimal therapy in overweight or obese individuals. Potential biologic mechanisms have included sex hormones, insulin and related IGFs, adipocytokines and inflammatory markers. In breast cancer there is growing evidence that insulin (and associated insulin resistance) may play a key role in mediating these prognostic associations - high insulin levels have been associated with increased risk of breast cancer recurrence or death. Breast cancer cells commonly overexpress insulin receptors (frequently a fetal form of the receptor that may hybridize with the IGF-1 receptor) that are not downregulated by circulating insulin; as a result, cancer cell growth may be stimulated by high circulating insulin levels. Observational clinical studies linking energy balance to prognosis of breast and colorectal cancer will be reviewed, along with early intervention work demonstrating the feasibility, short-term benefits (e.g. on QOL) and biologic (mechanistic) changes associated with lifestyle interventions in breast and colon cancer survivors. The impact of the available evidence on clinical practice and the role of large scale clinical trials of energy balance modification with recurrence or survival endpoints (completed, ongoing and planned) will be reviewed, with an emphasis on issues relating to feasibility, cost and the need for embedded correlative research to investigate biologic mechanisms for any survival effects that are identified. Related metformin trials (which target insulin and AMPK/mTOR signaling), notably NCIC MA.32, an adjuvant trial in early breast cancer that will be activated early in 2010, will also be reviewed. Citation Information: Cancer Prev Res 2010;3(1 Suppl):CN05-03.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.035 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".