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Study never initiated due to COVID pandemic, staffing changes
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In this observational pilot study urine samples will be collected from women receiving neoadjuvant chemotherapy with doxorubicin for triple negative breast cancer to determine whether: 1) exposures bisphenol and phthalate levels change over the course of neoadjuvant chemotherapy, and 2) levels differ between black women and those of other racial groups.
The hypothesis is that bisphenol and phthalate levels will be similar to those of the general US female population at the time of diagnosis, however levels will increase during treatment due to exposure to plastics in the medical setting. The investigators also hypothesize that because of differences in personal care product use, black women may have higher urinary levels of bisphenols and phthalates prior to starting chemotherapy.
Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype that does not express estrogen, progesterone, or the human epidermal growth factor (HER2/neu) receptors, and has a low overall survival rate compared to other types of breast cancer.
Unlike hormone and HER2/neu positive breast cancers, targeted therapies are not available for TNBC. Thus, the systemic chemotherapeutic agent doxorubicin is widely used for the treatment of TNBC. However, doxorubicin resistance is common, and leads to poorer treatment outcomes.
Understanding factors that contribute to doxorubicin resistance is critical to improving cancer treatment outcomes among women with TNBC. Pre-clinical in vitro studies indicate that exposure to endocrine disrupting chemicals, such as bisphenols and phthalates, contribute to doxorubicin resistance, but these findings have not been evaluated in humans.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study cohort | urinary bisphenol and phthalate levels |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| urine collection | Other | Collect three urine samples either in the clinic or at home. This will occur prior to starting neoadjuvant chemotherapy, and again at the end of the scheduled course of neoadjuvant chemotherapy. |
| Measure | Description | Time Frame |
|---|---|---|
| urinary bisphenol and phthalate metabolite levels | quantification of bisphenol and phthalate metabolites by liquid chromotography-tandem mass spectrometry | baseline |
| urinary bisphenol and phthalate metabolite levels | quantification of bisphenol and phthalate metabolites by liquid chromotography-tandem mass spectrometry | post-neoadjuvant chemotherapy (either 16 or 20 weeks) |
| change from baseline urinary bisphenol and phthalate levels at end of neoadjuvant chemotherapy | percent of change in urinary bisphenol and phthalate levels from pre- to post-neoadjuvant chemotherapy | baseline and post-neoadjuvant chemotherapy (16 or 20 weeks) |
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Inclusion Criteria:
Exclusion Criteria:
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Women being treated at the George Washington University for stage I - III triple negative breast cancer who are scheduled to receive a neoadjuvant chemotherapy regimen containing doxorubicin.
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| Name | Affiliation | Role |
|---|---|---|
| Kim Robien, PhD, RD | Milken Institute School of Public Health, George Washington University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Milken Institute School of Public Health, George Washington University | Washington D.C. | District of Columbia | 20052 | United States |
Will not share data until study is complete and all data deidentified
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| ID | Term |
|---|---|
| D064726 | Triple Negative Breast Neoplasms |
| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
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| ID | Term |
|---|---|
| D059349 | Urine Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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urine samples
| D012871 |
| Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D008919 | Investigative Techniques |