Investigating lifestyle and aspects of immunity among healthy women, patients undergoing neoadjuvant therapy for breast cancer and survivors of the disease

Abstract

Breast cancer is the most common cancer in the UK (CRUK, 2017). T-lymphocytes destroy cancerous cells through recognition of tumour-associated antigens. Unhealthy lifestyles can negatively influence immune function and detrimentally affect risk, treatment and survival of breast cancer. This thesis assesses the relationship between lifestyle, psychological factors, health and T-lymphocyte function in healthy women, breast cancer patients and survivors.

86% of healthy women (n=50) possessed tumour-associated antigen specific T lymphocytes, which, given links between immune function and cancer, may be protective. Tumour-associated antigens mammaglobin-A (MamA) and carcinoembryonic antigen (CEA) elicited the highest proportion of T-lymphocyte IFN-γ secretion (52% of women) and may prove useful targets for immunotherapeutic treatments.

Cytomegalovirus (CMV) seropositive healthy women (n=22/50), had higher numbers of tumour-associated antigen specific T-lymphocytes; MamA (p=0.009), CEA (p=0.042), Cl6 (p=0.033), CycB1 (p=0.050), ERB ICD (p=0.005) and SUR (p=0.033) versus seronegative counterparts. CMV seropositive tumour-associated antigen specific possessing individuals had less healthy lifestyles or psychological profiles (p<0.05), perhaps due to increased prior exposure to antigens. It may be an anti-cancer T-lymphocyte response helps individuals remain free from cancer.

Breast cancer patients receiving neoadjuvant chemotherapy (n=6) demonstrated reductions in predicted V ̇O2max post-chemotherapy. Hb (haemaglobin) levels were higher pre- versus mid- (p=0.046) and post-chemotherapy (p=0.043). These detrimental changes should be targeted with future interventions. A higher number of tumour-associated antigen specific T-lymphocytes were observed in a patient with a pathological clinical response (pCr), demonstrating a potential marker of prognosis.

In breast cancer survivors, 8-weeks of remotely monitored (n=15) or partly supervised (n=15) exercise saw no change in V ̇O2max (p=0.707 and 0.215) or body fat (p=0.685 and 0.365). Remotely monitored was deemed non-inferior to partly supervised exercise for body fat changes but not non-inferior in regards V ̇O2max, systolic blood pressure or 6-minute walk time. A partly supervised intervention is preferred to improve health following breast cancer treatment.

Date of Award	14 Oct 2020
Original language	English
Awarding Institution	University of Bath
Supervisor	Dylan Thompson (Supervisor) & James Turner (Supervisor)