{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:46:36Z","timestamp":1792633596136,"version":"4.5.0"},"reference-count":40,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"34","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Successful completion of chemotherapy is critical to improve breast cancer outcomes. Relative dose intensity (RDI), defined as the ratio of chemotherapy delivered to prescribed, is a measure of chemotherapy completion and is associated with cancer mortality. The effect of exercise and eating a healthy diet on RDI is unknown. We conducted a randomized trial of an exercise and nutrition intervention on RDI and pathologic complete response (pCR) in women diagnosed with breast cancer initiating chemotherapy. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> One hundred seventy-three women with stage I-III breast cancer were randomly assigned to usual care (UC; n = 86) or a home-based exercise and nutrition intervention with counseling sessions delivered by oncology-certified registered dietitians (n = 87). Chemotherapy dose adjustments and delays and pCR were abstracted from electronic medical records. T-tests and chi-square tests were used to examine the effect of the intervention versus UC on RDI and pCR. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Participants randomly assigned to intervention had greater improvements in exercise and diet quality compared with UC ( P &lt; .05). RDI was 92.9% \u00b1 12.1% and 93.6% \u00b1 11.1% for intervention and UC, respectively ( P = .69); the proportion of patients in the intervention versus UC who achieved \u226585% RDI was 81% and 85%, respectively ( P = .44). The proportion of patients who had at least one dose reduction and\/or delay was 38% intervention and 36% UC ( P = .80). Among 72 women who received neoadjuvant chemotherapy, women randomly assigned to intervention were more likely to have a pCR than those randomly assigned to UC (53% v 28%; P = .037). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Although a diet and exercise intervention did not affect RDI, the intervention was associated with a higher pCR in patients with hormone receptor\u2013positive\/human epidermal growth factor receptor 2\u2013negative and triple-negative breast cancer undergoing neoadjuvant chemotherapy. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.23.00871","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T20:02:10Z","timestamp":1693598530000},"page":"5285-5295","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":99,"title":["Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study"],"prefix":"10.1200","volume":"41","clinical-trial-number":[{"clinical-trial-number":"nct03314688","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1687-2538","authenticated-orcid":true,"given":"Tara","family":"Sanft","sequence":"first","affiliation":[{"name":"Yale University School of Medicine, New Haven, CT"},{"name":"Yale Cancer Center, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Harrigan","sequence":"additional","affiliation":[{"name":"Yale School of Public Health, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"McGowan","sequence":"additional","affiliation":[{"name":"Yale School of Public Health, New Haven, 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