scholarly journals Differential Benefit of Adjuvant Docetaxel-Based Chemotherapy in Patients With Early Breast Cancer According to Baseline Body Mass Index

2020 ◽  
Vol 38 (25) ◽  
pp. 2883-2891 ◽  
Author(s):  
Christine Desmedt ◽  
Marco Fornili ◽  
Florian Clatot ◽  
Romano Demicheli ◽  
Davide De Bortoli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Disease Free Survival ◽  
Dose Intensity ◽  
Clinical Trial Data ◽  
Volume Of Distribution ◽  
Baseline Body Mass Index ◽  
Docetaxel Group ◽  
Er Status

PURPOSE Lipophilic drugs, such as taxanes, have a high affinity for adipose tissue and a resulting higher volume of distribution. Here, we reanalyzed clinical trial data to investigate whether the efficacy of docetaxel-based chemotherapy differs from non-docetaxel–based chemotherapy in patients with breast cancer according to their baseline body mass index (BMI). PATIENTS AND METHODS We retrospectively analyzed data from all of the patients in the adjuvant BIG 2-98 trial (ClinicalTrials.gov identifier: NCT00174655 ; N = 2,887) comparing non-docetaxel– to docetaxel-containing chemotherapy. BMI (kg/m2) was categorized as follows: 18.5 to < 25, lean; 25 to < 30, overweight; and ≥ 30, obese. Disease-free survival (DFS) was the primary endpoint, and overall survival (OS) was the secondary endpoint. A second-order interaction was assessed among treatment, BMI, and estrogen receptor (ER) status. RESULTS There was no difference in DFS or OS according to BMI in the non-docetaxel group, while reduced DFS and OS were observed with increasing BMI category in the docetaxel group. Adjusted hazard ratios for DFS and OS were, respectively, 1.12 (95% CI, 0.98 to 1.50; P = .21) and 1.27 (95% CI, 1.01 to 1.60; P = .04) for overweight versus lean groups and were 1.32 (95% CI, 1.08 to 1.62; P = .007) and 1.63 (95% CI, 1.27 to 2.09; P < .001), respectively, for obese versus lean groups. Similar results were obtained when considering ER-negative and ER-positive tumors separately and when considering only patients who received a relative dose intensity ≥ 85% for docetaxel. A joint modifying role of BMI and ER status on treatment effect was evident for DFS (adjusted P = .06) and OS (adjusted P = .04). CONCLUSION This retrospective analysis of a large adjuvant trial highlights a differential response to docetaxel according to BMI, which calls for a body composition–based re-evaluation of the risk-benefit ratio of the use of taxanes in breast cancer. These results now must be confirmed in additional series.

Recurrence dynamics of breast cancer according to baseline body mass index

2017 ◽  
Vol 87 ◽  
pp. 10-20 ◽  
Author(s):  
Elia Biganzoli ◽  
Christine Desmedt ◽  
Marco Fornili ◽  
Evandro de Azambuja ◽  
Nathalie Cornez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Baseline Body Mass Index

Prognostic significance of body mass index in breast cancer patients with hormone receptor-positive tumours after curative surgery

2013 ◽  
Vol 36 (6) ◽  
pp. 297 ◽  
Author(s):  
Peng Xing ◽  
Ji-Guang Li ◽  
Feng Jin ◽  
Ting-Ting Zhao ◽  
Qun Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Hormone Receptor ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Axillary Lymph ◽  
Nodal Stage ◽  
Hormone Receptor Positive ◽  
High Bmi

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.

scholarly journals Physical Activity, Weight, and Outcomes in Patients Receiving Chemotherapy for Metastatic Breast Cancer (C40502/Alliance)

2021 ◽  
Author(s):  
Jennifer A Ligibel ◽  
Luke Huebner ◽  
Hope S Rugo ◽  
Harold J Burstein ◽  
Debra L Toppmeyer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Body Mass Index ◽  
Metastatic Breast Cancer ◽  
Body Mass ◽  
Hormone Receptor ◽  
Metastatic Breast ◽  
Hazard Ratio ◽  
First Line ◽  
Risk Of Cancer

Abstract Background Obesity and inactivity are associated with increased risk of cancer related- and overall mortality in breast cancer, but there are few data in metastatic disease. Methods CALGB 40502 was a randomized trial of first-line taxane-based chemotherapy for patients with metastatic breast cancer. Height and weight were collected at enrollment. After 299 patients enrolled, the study was amended to assess recreational physical activity (PA) at enrollment using the Nurses’ Health Study Exercise Questionnaire. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated using stratified Cox modeling (strata included hormone receptor status, prior taxane, bevacizumab use, and treatment arm). Results 799 patients were enrolled and at the time of data lock, median follow-up was 60 months. At enrollment, median age was 56.7 years, 73.1% of participants had hormone receptor-positive cancers, 42.6% had obesity, and 47.6% engaged in less than 3 metabolic equivalents of task (MET)-hours of PA/week (&lt;1 hour of moderate PA). Neither baseline body mass index nor PA was statistically significantly associated with PFS or OS, although there was a marginally statistically significant increase in PFS (hazard ratio = 0.83, 95% confidence interval [CI] = 0.79, 1.02; p = .08) and OS (hazard ratio = 0.81, 95% CI = 0.65, 1.02; p = .07) in patients who reported PA greater than 9 MET-hours/week vs 0–9 MET-hours/week. Conclusions In a trial of first-line chemotherapy for metastatic breast cancer, rates of obesity and inactivity were high. There was no statistically significant relationship between body mass index and outcomes. More information is needed regarding the relationship between PA and outcomes.

scholarly journals Effect of body mass index on pharmacokinetics of paclitaxel in patients with early breast cancer

2021 ◽  
Author(s):  
Vikram Gota ◽  
Manjunath Nookala ◽  
Avinash Bonda ◽  
Ashwin Karanam ◽  
Bharati Shriyan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Early Breast Cancer
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