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Hormone receptor status influences the impact of body mass index and hyperglycemia on the risk of tumor relapse in early-stage HER2-positive breast cancer patients
| Content Provider | SAGE Publishing |
|---|---|
| Author | Ligorio, Francesca Zambelli, Luca Bottiglieri, Achille Castagnoli, Lorenzo Zattarin, Emma Lobefaro, Riccardo Ottini, Arianna Vingiani, Andrea Pupa, Serenella M. Bianchi, Giulia V. Capri, Giuseppe Pruneri, Giancarlo Braud, Filippo De Vernieri, Claudio |
| Copyright Year | 2021 |
| Abstract | High body mass index (BMI) has been associated with worse clinical outcomes in patients with early-stage breast cancer (BC), and its negative effects could be mediated by hyperglycemia/diabetes. However, the prognostic impact of high BMI in early-stage HER2-positive (HER2+) BC patients remains controversial.Methods:We conducted a retrospective study to investigate the impact of baseline BMI or glycemia on relapse-free survival (RFS) and overall survival (OS) in patients with surgically resected, stage I–III HER2+ BC treated with standard-of-care, trastuzumab-containing adjuvant biochemotherapy. The optimal BMI and glycemia cut-off values for RFS were identified through maximally selected rank statistics. Cox regression models were used to assess the impact of BMI, glycemia and other relevant variables on clinical outcomes.Results:Among 505 patients included in the study, a BMI cut-off of 27.77 kg/m2 was identified as the best threshold to discriminate between patients with low BMI (n = 390; 77.2%) or high BMI (n = 115; 22.8%). At multivariable analysis, higher BMI was associated with significantly worse RFS [hazard ratio 2.26; 95% confidence interval (CI): 1.08–4.74, p = 0.031] and worse OS (hazard ratio 2.25, 95% CI 1.03–4.94, p = 0.043) in the whole patient population. The negative impact of high BMI was only observed in patients with hormone receptor (HR)-negative/HER2+ BC (hazard ratio 2.29; 95% CI: 1.01–5.20; p = 0.047), but not in patients with HR-positive (HR+)/HER2+ BC (hazard ratio 1.36; 95% CI: 0.61–3.07, p = 0.452). By contrast, hyperglycemia (⩾109 mg/dl) at baseline was associated with a trend toward significantly worse RFS at multivariable analysis only in patients with HR+/HER2+ BC (hazard ratio 2.52; 95% CI: 0.89–7.1; p = 0.080).Conclusions:High BMI is associated with worse clinical outcomes in early-stage HR−/HER2+ BC patients treated with trastuzumab-containing adjuvant biochemotherapy, while baseline hyperglycemia could be a predictor of worse RFS in HR+/HER2+ BC patients. Prospective studies are needed to investigate if modifying patient BMI/glycemia during treatment can improve clinical outcomes. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/17588359211006960?download=true |
| ISSN | 17588359 |
| Volume Number | 13 |
| Journal | Therapeutic Advances in Medical Oncology (TAM) |
| e-ISSN | 17588359 |
| DOI | 10.1177/17588359211006960 |
| Language | English |
| Publisher | Sage Publications UK |
| Publisher Date | 2021-04-16 |
| Publisher Place | London |
| Access Restriction | Open |
| Rights Holder | © The Author(s), 2021 |
| Subject Keyword | relapse-free survival early-stage breast cancer HER2-positive breast cancer trastuzumab body mass index |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology |
