Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer

S. Martel, E. Poletto, A.R. Ferreira, M. Lambertini, F. Sottotetti, I. Bertolini, F. Montemurro, A. Bernardo, E. Risi, E. Zanardi, S. Ziliani, S. Mura, C. Dellepiane, L. Del Mastro, A.M. Minisini, F. Puglisi

Research output: Contribution to journalArticle

Abstract

Background Overweight and obesity are associated with an increased risk of developing many types of cancer, including breast cancer. Moreover, increased body mass index (BMI) seems to be associated with a worse prognosis in patients with HER2-positive early breast cancer. However, little is known about the impact of BMI on the clinical outcomes of HER2-positive metastatic breast cancer (MBC). Methods This was a multicenter retrospective cohort study including 329 consecutive patients with HER2-positive MBC treated with first-line trastuzumab-based regimens. BMI at the time of MBC diagnosis was collected. World Health Organization BMI categories were used: underweight <18.5, normal 18.5–24.9 Kg/m2, overweight 25–29.9 Kg/m2, and obese ≥30 Kg/m2. The analyses were conducted using two categories: BMI < 25.0 (normal/underweight) and BMI ≥ 25 (overweight/obese). Progression-free survival (PFS) and overall survival (OS) rates were estimated using Kaplan-Meier method. Univariate and multivariate survival analyses were performed using the Cox's proportional hazards model. Disease response to therapy was analyzed using univariate and multivariate logistic regression. Results Overall, 176 (53.5%) patients were normal/underweight and 153 (46.5%) overweight/obese. Median PFS was 14.8 months in BMI < 25 group and 15.7 months in BMI ≥ 25 group (adjusted-HR 0.88; 95% CI 0.66–1.17; p = 0.387). Median OS was 58.6 months in BMI < 25 group and 52.6 in BMI ≥ 25 group (adjusted-HR 0.88; 95% CI 0.59–1.31; p = 0.525). Overall response rate was 71.7% and 65.9% (p = 0.296) and clinical benefit rate was 82.1% and 83.3% (p = 0.781) in BMI < 25 and BMI ≥ 25 groups, respectively. Conclusions BMI does not seem to be associated with clinical outcomes in HER2-positive MBC patients. © 2017 Elsevier Ltd
Original languageEnglish
Pages (from-to)142-147
Number of pages6
JournalBreast
Volume37
DOIs
Publication statusPublished - 2018

Fingerprint

Body Mass Index
Breast Neoplasms
Thinness
Disease-Free Survival
Survival Analysis
Proportional Hazards Models
Cohort Studies
Multivariate Analysis
Survival Rate
Retrospective Studies
Obesity
Logistic Models
Survival

Keywords

  • Body mass index
  • HER2-positive
  • Metastatic breast cancer
  • Trastuzumab
  • trastuzumab
  • adult
  • aged
  • Article
  • body mass
  • cancer survival
  • clinical outcome
  • cohort analysis
  • comparative effectiveness
  • controlled study
  • drug response
  • female
  • human
  • human epidermal growth factor receptor 2 positive breast cancer
  • major clinical study
  • metastatic breast cancer
  • middle aged
  • multicenter study
  • obesity
  • outcome assessment
  • overall survival
  • priority journal
  • progression free survival
  • retrospective study
  • survival rate
  • underweight

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Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer. / Martel, S.; Poletto, E.; Ferreira, A.R.; Lambertini, M.; Sottotetti, F.; Bertolini, I.; Montemurro, F.; Bernardo, A.; Risi, E.; Zanardi, E.; Ziliani, S.; Mura, S.; Dellepiane, C.; Del Mastro, L.; Minisini, A.M.; Puglisi, F.

In: Breast, Vol. 37, 2018, p. 142-147.

Research output: Contribution to journalArticle

Martel, S, Poletto, E, Ferreira, AR, Lambertini, M, Sottotetti, F, Bertolini, I, Montemurro, F, Bernardo, A, Risi, E, Zanardi, E, Ziliani, S, Mura, S, Dellepiane, C, Del Mastro, L, Minisini, AM & Puglisi, F 2018, 'Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer', Breast, vol. 37, pp. 142-147. https://doi.org/10.1016/j.breast.2017.11.004
Martel, S. ; Poletto, E. ; Ferreira, A.R. ; Lambertini, M. ; Sottotetti, F. ; Bertolini, I. ; Montemurro, F. ; Bernardo, A. ; Risi, E. ; Zanardi, E. ; Ziliani, S. ; Mura, S. ; Dellepiane, C. ; Del Mastro, L. ; Minisini, A.M. ; Puglisi, F. / Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer. In: Breast. 2018 ; Vol. 37. pp. 142-147.
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abstract = "Background Overweight and obesity are associated with an increased risk of developing many types of cancer, including breast cancer. Moreover, increased body mass index (BMI) seems to be associated with a worse prognosis in patients with HER2-positive early breast cancer. However, little is known about the impact of BMI on the clinical outcomes of HER2-positive metastatic breast cancer (MBC). Methods This was a multicenter retrospective cohort study including 329 consecutive patients with HER2-positive MBC treated with first-line trastuzumab-based regimens. BMI at the time of MBC diagnosis was collected. World Health Organization BMI categories were used: underweight <18.5, normal 18.5–24.9 Kg/m2, overweight 25–29.9 Kg/m2, and obese ≥30 Kg/m2. The analyses were conducted using two categories: BMI < 25.0 (normal/underweight) and BMI ≥ 25 (overweight/obese). Progression-free survival (PFS) and overall survival (OS) rates were estimated using Kaplan-Meier method. Univariate and multivariate survival analyses were performed using the Cox's proportional hazards model. Disease response to therapy was analyzed using univariate and multivariate logistic regression. Results Overall, 176 (53.5{\%}) patients were normal/underweight and 153 (46.5{\%}) overweight/obese. Median PFS was 14.8 months in BMI < 25 group and 15.7 months in BMI ≥ 25 group (adjusted-HR 0.88; 95{\%} CI 0.66–1.17; p = 0.387). Median OS was 58.6 months in BMI < 25 group and 52.6 in BMI ≥ 25 group (adjusted-HR 0.88; 95{\%} CI 0.59–1.31; p = 0.525). Overall response rate was 71.7{\%} and 65.9{\%} (p = 0.296) and clinical benefit rate was 82.1{\%} and 83.3{\%} (p = 0.781) in BMI < 25 and BMI ≥ 25 groups, respectively. Conclusions BMI does not seem to be associated with clinical outcomes in HER2-positive MBC patients. {\circledC} 2017 Elsevier Ltd",
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author = "S. Martel and E. Poletto and A.R. Ferreira and M. Lambertini and F. Sottotetti and I. Bertolini and F. Montemurro and A. Bernardo and E. Risi and E. Zanardi and S. Ziliani and S. Mura and C. Dellepiane and {Del Mastro}, L. and A.M. Minisini and F. Puglisi",
note = "Export Date: 21 February 2018 CODEN: BREAE Correspondence Address: Lambertini, M.; Department of Medicine, Institut Jules Bordet, Universit{\'e} Libre de Bruxelles (U.L.B.), Boulevard de Waterloo, 121, Belgium; email: matteo.lambertini85@gmail.com",
year = "2018",
doi = "10.1016/j.breast.2017.11.004",
language = "English",
volume = "37",
pages = "142--147",
journal = "Breast",
issn = "0960-9776",
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}

TY - JOUR

T1 - Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer

AU - Martel, S.

AU - Poletto, E.

AU - Ferreira, A.R.

AU - Lambertini, M.

AU - Sottotetti, F.

AU - Bertolini, I.

AU - Montemurro, F.

AU - Bernardo, A.

AU - Risi, E.

AU - Zanardi, E.

AU - Ziliani, S.

AU - Mura, S.

AU - Dellepiane, C.

AU - Del Mastro, L.

AU - Minisini, A.M.

AU - Puglisi, F.

N1 - Export Date: 21 February 2018 CODEN: BREAE Correspondence Address: Lambertini, M.; Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Boulevard de Waterloo, 121, Belgium; email: matteo.lambertini85@gmail.com

PY - 2018

Y1 - 2018

N2 - Background Overweight and obesity are associated with an increased risk of developing many types of cancer, including breast cancer. Moreover, increased body mass index (BMI) seems to be associated with a worse prognosis in patients with HER2-positive early breast cancer. However, little is known about the impact of BMI on the clinical outcomes of HER2-positive metastatic breast cancer (MBC). Methods This was a multicenter retrospective cohort study including 329 consecutive patients with HER2-positive MBC treated with first-line trastuzumab-based regimens. BMI at the time of MBC diagnosis was collected. World Health Organization BMI categories were used: underweight <18.5, normal 18.5–24.9 Kg/m2, overweight 25–29.9 Kg/m2, and obese ≥30 Kg/m2. The analyses were conducted using two categories: BMI < 25.0 (normal/underweight) and BMI ≥ 25 (overweight/obese). Progression-free survival (PFS) and overall survival (OS) rates were estimated using Kaplan-Meier method. Univariate and multivariate survival analyses were performed using the Cox's proportional hazards model. Disease response to therapy was analyzed using univariate and multivariate logistic regression. Results Overall, 176 (53.5%) patients were normal/underweight and 153 (46.5%) overweight/obese. Median PFS was 14.8 months in BMI < 25 group and 15.7 months in BMI ≥ 25 group (adjusted-HR 0.88; 95% CI 0.66–1.17; p = 0.387). Median OS was 58.6 months in BMI < 25 group and 52.6 in BMI ≥ 25 group (adjusted-HR 0.88; 95% CI 0.59–1.31; p = 0.525). Overall response rate was 71.7% and 65.9% (p = 0.296) and clinical benefit rate was 82.1% and 83.3% (p = 0.781) in BMI < 25 and BMI ≥ 25 groups, respectively. Conclusions BMI does not seem to be associated with clinical outcomes in HER2-positive MBC patients. © 2017 Elsevier Ltd

AB - Background Overweight and obesity are associated with an increased risk of developing many types of cancer, including breast cancer. Moreover, increased body mass index (BMI) seems to be associated with a worse prognosis in patients with HER2-positive early breast cancer. However, little is known about the impact of BMI on the clinical outcomes of HER2-positive metastatic breast cancer (MBC). Methods This was a multicenter retrospective cohort study including 329 consecutive patients with HER2-positive MBC treated with first-line trastuzumab-based regimens. BMI at the time of MBC diagnosis was collected. World Health Organization BMI categories were used: underweight <18.5, normal 18.5–24.9 Kg/m2, overweight 25–29.9 Kg/m2, and obese ≥30 Kg/m2. The analyses were conducted using two categories: BMI < 25.0 (normal/underweight) and BMI ≥ 25 (overweight/obese). Progression-free survival (PFS) and overall survival (OS) rates were estimated using Kaplan-Meier method. Univariate and multivariate survival analyses were performed using the Cox's proportional hazards model. Disease response to therapy was analyzed using univariate and multivariate logistic regression. Results Overall, 176 (53.5%) patients were normal/underweight and 153 (46.5%) overweight/obese. Median PFS was 14.8 months in BMI < 25 group and 15.7 months in BMI ≥ 25 group (adjusted-HR 0.88; 95% CI 0.66–1.17; p = 0.387). Median OS was 58.6 months in BMI < 25 group and 52.6 in BMI ≥ 25 group (adjusted-HR 0.88; 95% CI 0.59–1.31; p = 0.525). Overall response rate was 71.7% and 65.9% (p = 0.296) and clinical benefit rate was 82.1% and 83.3% (p = 0.781) in BMI < 25 and BMI ≥ 25 groups, respectively. Conclusions BMI does not seem to be associated with clinical outcomes in HER2-positive MBC patients. © 2017 Elsevier Ltd

KW - Body mass index

KW - HER2-positive

KW - Metastatic breast cancer

KW - Trastuzumab

KW - trastuzumab

KW - adult

KW - aged

KW - Article

KW - body mass

KW - cancer survival

KW - clinical outcome

KW - cohort analysis

KW - comparative effectiveness

KW - controlled study

KW - drug response

KW - female

KW - human

KW - human epidermal growth factor receptor 2 positive breast cancer

KW - major clinical study

KW - metastatic breast cancer

KW - middle aged

KW - multicenter study

KW - obesity

KW - outcome assessment

KW - overall survival

KW - priority journal

KW - progression free survival

KW - retrospective study

KW - survival rate

KW - underweight

U2 - 10.1016/j.breast.2017.11.004

DO - 10.1016/j.breast.2017.11.004

M3 - Article

VL - 37

SP - 142

EP - 147

JO - Breast

JF - Breast

SN - 0960-9776

ER -