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

Samuel Martel, Elena Poletto, Arlindo R Ferreira, Matteo Lambertini, Federico Sottotetti, Ilaria Bertolini, Filippo Montemurro, Antonio Bernardo, Emanuela Risi, Elisa Zanardi, Serena Ziliani, Silvia Mura, Chiara Dellepiane, Lucia Del Mastro, Alessandro Marco Minisini, Fabio 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.

Original languageEnglish
Pages (from-to)142-147
Number of pages6
JournalBreast
Volume37
DOIs
Publication statusPublished - Feb 2018

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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

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Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer. / Martel, Samuel; Poletto, Elena; Ferreira, Arlindo R; Lambertini, Matteo; Sottotetti, Federico; Bertolini, Ilaria; Montemurro, Filippo; Bernardo, Antonio; Risi, Emanuela; Zanardi, Elisa; Ziliani, Serena; Mura, Silvia; Dellepiane, Chiara; Del Mastro, Lucia; Minisini, Alessandro Marco; Puglisi, Fabio.

In: Breast, Vol. 37, 02.2018, 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 AR, Lambertini M, Sottotetti F, Bertolini I et al. Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer. Breast. 2018 Feb;37:142-147. https://doi.org/10.1016/j.breast.2017.11.004
Martel, Samuel ; Poletto, Elena ; Ferreira, Arlindo R ; Lambertini, Matteo ; Sottotetti, Federico ; Bertolini, Ilaria ; Montemurro, Filippo ; Bernardo, Antonio ; Risi, Emanuela ; Zanardi, Elisa ; Ziliani, Serena ; Mura, Silvia ; Dellepiane, Chiara ; Del Mastro, Lucia ; Minisini, Alessandro Marco ; Puglisi, Fabio. / 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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title = "Impact of body mass index on the clinical outcomes of patients with HER2-positive metastatic breast cancer",
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.",
author = "Samuel Martel and Elena Poletto and Ferreira, {Arlindo R} and Matteo Lambertini and Federico Sottotetti and Ilaria Bertolini and Filippo Montemurro and Antonio Bernardo and Emanuela Risi and Elisa Zanardi and Serena Ziliani and Silvia Mura and Chiara Dellepiane and {Del Mastro}, Lucia and Minisini, {Alessandro Marco} and Fabio Puglisi",
note = "Copyright {\circledC} 2017 Elsevier Ltd. All rights reserved.",
year = "2018",
month = "2",
doi = "10.1016/j.breast.2017.11.004",
language = "English",
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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, Samuel

AU - Poletto, Elena

AU - Ferreira, Arlindo R

AU - Lambertini, Matteo

AU - Sottotetti, Federico

AU - Bertolini, Ilaria

AU - Montemurro, Filippo

AU - Bernardo, Antonio

AU - Risi, Emanuela

AU - Zanardi, Elisa

AU - Ziliani, Serena

AU - Mura, Silvia

AU - Dellepiane, Chiara

AU - Del Mastro, Lucia

AU - Minisini, Alessandro Marco

AU - Puglisi, Fabio

N1 - Copyright © 2017 Elsevier Ltd. All rights reserved.

PY - 2018/2

Y1 - 2018/2

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.

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.

U2 - 10.1016/j.breast.2017.11.004

DO - 10.1016/j.breast.2017.11.004

M3 - Article

C2 - 29161652

VL - 37

SP - 142

EP - 147

JO - Breast

JF - Breast

SN - 0960-9776

ER -