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Impact of BMI on HER2+ metastatic breast cancer patients treated with pertuzumab and/or trastuzumab emtansine. Real‐world evidence
Author(s) -
Krasniqi Eriseld,
Pizzuti Laura,
Barchiesi Giacomo,
Sergi Domenico,
Carpano Silvia,
Botti Claudio,
Kayal Ramy,
Sanguineti Giuseppe,
Marchetti Paolo,
Botticelli Andrea,
Marinelli Daniele,
Gamucci Teresa,
Natoli Clara,
Grassadonia Antonino,
Tinari Nicola,
Tomao Silverio,
Tonini Giuseppe,
Santini Daniele,
Michelotti Aandrea,
Mentuccia Lucia,
Vaccaro Aangela,
Magnolfi Emanuela,
Gelibter Alain,
Magri Valentina,
Cortesi Enrico,
D’Onofrio Loretta,
Cassano Alessandra,
Cazzaniga Marina,
Moscetti Luca,
Fabbri Agnese,
Scinto Angelo Fedele,
Corsi Domenico,
Carbognin Luisa,
Bria Emilio,
La Verde Nicla,
Garufi Carlo,
Di Stefano Pia,
Mirabelli Rossana,
Veltri Enzo,
Paris Ida,
Giotta Francesco,
Lorusso Vito,
Landucci Elisa,
Ficorella Corrado,
Roselli Mario,
Adamo Vincenzo,
Ricciardi Giuseppina,
Russo Antonio,
Valerio Maria Rosaria,
Berardi Rossana,
Pistelli Mirco,
Cannita Katia,
Zamagni Claudio,
Garrone Ornella,
Baldini Editta,
Livi Lorenzo,
Meattini Icro,
Del Medico Pietro,
Generali Daniele,
De Maria Ruggero,
Risi Emanuela,
Ciliberto Gennaro,
Villa Alice,
Sperduti Isabella,
Mazzotta Marco,
Barba Maddalena,
Giordano Antonio,
Vici Patrizia
Publication year - 2020
Publication title -
journal of cellular physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 174
eISSN - 1097-4652
pISSN - 0021-9541
DOI - 10.1002/jcp.29445
Subject(s) - medicine , oncology , breast cancer , body mass index , pertuzumab , population , metastatic breast cancer , quartile , overweight , cancer , confidence interval , environmental health
Body mass index (BMI) is a main indicator of obesity and its association with breast cancer is well established. However, little is known in the metastatic setting, especially in HER2‐positive patients. We assessed the influence of BMI on clinical outcomes of patients treated with pertuzumab and/or trastuzumab emtansine (T‐DM1) for HER2+ metastatic breast cancer (mBC). BMI was addressed as a categorical variable, being classified on the basis of the following ranges, that is, 18.5–24.9, 25–29.9, and 30.0–34.9, namely, normal weight, overweight, and Class I obesity. The outcomes chosen were progression‐free survival to first‐line chemotherapy (PFS1) and overall survival (OS). Overall ( N = 709), no impact of BMI was observed on PFS1 ( p = .15), while BMI ≥ 30 was associated with worse OS ( p = .003). In subjects who progressed to first line ( N = 575), analyzing data across PFS1 quartiles and strata of disease burden, BMI predicted lower PFS1 in patients within the I PFS1 quartile and with the lowest disease burden ( p = .001). Univariate analysis showed a detrimental effect of BMI ≥ 30 on OS for women within the I PFS1 quartile ( p = .03). Results were confirmed in multivariate analysis. According to PFS1 quartiles a higher percentage of patients with high BMI and low disease burden progressed within 6 months of therapy. The effect of BMI on prognosis was also confirmed in multivariate analysis of OS for overall population. In our cohort, a BMI ≥ 30 correlated with worse OS in patients with HER2+ mBC who received pertuzumab and/or T‐DM1 but had no impact on PFS to first line. BMI predicted worse I PFS1 quartile.