Impact of BMI on HER2+ metastatic breast cancer patients treated with pertuzumab and/or trastuzumab emtansine. Real-world evidence
- Autori: Eriseld K.; Laura P.; Giacomo B.; Domenico S.; Silvia C.; Claudio B.; Ramy K.; Giuseppe S.; Paolo M.; Andrea B.; Daniele M.; Teresa G.; Clara N.; Antonino G.; Nicola T.; Silverio T.; Giuseppe T.; Daniele S.; Aandrea M.; Lucia M.; Aangela V.; Emanuela M.; Alain G.; Valentina M.; Enrico C.; Loretta D.; Alessandra C.; Marina C.; Luca M.; Agnese F.; Angelo Fedele S.; Domenico C.; Luisa C.; Emilio B.; Nicla L.V.; Carlo G.; Pia D.S.; Rossana M.; Enzo V.; Ida P.; Francesco G.; Vito L.; Elisa L.; Corrado F.; Mario R.; Vincenzo A.; Giuseppina R.; Antonio R.; Maria Rosaria V.; Rossana B.; Mirco P.; Katia C.; Claudio Z.; Ornella G.; Editta B.; Lorenzo L.; Icro M.; Pietro D.M.; Daniele G.; Ruggero D.M.; Emanuela R.; Gennaro C.; Alice V.; Isabella S.; Marco M.; Maddalena B.; Antonio G.; Patrizia V.
- Anno di pubblicazione: 2020
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/412556
Abstract
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.