Universität zu Köln

Martel, Samuel, Lambertini, Matteo, Agbor-Tarh, Dominique, Ponde, Noam F., Gombos, Andrea, Paterson, Vicki, Hilbers, Florentine ORCID: 0000-0002-6764-3102, Korde, Larissa, Manukyants, Anna, Dueck, Amylou, Maurer, Christian, Piccart, Martine, Moreno-Aspitia, Alvaro, Desmedt, Christine ORCID: 0000-0002-5223-5579, Di Cosimo, Serena and de Azambuja, Evandro (2021). Body Mass Index and Weight Change in Patients With HER2-Positive Early Breast Cancer: Exploratory Analysis of the ALTTO BIG 2-06 Trial. J. Natl. Compr. Cancer Netw., 19 (2). S. 181 - 203. HUNTINGTON: HARBORSIDE PRESS. ISSN 1540-1413

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Abstract

Background: The association between obesity and prognosis in HER2-positive early breast cancer remains unclear, with limited data available. This study aimed to determine the impact of body mass index (BMI) at baseline and weight change after 2 years on outcomes of patients with HER2-positive early breast cancer. Methods: ALTTO was a randomized phase III trial in patients with HER2-positive early breast cancer. BMI was collected at randomization and 2 years after. WHO BMI categories were used: underweight, <18.5 kg/m(2); normal weight, 18.5 to <25 kg/m(2); overweight, >= 25 to <30 kg/m(2); and obese >= 30 kg/m(2). A weight change from baseline of >= 5.0% and <= 5.0% was categorized as weight gain and weight loss. The impact of BMI at randomization and of weight change on disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS) were investigated with multivariate analyses, adjusting for baseline patients and tumor characteristics. Results: A total of 8,381 patients were included: 187 (2.2%), 3,797 (45.3%), 2,690 (32.1%), and 1,707 (20.4%) were underweight, normal weight, overweight, and obese at baseline, respectively. Compared with normal weight, being obese at randomization was associated with a significantly worse DDFS (adjusted hazard ratio [aHR], 1.25; 95% CI, 1.04-1.50) and OS (aHR, 1.27; 95% CI, 1.01-1.60), but no significant difference in DFS (aHR, 1.14; 95% CI, 0.97-1.32). Weight loss >= 5.0% at 2 years after randomization was associated with significantly poorer DFS (aHR, 1.34; 95% CI, 1.05-1.71), DDFS (aHR, 1.46; 95% CI, 1.07-1.98), and OS (aHR, 1.83; 95% CI, 1.18-2.84). Hormone receptor and menopausal status but not anti-HER2 treatment type influenced outcomes. Toxicities were more frequent in obese patients. Conclusions: In patients with HER2-positive early breast cancer, obesity at baseline is a poor prognostic factor. Weight loss during treatment and follow-up negatively impacts clinical outcomes. Dietary counseling should be part of survivorship care programs.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Martel, Samuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lambertini, Matteo UNSPECIFIED UNSPECIFIED UNSPECIFIED Agbor-Tarh, Dominique UNSPECIFIED UNSPECIFIED UNSPECIFIED Ponde, Noam F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gombos, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Paterson, Vicki UNSPECIFIED UNSPECIFIED UNSPECIFIED Hilbers, Florentine UNSPECIFIED orcid.org/0000-0002-6764-3102 UNSPECIFIED Korde, Larissa UNSPECIFIED UNSPECIFIED UNSPECIFIED Manukyants, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Dueck, Amylou UNSPECIFIED UNSPECIFIED UNSPECIFIED Maurer, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Piccart, Martine UNSPECIFIED UNSPECIFIED UNSPECIFIED Moreno-Aspitia, Alvaro UNSPECIFIED UNSPECIFIED UNSPECIFIED Desmedt, Christine UNSPECIFIED orcid.org/0000-0002-5223-5579 UNSPECIFIED Di Cosimo, Serena UNSPECIFIED UNSPECIFIED UNSPECIFIED de Azambuja, Evandro UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-602282
DOI:	10.6004/jnccn.2020.7606
Journal or Publication Title:	J. Natl. Compr. Cancer Netw.
Volume:	19
Number:	2
Page Range:	S. 181 - 203
Date:	2021
Publisher:	HARBORSIDE PRESS
Place of Publication:	HUNTINGTON
ISSN:	1540-1413
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AMERICAN SOCIETY; FOLLOW-UP; OBESITY; SURVIVAL; CROSSTALK; MORTALITY Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60228