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Poster Display session 2

3608 - Prognostic impact of Body Mass Index (BMI) on overall survival in patients with metastatic breast cancer

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Breast Cancer

Presenters

Khalil SALEH

Citation

Annals of Oncology (2019) 30 (suppl_5): v104-v142. 10.1093/annonc/mdz242

Authors

K. SALEH1, M. Carton2, V.C. Dieras3, P. Heudel4, E. Brain5, N. Firmin6, A. Mailliez7, A. Patsouris8, M.A. Mouret Reynier9, A. Gonçalves10, J. Ferrero11, T. Petit12, C. Levy13, L. Uwer14, P.H. Cottu15, L. Veron15, E. Deluche1, A. Savignoni16, M. Robain17, S. Delaloge1

Author affiliations

  • 1 Medical Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 2 Statistics, Institut Curie, Saint-Cloud, 75005 - Paris/FR
  • 3 Praticien Specialiste En Oncologie Medicale, Centre Eugene - Marquis, 35042 - Rennes/FR
  • 4 Medical Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 5 Medical Oncology, Hôpital René Huguenin - Institut Curie, 92210 - St. Cloud/FR
  • 6 Medical Oncology, institut du cancer de Montpellier, 34298 - Montpellier/FR
  • 7 Oncological Cancer, Centre Oscar Lambret, 59000 - Lille/FR
  • 8 Medical Oncology Department, Centre Paul Papin, 49055 - Angers/FR
  • 9 Medical Oncology, Centre Jean Perrin, 63011 - Clermont-Ferrand/FR
  • 10 Medical Oncology, Institut Paoli Calmettes, 13274 - Marseille/FR
  • 11 Medical Oncology, Centre Anticancer Antoine Lacassagne, 06189 - Nice/FR
  • 12 Bas-rhin, Centre Paul Strauss Centre de Lutte contre le Cancer, 67065 - Strasbourg/FR
  • 13 Medical Oncology, Centre Francois Baclesse, 14076 - Caen/FR
  • 14 Medical Oncology, Institut de Cancérologie de Lorraine - Alexis Vautrin, 54519 - Vandoeuvre les Nancy/FR
  • 15 Medical Oncology, Institut Curie, 75005 - Paris/FR
  • 16 Biostatistics, Institut Curie, 75005 - Paris/FR
  • 17 R And D, Unicancer, 92210 - St. Cloud/FR

Resources

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Abstract 3608

Background

High BMI has been repeatedly identified as a risk factor for breast cancer (BC), but also as an adverse prognostic factor in women with early-stage BC. Little is known about its impact on outcome in patients with metastatic BC (MBC).

Methods

We used the National ESME-MBC cohort, which includes all consecutive patients (pts) newly diagnosed with MBC between Jan 2008 and Dec 2016 in 18 French comprehensive cancer centres. Women with available BMI at the diagnosis of MBC were selected. Four groups were defined according to WHO classification: underweight (BMI < 18.5 kg/m2), normal weight (18.5-24.9), overweight (25.0-29.9) and obese (≥30.0). Multivariate Cox analyses for OS were conducted in the whole population (primary objective). OS and 1st line progression-free survival (PFS) in subtypes (HER2+, Triple negative BC (TNBC) and HR+ HER2-) were secondary objectives.

Results

Of 22 463 patients in the ESME cohort, 12 999 women had BMI data available. Med BMI was 24.9 kg/m2 (range 12.1-66.5). Pts characteristics are reported in Table. Obesity was associated with more de novo MBC, while underweight pts had more aggressive features. Median follow-up was 48.6 months. Median OS was 47.4 months (95% CI [46.2-48.5]). By multivariate analysis, age, visceral metastases, time to MBC, number of metastatic sites, tumor subtype and BMI were independent predictors for OS. Underweight (but not overweight or obesity) was associated with a worse prognosis (HR 1.29, 95%CI [1.16-1.44]), and this was true in each tumour subtype. Median 1st line PFS was 12.2 months, with similar multivariate results.Table:

367P

UnderweightNormal weightOverweightObesep
N637 (5%)6020 (46%)3708 (29%)2634 (20%)
Age at MBC diagnosis (med)58586160<0.001
De novo MBC228 (36%)1939 (32%)1389 (37%)1132 (43%)0.000
Time to MBC (med, months)24332718<0.001
Visceral metastases400 (63%)3543 (59%)2148 (58%)1484 (56%)0.012
Subtype HR+HER2-354 (56%)3566 (59%)2311 (62%)1633 (62%)0.000
HER2+131 (21%)1295 (21%)725 (20%)545 (21%)
TNBC105 (16%)860 (14%)499 (13%)345 (13%)
>3 metastatic sites180 (28%)1306 (22%)753 (20%)553 (21%)0.000
Median OS (95% CI)33 (29-40)47 (45-49)49 (47-51)48 (45-51)

Conclusions

Unlike in early-stage BC, overweight and obesity do not seem associated with poorer OS in MBC women, whatever the subtype, on the opposite of underweight.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Robain: Research grant / Funding (institution), ESME plateform support: Roche; Research grant / Funding (institution), ESME plateform support: AstraZeneca; Research grant / Funding (institution), ESME plateform support: Pfizer; Research grant / Funding (institution), ESME plateform support: BMS; Research grant / Funding (institution), ESME plateform support: DAIICHI Sankyo. All other authors have declared no conflicts of interest.

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