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
Underweight | Normal weight | Overweight | Obese | p | |
---|---|---|---|---|---|
N | 637 (5%) | 6020 (46%) | 3708 (29%) | 2634 (20%) | |
Age at MBC diagnosis (med) | 58 | 58 | 61 | 60 | <0.001 |
De novo MBC | 228 (36%) | 1939 (32%) | 1389 (37%) | 1132 (43%) | 0.000 |
Time to MBC (med, months) | 24 | 33 | 27 | 18 | <0.001 |
Visceral metastases | 400 (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%) | |
TNBC | 105 (16%) | 860 (14%) | 499 (13%) | 345 (13%) | |
>3 metastatic sites | 180 (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.
Resources from the same session
5887 - Factors of importance in procuring tumoroids from colorectal liver metastasis biopsies for precision medicine.
Presenter: Lars Henrik Jensen
Session: Poster Display session 2
Resources:
Abstract
2196 - FUSAFE individual patient data meta-analysis (MA) to assess the performance of dihydropyrimidine dehydrogenase (DPD) gene polymorphisms for predicting grade 4-5 fluoropyrimidine (FP) toxicity
Presenter: Marie-Christine Etienne-Grimaldi
Session: Poster Display session 2
Resources:
Abstract
2859 - Treatments (tx) after progression to first-line FOLFOXIRI + bevacizumab (bev) in metastatic colorectal cancer (mCRC) patients (pts): A pooled analysis of TRIBE and TRIBE-2 studies by GONO.
Presenter: Daniele Rossini
Session: Poster Display session 2
Resources:
Abstract
3888 - Randomized phase III study of sequential treatment with capecitabine or 5-fluorouracil (FP) plus bevacizumab (BEV) followed by the addition with oxaliplatin (OX) versus initial combination with OX+FP+ BEV in the first-line chemotherapy for metastatic colorectal cancer: The C-cubed study
Presenter: Takeshi Nagasaka
Session: Poster Display session 2
Resources:
Abstract
1065 - Early tumour shrinkage (ETS), depth of response (DpR) and associated survival outcomes in patients (pts) with RAS wild type (WT) metastatic colorectal cancer (mCRC) classified according to Köhne prognostic category: retrospective analysis of the panitumumab (Pmab) PRIME study
Presenter: Andrea Sartore-Bianchi
Session: Poster Display session 2
Resources:
Abstract
1702 - Randomized phase II trial of CAPOX with planned oxaliplatin stop-and-go strategy as adjuvant chemotherapy after curative resection of colon cancer (CCOG-1302 study)
Presenter: Hiroyuki Yokoyama
Session: Poster Display session 2
Resources:
Abstract
5104 - A metabolomic recurrence score for risk-stratification of elderly patients (pts) with early colorectal cancer (eCRC)
Presenter: Samantha Di Donato
Session: Poster Display session 2
Resources:
Abstract
5285 - RAS mutant allele fraction in plasma predicts benefit to anti-angiogenic based first line treatment in metastatic colorectal cancer
Presenter: Giulia Martini
Session: Poster Display session 2
Resources:
Abstract
1790 - Impact of prophylactic systemic antibiotics (SA) on outcome of patients (pts) with RAS-wildtype (RAS-wt) metastatic colorectal carcinoma (mCRC) treated with cetuximab-based first-line therapy. Subgroup analysis of the german non-interventional study ERBITAG
Presenter: Stephan Sahm
Session: Poster Display session 2
Resources:
Abstract
3059 - Intraoperative chemotherapy with 5-FU for colorectal cancer patients receiving curative resection (IOCCRC): A randomized, multicenter, prospective, phase III trial
Presenter: Rongxin Zhang
Session: Poster Display session 2
Resources:
Abstract