581 - The rationale for the effectiveness of systemic treatment of breast cancer depending on the body weight index

Background

Breast cancer in the world in general and in Ukraine is steadily increasing. Epidemiological, experimental and clinical studies have shown that metabolic disturbances associated with BMI> 30 kg / m² increase the risk of occurrence and worsen the clinical course of breast cancer. Thus, in patients with obesity, a decrease in the sensitivity of the tumor to systemic antitumor therapy, an increase in the frequency of postoperative complications and a decrease in the rates of general and non-recurrent survival.

Methods

The aim of the study was to improve the results of neoadjuvant systemic antitumor therapy in breast cancer patients with abdominal obesity (BMI greater than 30 kg / m²) by administering levocarnitine in combination with neoadjuvant systemic anticancer therapy (NSAT) for the correction of metabolic disorders as the main pathogenetic part of obesity. Following randomization of all patients (n = 108) with breast cancer with BMI> 30 kg / m², depending on the appointment of levocarnitine during NSAT, were divided into 2 groups: comparison and observation. In the comparison group, patients (n = 58) with BMI> 30 kg / m² patients with breast cancer who did not receive levocarnitine during NSPT, and in the, observation group - patients (n = 50) on breast cancer with BMI> 30 kg / m² who received levocarnitine during NIST

Results

After neoadjuvant systemic anticancer therapy, regardless of the purpose levocarnitine decreased residual tumor cell proliferation index (Ki-67) and increased incidence of Luminal A molecular type of breast cancer. Against neoadjuvant systemic anticancer therapy for breast cancer patients with a BMI over 30 kg / m² to be additionally administered drugs that increases the incidence of complete morphological regression. This drug is levocarnitine in therapeutic doses (1500 mg / day), which has proven to be an effective means to increase the number of cases of clinically relevant responses (CR + PR) to the treatment.

Conclusions

Levocarnitine contributes to an increase in the number of cases of objective clinical (complete regression and partial regression) and morphological (therapeutic pathomorphosis IV and V degree) tumor response to cytotoxic breast cancer therapy in patients with BMI> 30 kg / m² and frequency of organ-saving surgical interventions.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.