Abstract 131P
Background
A better knowledge of the impact of BMI on prognosis and response to treatments is important to tailor treatment strategies and survivorship care. We assessed the impact of BMI at diagnosis and weight changes on outcomes of pts with HER2-positive early BC included in the APHINITY trial, who all received chemotherapy (ChT) plus single or dual HER2 blockade.
Methods
Pts were classified as normal/underweight (BMI<25kg/m2) and overweight/obese (BMI≥25kg/m2). The impact of baseline BMI on invasive disease-free survival (IDFS) and distant recurrence-free interval (DRFI) was assessed. Multivariable analyses adjusting for baseline features that differed according to BMI (age, menopausal status, tumor size, type of endocrine therapy and ChT) were performed. A landmark analysis was done to study the impact of weight changes (5% loss or gain) at 2y.
Results
4787 pts were included: 2535 (53%) were normal/underweight and 2252 (47%) overweight/obese. BMI≥25 at baseline was associated with older age, postmenopausal status, larger tumours, less treatment with anthracyclines and more use of aromatase inhibitors. BMI≥25 was associated with worse IDFS (adjusted hazard ratio [aHR] 1.27; 95% CI 1.06-1.52) and DRFI (aHR 1.32; 95% CI 1.06-1.64). Subgroup analyses suggested a negative impact of BMI≥25 for pts with hormone receptor-negative BC (IDFS: aHR 1.52; 95% CI 1.14-2.03; DRFI: aHR 1.57; 95% CI 1.10-2.24), postmenopausal (IDFS aHR:1.30; 95% CI 1.01-1.68; DRFI: aHR 1.37; 95% CI 1.00-1.89), pts treated with dual HER2-blockade (IDFS: aHR 1.47; 95% CI 1.12-1.93; DRFI: aHR 1.51; 95% CI 1.09-2.11), and anthracyclines (IDFS: aHR 1.26; 95% CI 1.03-1.54; DRFI: aHR 1.34; 95% CI 1.05-1.70). Weight changes did not impact on IDFS (n=3961)-Loss aHR 1.03, 95% CI 0.71-1.50; Gain aHR 1.00; 95% CI 0.76-1.31 or DRFI (n=3965)-Loss aHR 0.93, 95% CI 0.59-1.47; Gain aHR 0.90; 95% CI 0.64-1.26. Analysis with 4 BMI categories did not profoundly change the conclusions (data will be presented).
Conclusions
In this exploratory analysis, BMI≥25 at baseline appeared to be associated with inferior IDFS and DRFI in pts with HER2-positive early BC. Further research assessing the impact of weight changes on IDFS and DRFI is needed to better inform survivorship programs.
Clinical trial identification
NCT01358877.
Editorial acknowledgement
Legal entity responsible for the study
The APHINITY trial was carried out by Roche in collaboration with the Breast International Group.
Funding
Has not received any funding.
Disclosure
S. Martel: Financial Interests, Personal, Other, Honoraria: Novartis. M. Piccart: Other, Personal, Other, Scientific board: Oncolytics; Financial Interests, Personal, Other, Consultant (honoraria): AstraZeneca; Financial Interests, Personal, Other, Consultant (honoraria): Camel-IDS; Financial Interests, Personal, Other, Consultant (honoraria): Immunomedics; Financial Interests, Personal, Other, Consultant (honoraria): Lilly; Financial Interests, Personal, Other, Consultant (honoraria): Menarini; Financial Interests, Personal, Other, Consultant (honoraria): MSD; Financial Interests, Personal, Other, Consultant (honoraria): Novartis; Financial Interests, Personal, Other, Consultant (honoraria): Odonate; Financial Interests, Personal, Other, Consultant (honoraria): Pfizer; Financial Interests, Personal, Other, Consultant (honoraria): Roche-Genentech; Financial Interests, Personal, Other, Consultant (honoraria): Seattle Genetics; Financial Interests, Personal, Other, Consultant (honoraria): Immutep; Financial Interests, Personal, Other, Consultant (honoraria): Seagen; Financial Interests, Personal, Other, Consultant (honoraria): NBE Therapeutics; Financial Interests, Institutional, Other, Research grants: AstraZeneca; Financial Interests, Institutional, Other, Research grants: Immunomedics; Financial Interests, Institutional, Other, Research grants: Lilly; Financial Interests, Institutional, Other, Research grants: Menarini; Financial Interests, Institutional, Other, Research grants: MSD; Financial Interests, Institutional, Other, Research grants: Novartis; Financial Interests, Institutional, Other, Research grants: pfizer; Financial Interests, Institutional, Other, Research grants: Radius; Financial Interests, Institutional, Other, Research grants: Roche-Genentech; Financial Interests, Institutional, Other, Research grants: Servier; Financial Interests, Institutional, Other, Research grants: Synthon. J. Bines: Financial Interests, Personal, Advisory Board: AbbVie; Financial Interests, Personal, Advisory Board: Genomic Health; Financial Interests, Personal, Advisory Board: Libbs; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Personal, Advisory Board: F. Hoffmann-La Roche Ltd.; Financial Interests, Personal, Other, Travel/accommodation: AstraZeneca; Financial Interests, Personal, Other, Travel/accommodation: F. Hoffmann-La Roche. S. Loibl: Financial Interests, Institutional, Other, Grants and honoraria: AbbVie; Financial Interests, Institutional, Other, Grants and honoraria: Amgen; Financial Interests, Institutional, Other, Grants and honoraria: AstraZeneca; Financial Interests, Institutional, Other, Grants and honoraria: Celgene; Financial Interests, Institutional, Other, Grants and honoraria: Daiichi-Sankyo; Financial Interests, Institutional, Other, Grants and honoraria: Novartis; Financial Interests, Institutional, Other, Grants and honoraria: Pfizer; Financial Interests, Institutional, Other, Grants and honoraria: Roche; Financial Interests, Institutional, Other, Grants and honoraria: Seattle Genetics; Financial Interests, Institutional, Other, Honorarium: Bayer; Financial Interests, Institutional, Other, Honorarium: BMS; Financial Interests, Institutional, Other, Honorarium: Eirgenix; Financial Interests, Institutional, Other, Honorarium: GSK; Financial Interests, Institutional, Other, Honorarium: Ipsen; Financial Interests, Institutional, Other, Honorarium: Lilly; Financial Interests, Institutional, Other, Honorarium: Merck; Financial Interests, Institutional, Other, Honorarium: Pierre Fabre; Financial Interests, Institutional, Other, Honorarium: PrIME/Medscape; Financial Interests, Institutional, Other, Honorarium: Puma; Financial Interests, Institutional, Other, Honorarium: Samsung; Financial Interests, Institutional, Other, Grants: Cepheid; Financial Interests, Institutional, Other, Grants: Immunomedics/Gilead; Financial Interests, Institutional, Other, Grants: Vifor; Financial Interests, Institutional, Other, Patents and licence fees: VM Scope GmbH; Financial Interests, Personal, Other, Personal fee: Chugai; Non-Financial Interests, Personal, Other, Steering commitee: Immunomedics/Gilead; Non-Financial Interests, Personal, Other, Steering commitee: Novartis; Non-Financial Interests, Personal, Other, Steering commitee: Pfizer; Non-Financial Interests, Personal, Other, Steering commitee: Roche and Seattle Genetics. S. Di Cosimo: Financial Interests, Personal, Other, Honoraria and advisory board (outside the submitted work): Novartis; Financial Interests, Personal, Other, Honoraria and advisory board (outside the submitted work): Pierre Fabre. I. Vaz-Luis: Financial Interests, Personal, Other, Personal fees (outside the submitted work): AstraZeneca; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Novartis; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Kephren; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Amgen. L. Del Mastro: Financial Interests, Personal, Other, Personal fees (outside the submitted work): Roche; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Novartis; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Pfizer; Financial Interests, Personal, Other, Personal fees (outside the submitted work): AstraZeneca; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Daiichi Sankyo; Financial Interests, Personal, Other, Personal fees (outside the submitted work): MSD; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Seattle Genetics; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Ipsen; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Celgene; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Eisai; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Eli Lilly; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Amgen; Financial Interests, Personal, Other, Personal fees (outside the submitted work): Pierre Fabre. A. Gombos: Financial Interests, Personal, Other, Advisory board, travel grants, speaker fees (outside the submitted work): Lilly; Financial Interests, Personal, Other, Advisory board, travel grants, speaker fees (outside the submitted work): Daiichi Sankyo; Financial Interests, Personal, Other, Advisory board, travel grants, speaker fees (outside the submitted work): Pfizer; Financial Interests, Personal, Other, Advisory board, travel grants, speaker fees (outside the submitted work): AstraZeneca. G. Jerusalem: Non-Financial Interests, Personal, Other, Medical Writing: Novartis; Financial Interests, Institutional, Other, Grants: Novartis; Financial Interests, Institutional, Other, Grants: Pfizer; Financial Interests, Institutional, Other, Grants: Roche; Financial Interests, Personal, Other, Consulting fees + travel support + honoraria: Novartis; Financial Interests, Personal, Other, Consulting fees + travel support: Amgen; Financial Interests, Personal, Other, Consulting fees + travel support + honoraria: Roche; Financial Interests, Personal, Other, Consulting fees + honoraria: Pfizer; Financial Interests, Personal, Other, Consulting fees + travel support + honoraria: BMS; Financial Interests, Personal, Other, Consulting fees + travel support + honoraria: Lilly; Financial Interests, Personal, Other, Consulting fees + honoraria: AstraZeneca; Non-Financial Interests, Personal, Other, Medical Writing: Roche; Non-Financial Interests, Personal, Other, Medical Writing: Lilly; Non-Financial Interests, Personal, Other, Medical Writing: BMS; Non-Financial Interests, Personal, Other, Medical Writing: AstraZeneca; Non-Financial Interests, Personal, Other, Medical Writing: MedImmune; Non-Financial Interests, Personal, Other, Medical Writing: Merck. T. Pienkowski: Financial Interests, Personal, Other, Honoraria for lectures + research grant: Roche. M. Lambertini: Financial Interests, Personal, Other, Consultant: Roche; Financial Interests, Personal, Other, Consultant: Lilly; Financial Interests, Personal, Other, Consultant: AstraZeneca; Financial Interests, Personal, Other, Consultant: Novartis; Financial Interests, Personal, Other, Honoraria (outside de submitted work): Sandoz; Financial Interests, Personal, Other, Honoraria (outside de submitted work: Takeda; Financial Interests, Personal, Other, Honoraria (outside de submitted work: Roche; Financial Interests, Personal, Other, Honoraria (outside de submitted work: Lilly; Financial Interests, Personal, Other, Honoraria (outside de submitted work: Pfizer; Financial Interests, Personal, Other, Honoraria (outside de submitted work: Novartis. E. de Azambuja: Financial Interests, Personal, Other, Honoraria and avisory board: Roche/GNE; Financial Interests, Personal, Other, Honoraria and advisory board: Novartis; Financial Interests, Personal, Other, Honoraria and advisory board: Seattle Genetics; Financial Interests, Personal, Other, Honoraria and advisory board: Zodiacs; Financial Interests, Personal, Other, Honoraria and advisory board: Lilly; Financial Interests, Personal, Other, Honoraria and advisory board: Pierre Fabre; Financial Interests, Personal, Other, Honoraria and advisory board: Libbs; Financial Interests, Personal, Other, Travel Grants: Roche/GNE; Financial Interests, Personal, Other, Travel Grants: GSK/Novartis; Financial Interests, Institutional, Other, Research grant (outside the submitted work): Roche/GNE; Financial Interests, Institutional, Other, Research grant (outside the submitted work): AstraZeneca; Financial Interests, Institutional, Other, Research grant (outside the submitted work): Novartis; Financial Interests, Institutional, Other, Research grant (outside the submitted work): Servier. All other authors have declared no conflicts of interest.