Abstract 179P
Background
Body weight and BC may change during NACT for breast cancer. Particularly, low skeletal muscle mass (SMM) and adipose tissue measurements have emerged as potential prognostic factors in solid tumours. The present study aimed to evaluate changes in BC during NACT and its association with clinical outcomes in pts treated for operable/locally-advanced breast cancer.
Methods
A retrospective review of breast cancer pts treated with NACT at Oncology of Verona between 2014 and 2019 was performed. Body composition parameters (SMM, intramuscular adipose tissue [IMAT], subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT]) were measured at third lumbar vertebra by computerized tomography (CT), at diagnosis and after NACT. The associations of BC measures with pathological complete response (pCR) and disease-free survival (DSF) were analyzed.
Results
Data from 93 pts, with a median age of 47 years (range 30-72) and a median follow-up of 40 months (range 14-76), were collected. At baseline, 24.7% of pts were overweight and 18.3% were obese. High levels of SMM, IMAT, SAT and VAT were significantly correlated with body mass index (BMI) levels >=25 Kg/m2 (p=0.003, p=0.042, p=0.002 and p=0.002, respectively). After NACT, adipose compound significantly changed (median IMAT from 5.6 cm2 to 6.6 cm2, p<0.0001; SAT from 177.1 cm2 to 191.5 cm2, p=0.010; VAT from 61.7 cm2 to 76.0 cm2, p=0.001), across all BMI categories. BC parameters were not associated with pCR, but a trend with baseline SMM was observed (p=0.078). At the multivariate analysis for DFS, pCR (HR 8.29, 95% CI 0.87-78.6, p=0.065), immunophenotype (HR 1.97, 95% CI 1.14-3.46, p=0.016) and VAT changes (HR 7.48, 95% CI 0.91-60.5, p=0.061) were independent prognostic factors. DFS was significantly worse in pts who gained VAT >12 cm2 compared to pts who gained VAT <=12 cm2 or decreased VAT during NACT (3-year DFS 79.8% vs. 95.7%, p=0.03, respectively).
Conclusions
Our results suggest that NACT significantly affects BC, which impacts on clinical outcome of breast cancer. Thus, CT-derived BC measures may provide significant prognostic information that outperform BMI value. Interventions targeting visceral fat accumulation may improve NACT outcomes in breast cancer pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
E. Bria: Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: MSD; Speaker Bureau/Expert testimony, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Celgene; Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Pfizer; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Helsinn; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Eli Lilly; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Novartis; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: BMS. All other authors have declared no conflicts of interest.