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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorDi Cosimo, Serena
dc.contributor.authorPorcu, Luca
dc.contributor.authorAgbor-tarh, Dominique
dc.contributor.authorCinieri, Saverio
dc.contributor.authorFranzoi, Maria Alice
dc.contributor.authorDe Santis, Maria Carmen
dc.contributor.authorSaura Manich, Cristina
dc.date.accessioned2021-09-10T10:04:01Z
dc.date.available2021-09-10T10:04:01Z
dc.date.issued2020-10-27
dc.identifier.citationDi Cosimo S, Porcu L, Agbor-tarh D, Cinieri S, Franzoi MA, De Santis MC, et al. Effect of body mass index on response to neo-adjuvant therapy in HER2-positive breast cancer: an exploratory analysis of the NeoALTTO trial. Breast Cancer Res. 2020 Oct 27;22:115.
dc.identifier.issn1465-542X
dc.identifier.urihttp://hdl.handle.net/11351/6297
dc.descriptionBody mass index; HER2-positive breast cancer; Neo-adjuvant treatment
dc.description.abstractBackground Obesity is a risk factor for breast cancer (BC) development, recurrence, and death. In view of this, we aimed to investigate the clinical value of obesity in BC patients treated with anti-HER2 therapies in the NeoALTTO trial, which randomized 455 patients to neo-adjuvant lapatinib, trastuzumab, or their combination plus paclitaxel. Methods Patients were classified according to their basal body mass index (BMI) into underweight (< 18.5 kg/m2), normal (≥ 18.5; < 25 kg/m2), overweight (≥ 25; < 30 kg/m2), and obese (≥ 30 kg/m2) WHO categories. Univariate and multivariate logistic regression analyses were performed using BMI as a categorical variable. Pathological complete response (pCR) and event-free survival (EFS) were the NeoALTTO primary and secondary outcomes, respectively. Results Among 454 patients analyzed, 14 (3%), 220 (48%), 137 (30%), and 83 (18%) were classified as underweight, normal weight, overweight, and obese, respectively; 231 (51%) and 223 (49%) had hormone receptor (HR)-positive and HR-negative primary tumors; 160 (35%) achieved pCR. In the overall patient population, no association was found between BMI groups and pCR, as we reported pCR rates of 57.1%, 35%, 30.7%, and 39.8% in underweight, normal weight, overweight, and obese cases, respectively. In contrast, in HR-positive tumors, overweight or obesity was generally associated with decreased likelihood of achieving a pCR independently of other clinical variables, including planned surgery, nodal status, and tumor size (odds ratio [OR] = 0.55, 95%CI 0.30–1.01, as compared to normal or underweight; p = 0.053); notably, no differential effect of BMI with respect to pCR was observed in HR-negative cases (odds ratio [OR] = 1.30, 95%CI 0.76–2.23, as compared to normal or underweight; p = 0.331), resulting in a statistically significant interaction between BMI and HR status (p = 0.036). There was no association between BMI and EFS neither in the overall nor in the HR-positive population, but this analysis was under-powered. Conclusions NeoALTTO patients overweight or obese at baseline and with HR-positive primary BC appeared less likely to achieve pCR after neo-adjuvant anti-HER2 therapies. This finding paves the way to future research in targeting the interplay between HER2/HR signaling and metabolism.
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofseriesBreast Cancer Research;22
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectMama - Càncer - Tractament
dc.subjectObesitat - Fisiologia patològica
dc.subject.meshBreast Neoplasms
dc.subject.meshNeoadjuvant Therapy
dc.subject.meshOverweight
dc.subject.mesh/physiopathology
dc.titleEffect of body mass index on response to neo-adjuvant therapy in HER2-positive breast cancer: an exploratory analysis of the NeoALTTO trial
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1186/s13058-020-01356-w
dc.subject.decsneoplasias de la mama
dc.subject.decstratamiento neoadyuvante
dc.subject.decssobrepeso
dc.subject.decs/fisiopatología
dc.relation.publishversionhttps://doi.org/10.1186/s13058-020-01356-w
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Di Cosimo S] Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, via G.A. Amadeo 42, 20133 Milano, Italy. [Porcu L] Laboratory of Methodology for Clinical Research, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy. [Agbor-tarh D] Frontier Science (Scotland) Ltd, Kincraig, UK. [Cinieri S] San Antonio Perrino Hospital, Brindisi, Italy. [Franzoi MA] Institut Jules Bordet and l’Universitè Libre de Bruxelles (U.LB), Brussels, Belgium. [De Santis MC] Radiation Oncology, Fondazione IRSCCS Istituto Nazionale dei Tumori, Milano, Italy. [Saura C] Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
dc.identifier.pmid33109233
dc.identifier.wos000589613500004
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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