Rima Patel1, Zhiqiang Li2, Brittney S Zimmerman3, Marc Y Fink2, Jason D Wells2, Xiang Zhou2, Kristin Ayers2, Arielle Redfern2, Scott Newman2, Eric Schadt2, William K Oh3,2, Rong Chen4, Amy Tiersten5. 1. Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029-6574, USA. Rima.patel2@mountsinai.org. 2. Sema4, Stamford, CT, USA. 3. Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029-6574, USA. 4. Sema4, Stamford, CT, USA. rong.chen@sema4.com. 5. Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029-6574, USA. amy.tiersten@mssm.edu.
Abstract
PURPOSE: Higher levels of estrogen in obese patients may lead to incomplete inhibition by aromatase inhibitors (AIs). The aim of this study was to determine the impact of body mass index (BMI) on efficacy of AIs in patients with metastatic hormone receptor (HR)-positive breast cancer (BC). METHODS: We performed a retrospective chart review of all female patients with metastatic HR-positive BC on an AI in first- or second-line settings and seen at our academic institution between 2001 and 2020. The primary endpoint was progression-free survival (PFS), defined as the time from start of AI to disease progression or death from any cause. RESULTS: We identified 219 patients who had received an AI in the first- or second-line settings for metastatic HR-positive BC and with documented information on BMI. Of the 219 patients, 56% (123) had a low BMI (defined as < 27 kg/m2) and 44% (96) had a high BMI (≥ 27 kg/m2). The median PFS was 21.9 months (95% CI 14.5 to 28.4) in the low BMI group versus 20.2 months (95% CI 14.3 to 27.5) in the high BMI group (p = 0.73). CONCLUSION: While BMI influences efficacy of AIs in the adjuvant setting, our results suggest that in the metastatic setting, BMI may not impact the efficacy of AIs. This discrepancy could be due to other differences in disease characteristics that make complete aromatase inhibition more important in the adjuvant setting when disease burden is the lowest.
PURPOSE: Higher levels of estrogen in obese patients may lead to incomplete inhibition by aromatase inhibitors (AIs). The aim of this study was to determine the impact of body mass index (BMI) on efficacy of AIs in patients with metastatic hormone receptor (HR)-positive breast cancer (BC). METHODS: We performed a retrospective chart review of all female patients with metastatic HR-positive BC on an AI in first- or second-line settings and seen at our academic institution between 2001 and 2020. The primary endpoint was progression-free survival (PFS), defined as the time from start of AI to disease progression or death from any cause. RESULTS: We identified 219 patients who had received an AI in the first- or second-line settings for metastatic HR-positive BC and with documented information on BMI. Of the 219 patients, 56% (123) had a low BMI (defined as < 27 kg/m2) and 44% (96) had a high BMI (≥ 27 kg/m2). The median PFS was 21.9 months (95% CI 14.5 to 28.4) in the low BMI group versus 20.2 months (95% CI 14.3 to 27.5) in the high BMI group (p = 0.73). CONCLUSION: While BMI influences efficacy of AIs in the adjuvant setting, our results suggest that in the metastatic setting, BMI may not impact the efficacy of AIs. This discrepancy could be due to other differences in disease characteristics that make complete aromatase inhibition more important in the adjuvant setting when disease burden is the lowest.
Authors: Alan S Coates; Aparna Keshaviah; Beat Thürlimann; Henning Mouridsen; Louis Mauriac; John F Forbes; Robert Paridaens; Monica Castiglione-Gertsch; Richard D Gelber; Marco Colleoni; István Láng; Lucia Del Mastro; Ian Smith; Jacquie Chirgwin; Jean-Marie Nogaret; Tadeusz Pienkowski; Andrew Wardley; Erik H Jakobsen; Karen N Price; Aron Goldhirsch Journal: J Clin Oncol Date: 2007-01-02 Impact factor: 44.544
Authors: Georg Pfeiler; Robert Königsberg; Christian Fesl; Brigitte Mlineritsch; Herbert Stoeger; Christian F Singer; Sabine Pöstlberger; Guenther G Steger; Michael Seifert; Peter Dubsky; Susanne Taucher; Hellmut Samonigg; Vesna Bjelic-Radisic; Richard Greil; Christian Marth; Michael Gnant Journal: J Clin Oncol Date: 2011-05-09 Impact factor: 44.544
Authors: A Howell; J Cuzick; M Baum; A Buzdar; M Dowsett; J F Forbes; G Hoctin-Boes; J Houghton; G Y Locker; J S Tobias Journal: Lancet Date: 2005 Jan 1-7 Impact factor: 79.321
Authors: Anne McTiernan; Kumar B Rajan; Shelley S Tworoger; Melinda Irwin; Leslie Bernstein; Richard Baumgartner; Frank Gilliland; Frank Z Stanczyk; Yutaka Yasui; Rachel Ballard-Barbash Journal: J Clin Oncol Date: 2003-05-15 Impact factor: 44.544
Authors: R Charles Coombes; Emma Hall; Lorna J Gibson; Robert Paridaens; Jacek Jassem; Thierry Delozier; Stephen E Jones; Isabel Alvarez; Gianfilippo Bertelli; Olaf Ortmann; Alan S Coates; Emilio Bajetta; David Dodwell; Robert E Coleman; Lesley J Fallowfield; Elizabeth Mickiewicz; Jorn Andersen; Per E Lønning; Giorgio Cocconi; Alan Stewart; Nick Stuart; Claire F Snowdon; Marina Carpentieri; Giorgio Massimini; Judith M Bliss; Cornelius van de Velde Journal: N Engl J Med Date: 2004-03-11 Impact factor: 91.245
Authors: Richard S Finn; Miguel Martin; Hope S Rugo; Stephen Jones; Seock-Ah Im; Karen Gelmon; Nadia Harbeck; Oleg N Lipatov; Janice M Walshe; Stacy Moulder; Eric Gauthier; Dongrui R Lu; Sophia Randolph; Véronique Diéras; Dennis J Slamon Journal: N Engl J Med Date: 2016-11-17 Impact factor: 91.245
Authors: Matthew P Goetz; Masakazu Toi; Mario Campone; Joohyuk Sohn; Shani Paluch-Shimon; Jens Huober; In Hae Park; Olivier Trédan; Shin-Cheh Chen; Luis Manso; Orit C Freedman; Georgina Garnica Jaliffe; Tammy Forrester; Martin Frenzel; Susana Barriga; Ian C Smith; Nawel Bourayou; Angelo Di Leo Journal: J Clin Oncol Date: 2017-10-02 Impact factor: 44.544
Authors: John F Forbes; Jack Cuzick; Aman Buzdar; Anthony Howell; Jeffrey S Tobias; Michael Baum Journal: Lancet Oncol Date: 2008-01 Impact factor: 41.316
Authors: Gabriel N Hortobagyi; Salomon M Stemmer; Howard A Burris; Yoon-Sim Yap; Gabe S Sonke; Shani Paluch-Shimon; Mario Campone; Kimberly L Blackwell; Fabrice André; Eric P Winer; Wolfgang Janni; Sunil Verma; Pierfranco Conte; Carlos L Arteaga; David A Cameron; Katarina Petrakova; Lowell L Hart; Cristian Villanueva; Arlene Chan; Erik Jakobsen; Arnd Nusch; Olga Burdaeva; Eva-Maria Grischke; Emilio Alba; Erik Wist; Norbert Marschner; Anne M Favret; Denise Yardley; Thomas Bachelot; Ling-Ming Tseng; Sibel Blau; Fengjuan Xuan; Farida Souami; Michelle Miller; Caroline Germa; Samit Hirawat; Joyce O'Shaughnessy Journal: N Engl J Med Date: 2016-10-07 Impact factor: 91.245