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Observational Study
. 2020 Nov;235(11):7900-7910.
doi: 10.1002/jcp.29445. Epub 2020 Jan 15.

Impact of BMI on HER2+ metastatic breast cancer patients treated with pertuzumab and/or trastuzumab emtansine. Real-world evidence

Eriseld Krasniqi  1 , Laura Pizzuti  1 , Giacomo Barchiesi  1 , Domenico Sergi  1 , Silvia Carpano  1 , Claudio Botti  2 , Ramy Kayal  3 , Giuseppe Sanguineti  4 , Paolo Marchetti  5   6 , Andrea Botticelli  5 , Daniele Marinelli  6 , Teresa Gamucci  7 , Clara Natoli  8 , Antonino Grassadonia  8 , Nicola Tinari  8 , Silverio Tomao  9 , Giuseppe Tonini  10 , Daniele Santini  10 , Aandrea Michelotti  11 , Lucia Mentuccia  12 , Aangela Vaccaro  12 , Emanuela Magnolfi  12 , Alain Gelibter  5 , Valentina Magri  5 , Enrico Cortesi  5 , Loretta D'Onofrio  10 , Alessandra Cassano  13 , Marina Cazzaniga  14 , Luca Moscetti  15 , Agnese Fabbri  16 , Angelo Fedele Scinto  17 , Domenico Corsi  17 , Luisa Carbognin  18   19 , Emilio Bria  18   20 , Nicla La Verde  21 , Carlo Garufi  22 , Pia Di Stefano  22 , Rossana Mirabelli  23 , Enzo Veltri  24 , Ida Paris  19 , Francesco Giotta  25 , Vito Lorusso  25 , Elisa Landucci  11 , Corrado Ficorella  26 , Mario Roselli  27 , Vincenzo Adamo  28 , Giuseppina Ricciardi  28 , Antonio Russo  29 , Maria Rosaria Valerio  29 , Rossana Berardi  30 , Mirco Pistelli  30 , Katia Cannita  31 , Claudio Zamagni  32 , Ornella Garrone  33 , Editta Baldini  34 , Lorenzo Livi  35 , Icro Meattini  35 , Pietro Del Medico  36 , Daniele Generali  37 , Ruggero De Maria  38 , Emanuela Risi  39 , Gennaro Ciliberto  40 , Alice Villa  41 , Isabella Sperduti  42 , Marco Mazzotta  6 , Maddalena Barba  1 , Antonio Giordano  43 , Patrizia Vici  1
Affiliations
Observational Study

Impact of BMI on HER2+ metastatic breast cancer patients treated with pertuzumab and/or trastuzumab emtansine. Real-world evidence

Eriseld Krasniqi et al. J Cell Physiol. 2020 Nov.

Abstract

Body mass index (BMI) is a main indicator of obesity and its association with breast cancer is well established. However, little is known in the metastatic setting, especially in HER2-positive patients. We assessed the influence of BMI on clinical outcomes of patients treated with pertuzumab and/or trastuzumab emtansine (T-DM1) for HER2+ metastatic breast cancer (mBC). BMI was addressed as a categorical variable, being classified on the basis of the following ranges, that is, 18.5-24.9, 25-29.9, and 30.0-34.9, namely, normal weight, overweight, and Class I obesity. The outcomes chosen were progression-free survival to first-line chemotherapy (PFS1) and overall survival (OS). Overall (N = 709), no impact of BMI was observed on PFS1 (p = .15), while BMI ≥ 30 was associated with worse OS (p = .003). In subjects who progressed to first line (N = 575), analyzing data across PFS1 quartiles and strata of disease burden, BMI predicted lower PFS1 in patients within the I PFS1 quartile and with the lowest disease burden (p = .001). Univariate analysis showed a detrimental effect of BMI ≥ 30 on OS for women within the I PFS1 quartile (p = .03). Results were confirmed in multivariate analysis. According to PFS1 quartiles a higher percentage of patients with high BMI and low disease burden progressed within 6 months of therapy. The effect of BMI on prognosis was also confirmed in multivariate analysis of OS for overall population. In our cohort, a BMI ≥ 30 correlated with worse OS in patients with HER2+ mBC who received pertuzumab and/or T-DM1 but had no impact on PFS to first line. BMI predicted worse I PFS1 quartile.

Keywords: HER2-positive metastatic breast cancer; body mass index; pertuzumab; trastuzumab emtansine.

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