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. 2022 Oct;195(3):325-331.
doi: 10.1007/s10549-022-06681-6. Epub 2022 Aug 16.

The influence of body mass index on the tolerability and effectiveness of full-weight-based paclitaxel chemotherapy in women with early-stage breast cancer

Lishi Lin  1 , Marcel Soesan  2 , Dorieke E M van Balen  1 , Jos H Beijnen  1   3 , Alwin D R Huitema  4   5   6
Affiliations

The influence of body mass index on the tolerability and effectiveness of full-weight-based paclitaxel chemotherapy in women with early-stage breast cancer

Lishi Lin et al. Breast Cancer Res Treat. 2022 Oct.

Abstract

Purpose: To investigate the influence of body mass index (BMI) on the tolerability and effectiveness of full-weight-based paclitaxel chemotherapy in early breast cancer patients.

Methods: Early-stage breast cancer patients who received (neo)adjuvant weekly paclitaxel 80 mg/m2 chemotherapy were included in this retrospective study. Patients were divided into three groups based on their BMI: lean, overweight, and obese. Logistic regression was used to assess for association between BMI with administered relative dose intensity (RDI) < 85%. The occurrence of treatment modifications and the pathological response on neoadjuvant chemotherapy were compared between BMI categories.

Results: Four hundred (400) patients were included in this study; 200 (50%) lean, 125 (31%) overweight, and 75 (19%) obese patients. The adjusted odds ratio to receive RDI < 85% for BMI was 1.02 (p value, .263). Treatment modifications occurred in 115 (58%), 82 (66%), and 52 (69%) patients in the respective BMI categories (p value = .132). Peripheral neuropathy was observed in 79 (40%), 58 (46%), and 41 (55%) patients in the lean, overweight, and obese group (p value = .069), whereas hematologic toxicity was observed in 31 (16%), 10 (8%), and 4 (5%) patients (p value = .025). Pathological complete response was observed in 22 (17%), 11 (14%), and 6 (13%) patients in the respective BMI categories (p value = .799).

Conclusion: BMI did not significantly influence the tolerability and effectiveness of full-weight-based paclitaxel chemotherapy. Therefore, the results of this study align with current guideline recommendations of using full-weight-based paclitaxel chemotherapy in obese patients.

Keywords: Body mass index; Breast cancer; Chemotherapy; Obesity; Paclitaxel; Relative dose intensity.

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Conflict of interest statement

The authors L. Lin, M. Soesan, D.E.M. van Balen, and A.D.R. Huitema declare that they have no relevant financial or non-financial interests to disclose. J.H. Beijnen is a part-time employee and (indirect) shareholder of Modra Pharmaceuticals BV. He is (partly) patent holder of oral taxane formulations which are clinically developed by Modra Pharmaceuticals BV (a spin-off company of The Netherlands Cancer Institute, not related to this manuscript).

Figures

Fig. 1
Fig. 1
Administered relative dose intensity (RDI) for each body mass index (BMI) category visualized using a boxplot and a violin plot showing the distribution of RDI within each BMI category. The horizontal line shows a RDI of 85%
See this image and copyright information in PMC

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