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. 2024 Jan;203(2):339-349.
doi: 10.1007/s10549-023-07108-6. Epub 2023 Oct 25.

The prognostic impact of BMI in patients with HR+/HER2- advanced breast cancer: a study of the SONABRE registry

Senna W M Lammers  1 , Hannah Thurisch  1 , Ingeborg J H Vriens  1 , Marissa Meegdes  1 , Sanne M E Engelen  2 , Frans L G Erdkamp  3 , M Wouter Dercksen  4 , Birgit E P J Vriens  5 , Kirsten N A Aaldering  6 , Manon J A E Pepels  7 , Linda M H van de Winkel  8 , Natascha A J B Peters  9 , Jolien Tol  10 , Joan B Heijns  11 , Agnes J van de Wouw  12 , Nathalie J A Teeuwen  1 , Sandra M E Geurts  1 , Vivianne C G Tjan-Heijnen  13
Affiliations

The prognostic impact of BMI in patients with HR+/HER2- advanced breast cancer: a study of the SONABRE registry

Senna W M Lammers et al. Breast Cancer Res Treat. 2024 Jan.

Abstract

Purpose: This study determines the prognostic impact of body mass index (BMI) in patients with hormone receptor-positive/human epidermal growth factor receptor-2-negative (HR+/HER2-) advanced (i.e., metastatic) breast cancer (ABC).

Methods: All patients with HR+/HER2- ABC who received endocrine therapy +-a cyclin-dependent kinase 4/6 inhibitor as first-given systemic therapy in 2007-2020 in the Netherlands were identified from the Southeast Netherlands Advanced Breast Cancer (SONABRE) registry (NCT03577197). Patients were categorised as underweight (BMI: < 18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), or obese (≥ 30.0 kg/m2). Overall survival (OS) and progression-free survival (PFS) were compared between BMI classes using multivariable Cox regression analyses.

Results: This study included 1456 patients, of whom 35 (2%) were underweight, 580 (40%) normal weight, 479 (33%) overweight, and 362 (25%) obese. No differences in OS were observed between normal weight patients and respectively overweight (HR 0.99; 95% CI 0.85-1.16; p = 0.93) and obese patients (HR 1.04; 95% CI 0.88-1.24; p = 0.62). However, the OS of underweight patients (HR 1.45; 95% CI 0.97-2.15; p = 0.07) tended to be worse than the OS of normal weight patients. When compared with normal weight patients, the PFS was similar in underweight (HR 1.05; 95% CI 0.73-1.51; p = 0.81), overweight (HR 0.90; 95% CI 0.79-1.03; p = 0.14), and obese patients (HR 0.88; 95% CI 0.76-1.02; p = 0.10).

Conclusion: In this study among 1456 patients with HR+/HER2- ABC, overweight and obesity were prevalent, whereas underweight was uncommon. When compared with normal weight, overweight and obesity were not associated with either OS or PFS. However, underweight seemed to be an adverse prognostic factor for OS.

Keywords: Body mass index; Endocrine therapy; Hormone receptor-positive; Metastatic breast cancer; Overall survival; Progression-free survival.

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Conflict of interest statement

SWML reports grants from AstraZeneca and Eli Lilly outside the submitted work. IJHV reports grants from AstraZeneca, Pfizer, and Eli Lilly outside the submitted work. MM reports institutional grants from Roche, Pfizer, Novartis, Eli Lilly, and Gilead during the conduct of the study. MWD had a consulting role for Novartis. JT had a consulting role for Amgen. NJAT reports institutional grants from Roche, Pfizer, Novartis, Eli Lilly, Daiichi Sankyo, AstraZeneca, and Gilead during the conduct of the study. SMEG reports institutional grants from Roche, Pfizer, Novartis, Eli Lilly, Daiichi Sankyo, AstraZeneca, and Gilead during the conduct of the study; personal fees from AstraZeneca outside the submitted work. VCGT-H reports grants and personal fees from AstraZeneca, Novartis, and Eli Lilly during the conduct of the study; grants from Roche, Pfizer, Daiichi Sankyo, and Gilead during the conduct of the study. VCGT-H has a consulting role for AstraZeneca, Eli Lilly, and Novartis. The other authors have declared no conflicts of interests.

Figures

Fig. 1
Fig. 1
Flowchart of included patients
Fig. 2
Fig. 2
Overall survival (a) and first-line progression-free survival (b) according to BMI class at diagnosis of HR+/HER2− ABC
See this image and copyright information in PMC

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