Body Mass Index and Treatment Outcomes in Metastatic Breast Cancer Patients Treated With Eribulin

Abstract

Eribulin has shown survival advantage and manageable toxicity in heavily pre-treated metastatic breast cancer (mBC). We assessed whether body mass index (BMI) impacts treatment outcomes in 101 patients treated with eribulin at six Italian Oncologic Centers. BMI was addressed as a categorical variable (18.5-24.9 vs. at least 25). Clinical benefit rate (CBR) was assessed overall and in subgroups defined by BMI, line of therapy (LOT), and hormone receptor (HR) status. Analysis of CBR by LOT and HR status were further stratified by BMI. Survival curves were compared using the Kaplan-Meier method and log-rank test. Predictors of survival were tested in Cox models. Patients treated with eribulin as third line showed greater CBR when their BMI was in the lowest category (77.8 vs. 58.1%, P = 0.03). Median progression free survival (PFS) and overall survival (OS) in normal and overweight patients were 4 (95% CI, 3-5) versus 3 (2.1-4) months, P = 0.02 and 13 (11-15) versus 12 (6-18) months, P = 0.96, respectively. Median PFS and OS in estrogen receptor (ER) positive and negative tumours were 4 (3-5) versus 3 (2-4) months, P = 0.005 and 14 (10-18) versus 7 (4-10), P = 0.02, respectively. In multivariate analyses, BMI impacted PFS at a nearly significant extent (P = 0.05), while ER expression significantly affected PFS and OS (P = 0.01 and 0.02, respectively). No relevant findings emerged concerning toxicity. We found evidence of greater efficacy of eribulin in leaner mBC patients, particularly if given as third line and in ER positive tumors. Further studies are warranted to confirm our findings.

Real-world data of eribulin in advanced and pretreated HER2-negative breast cancer in a Spanish comprehensive cancer center

“…In some historical series, patients who are overweight and obese have shown worse outcomes compared to the normal weight group [20,23,24]. In an Italian observational multicentric study, there was a significantly better PFS in the lowest category of BMI, but no differences in OS were observed [25]. In our cohort, no differences in OS were found amongst patients with normal weight compared to overweight and obese patients or those with and without comorbidities.…”

Body mass index in HER2-negative metastatic breast cancer treated with first-line paclitaxel and bevacizumab

“…When addressing survival outcomes in the overall patient population, median PFS was 14 months (95% CI, [11][12][13][14][15][16][17], and median OS was 40 months (95% CI, 28-52). Survival outcomes were both affected by the molecular subtype ( Fig.…”

“…7 In light of the evidence emerged from recent literature and within our previously established research pipeline on the role of anthropometric and metabolic determinants of treatment efficacy in breast and ovarian cancer, we have now focused on a more restricted subgroup of patients from the original cohort with available data on body mass index (BMI) values at baseline assessment. [8][9][10][11][12][13][14][15] In this patient subgroup, data on several patient-and disease-related features were also analyzed and reinterpreted in light of the evidence emerging from the BMIrelated analysis. This study was designed and implemented within a real world setting.…”

Prognostic and predictive factors of eribulin efficacy in heavily pretreated patients affected by metastatic breast cancer: correlation with tumor biology and previous therapies

“…The potential impact of obesity in patients under active treatment for breast cancer (neoadjuvant, adjuvant, or metastatic setting) is still a matter of debate. Recently, Barba and colleagues have evaluated the role of obesity as a predictive factor of response to chemotherapy in a retrospective series of 101 patients with MBC treated with eribulin in six different Italian oncologic centers [ 7 ]. Lower BMI, ER-positive status, and third-line treatment resulted associated with a greater clinical benefit from eribulin, even if it was not statistically significant.…”