Impact of body mass index on pathological complete response following neoadjuvant chemotherapy in operable breast cancer: a meta-analysis

Wang, Haiyun; Zhang, Shijia; Yee, Douglas; Basu, Saonli; Beckwith, Heather; Potter, David A.; Blaes, Anne

doi:10.1007/s12282-020-01194-w

Cited by 25 publications

(22 citation statements)

References 52 publications

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“…breast cancer patients were less likely to achieve a pCR to NACT which was consistent with a meta-analysis carried out by Wang et al(16) in 2021.…”

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confidence: 90%

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An Overview of the Impact of Body Mass Index on Pathological Complete Response Following Neoadjuvant Chemotherapy in Operable Breast Cancer in a Tertiary Care Centre in South India

Sp¹,

Jaiswal²,

Kumar³

et al. 2022

EJBH

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Objective: The incidence of female breast cancer in the world is 11.7% with a mortality rate of 6.9%. According to Globocon 2020, breast cancer is the most commonly diagnosed cancer (24.5%) and the leading cause of cancer-related death amongst women worldwide. The purpose of this study was to analyze the impact of Body Mass Index (BMI) on pathological complete response (pCR) rates for operable breast cancer after neoadjuvant chemotherapy (NACT). The primary endpoint was to assess histopathological features of the surgical specimen in response to NACT and to investigate the relationship with pre-chemotherapy BMI taking into account the various molecular subtypes of breast cancer. Materials and Methods:Patients with biopsy-proven breast carcinoma who underwent surgery after NACT between January 2017 and May 2021 were included. All patients were initially divided into three groups depending on their pre-chemotherapy BMI. With BMI <22.9 as normal or underweight category, BMI of 23-27.4, was taken as overweight category and BMI ≥27.5 as obese category. Results:The study included 184 patients. Normal weight patients had the highest rate of pCR (75%) and the lowest was seen in the obese category (33.75%). Furthermore, the subtype most likely to achieve pCR was HER2+/ER negative followed by triple negative BC with odds ratios of 3.46 and 2.21, respectively. Conclusion:This retrospective study established that overweight and obese patients suffering from breast carcinoma had a lessened pCR rate following NACT in comparison with those who were under-/normal weight.

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“…breast cancer patients were less likely to achieve a pCR to NACT which was consistent with a meta-analysis carried out by Wang et al(16) in 2021.…”

supporting

confidence: 90%

“…It has been reported that the overall pCR rate varied widely between 9.6% and 40.3% in numerous studies in a meta-analysis of 18,702 women with biopsy-proven breast cancer who had received NACT (16).…”

Section: Discussionmentioning

confidence: 99%

An Overview of the Impact of Body Mass Index on Pathological Complete Response Following Neoadjuvant Chemotherapy in Operable Breast Cancer in a Tertiary Care Centre in South India

Sp¹,

Jaiswal²,

Kumar³

et al. 2022

EJBH

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“…Previous published studies including meta-analysis revealed that patients with lower BMI were associated with higher pCR rates in breast cancer receiving neoadjuvant chemotherapy (nCT). 33 , 34 Studies also reported that increased pCR rate was correlate to high levels of stromal tumor-infiltrating lymphocytes (sTIL). Therefore, BMI affected pCR by modifying sTIL in breast cancer patients who were treated with nCT.…”

Section: Discussionmentioning

confidence: 99%

Pathologic Complete Response Prediction to Neoadjuvant Immunotherapy Combined with Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma: Real-World Evidence from Integrative Inflammatory and Nutritional Scores

Feng¹,

Wang²,

Yang³

et al. 2022

JIR

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Purpose Neoadjuvant immunotherapy and chemotherapy (nICT) is an emerging hotspot that has been shown to be safe and feasible for locally advanced esophageal squamous cell carcinoma (LA-ESCC). This real-world study aimed to develop and validate a novel predictive model [integrative inflammatory and nutritional score (IINS)] in LA-ESCC patients receiving nICT to predict the pathologic complete response (pCR). Patients and Methods Patients with LA-ESCC who received nICT followed by surgery from Jun 2019 to Dec 2021 were enrolled and randomly divided into two sets (7:3). Using least absolute shrinkage and selection operator (LASSO) logistic regression analysis, the IINS was constructed in LA-ESCC patients received nICT to predict pCR. A nomogram based on IINS for pCR prediction was generated in the training cohort and verified in the validation cohort. Results Of the 285 enrolled LA-ESCC patients received nICT followed by radical resection, 84 (29.5%) patients achieved pCR. A predictive index of IINS based on 8 inflammatory and nutritional indicators was constructed using the LASSO model. According to the cutoff finder, patients were then stratified into two groups (high and low). The pCR rates were significantly higher in high-IINS group than in low-IINS group in both the training cohort (44.7% vs 17.4%, P < 0.001) and validation cohort (50.0% vs 13.3%, P < 0.001). The IINS [odds ratio (OR) = 0.237, 95% confidence interval (CI) = 0.117–0.480, P < 0.001] was an independent significant predictor for pCR in multivariate logistic analyses. The IINS-based nomogram showed an excellent discrimination for pCR prediction (C-indexes = 0.759 and 0.812 for training and validation cohorts, respectively). Conclusion Pretreatment IINS is an independent predictor for pCR in LA-ESCC patients who are treated with nICT. To our knowledge, the IINS-based nomogram is the first model for pCR prediction and may serve as a simple and potential risk stratification model in LA-ESCC who are treated with nICT.

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“…Moreover, obesity may adversely impact outcomes due to chemotherapy dose capping for obese patients to limit toxicity, resulting in lower dose intensity. A recent metaanalysis showed that among breast cancer patients who received neoadjuvant chemotherapy, overweight and obese patients had a lower pathological complete response (pCR) rate compared to those with under-or normal weight [14]. Biological effects are plausible as an association of higher levels of adiposity with risk of developing breast cancer in the first place among post-menopausal women is well established [15].…”

Section: Introductionmentioning

confidence: 99%

Associations of adiposity and weight change with recurrence and survival in breast cancer patients: a systematic review and meta-analysis

2022

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Background Adiposity and weight change among patients with breast cancer are associated with mortality, but there is limited evidence on the associations with distant recurrence or other causes of death or on central adiposity. Moreover, the relationship with breast cancer subtypes and by menopause status is unclear. Methods We conducted a systematic review and meta-analysis of prospective studies of breast cancer patients investigating the associations of general and central adiposity (body mass index [BMI] and waist circumference [WC], respectively), before and after diagnosis, and weight change, with all-cause mortality, breast cancer-specific mortality (BCSM), and recurrence. Results 173 studies (519,544 patients, 60,249 deaths overall, and 25,751 breast cancer deaths) were included. For BMI < 1 year post diagnosis, compared with normal weight women, the summary relative risk (RR) for obese women was 1.21 (1.15–1.27) for all-cause mortality, 1.22 (1.13–1.32) for BCSM, 1.12 (1.06–1.18) for recurrence, and 1.19 (1.11–1.28) for distant recurrence. Obesity was associated with all-cause mortality and BCSM in patients with ER+ or HER2+ tumors, whereas no clear association was observed in patients with triple-negative tumors. Similar associations were observed by menopausal status. Stronger associations were observed in East Asians than Europeans. Central adiposity was associated with all-cause mortality, while large weight gain was associated with all-cause mortality, BCSM, and recurrence. Conclusion Higher adiposity is associated with all-cause mortality, BCSM, recurrence, and distant recurrence in breast cancer patients, with similar associations by menopausal status and some evidence of heterogeneity by subtypes. Weight gain is also associated with recurrence and survival among breast cancer patients.

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Impact of body mass index on pathological complete response following neoadjuvant chemotherapy in operable breast cancer: a meta-analysis

Cited by 25 publications

References 52 publications

An Overview of the Impact of Body Mass Index on Pathological Complete Response Following Neoadjuvant Chemotherapy in Operable Breast Cancer in a Tertiary Care Centre in South India

An Overview of the Impact of Body Mass Index on Pathological Complete Response Following Neoadjuvant Chemotherapy in Operable Breast Cancer in a Tertiary Care Centre in South India

Pathologic Complete Response Prediction to Neoadjuvant Immunotherapy Combined with Chemotherapy in Resectable Locally Advanced Esophageal Squamous Cell Carcinoma: Real-World Evidence from Integrative Inflammatory and Nutritional Scores

Associations of adiposity and weight change with recurrence and survival in breast cancer patients: a systematic review and meta-analysis

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