Influence of body mass index on outcome in advanced colorectal cancer patients receiving chemotherapy with or without targeted therapy

Simkens, Lieke H.J.; Koopman, Miriam; Mol, Linda; Veldhuis, G.J.; Huinink, Daan ten Bokkel; Müller, E; Derleyn, Veerle A.; Teerenstra, Steven; Punt, Cornelis J.A.

doi:10.1016/j.ejca.2011.06.038

Cited by 83 publications

(74 citation statements)

References 25 publications

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“…However, the lack of effective prognostic prediction markers to stratify the patients remains a major challenge to establish an optimal personalized treatment paradigm of using these antiangiogenic agents to date. In a continuous effort to identify more effective prognostic markers, 'adiposity' has recently attracted research interest as a potential clinical biomarker to evaluate the efficacy of applying VEGF-targeted antiangiogenic therapy to treat a variety of cancers, including colon cancer (7,19), renal cell carcinoma (20,21) and ovarian cancer (9). However, previous studies generated somehow conflicting results (7,19,20,21).…”

Section: Discussionmentioning

confidence: 81%

“…In a continuous effort to identify more effective prognostic markers, 'adiposity' has recently attracted research interest as a potential clinical biomarker to evaluate the efficacy of applying VEGF-targeted antiangiogenic therapy to treat a variety of cancers, including colon cancer (7,19), renal cell carcinoma (20,21) and ovarian cancer (9). However, previous studies generated somehow conflicting results (7,19,20,21). In the present study, a CAD approach was developed for the first time to quantitatively extract adiposity-related image features and to demonstrate the feasibility of applying multivariate data analysis models to stratify EOC patients with and without potential clinical benefit by receiving maintenance bevacizumab-based chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Quantitative measurement of adiposity using CT images to predict the benefit of bevacizumab-based chemotherapy in epithelial ovarian cancer patients

et al. 2016

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Abstract. The present study aims to quantitatively measure adiposity-related image features and to test the feasibility of applying multivariate statistical data analysis-based prediction models to generate a novel clinical marker and predict the benefit of epithelial ovarian cancer (EOC) patients with and without maintenance bevacizumab-based chemotherapy. A dataset involving computed tomography (CT) images acquired from 59 patients diagnosed with advanced EOC was retrospectively collected. Among them, 32 patients received maintenance bevacizumab following primary chemotherapy, while 27 did not. A computer-aided detection scheme was developed to automatically segment visceral and subcutaneous fat areas depicted on CT images of abdominal sections, and 7 adiposity-related image features were computed. Upon combining these features with the measured body mass index, multivariate data analyses were performed using three statistical models (multiple linear, logistic and Cox proportional hazards regressions) to analyze the association between the model-generated prediction results and the treatment outcome, including progression-free survival (PFS) and overall survival (OS) of the patients. The results demonstrated that applying all three prediction models yielded a significant association between the adiposity-related image features and patients' PFS or OS in the group of the patients who received maintenance bevacizumab (P<0.010), while there was no significant difference when these prediction models were applied to predict both PFS and OS in the group of patients that did not receive maintenance bevacizumab. Therefore, the present study demonstrated that the use of a quantitative adiposity-related image feature-based statistical model may generate a novel clinical marker to predict who will benefit among EOC patients receiving maintenance bevacizumab-based chemotherapy.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Quantitative measurement of adiposity using CT images to predict the benefit of bevacizumab-based chemotherapy in epithelial ovarian cancer patients

et al. 2016

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“…This might explain slightly better outcomes in obese patients receiving bevacizumab in our cohort of patients evaluated. However, other studies have shown contradictory results, postulating decreased efficacy of bevacizumab in obese patients [13,20,21]. In fact, response rates, time to progression as well as survival was worse in patients receiving bevacizumab with a higher BMI [21].…”

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confidence: 82%

“…In fact, response rates, time to progression as well as survival was worse in patients receiving bevacizumab with a higher BMI [21]. The authors speculate it might be higher circulating levels of VEGF conferring resistance to bevacizumab alongside higher volume of distribution in obese patients [13]. Furthermore, in another study, obese patients with colon cancer were less likely to have deficient mismatch repair status (10 vs 17%, p-value <0.001), which maybe another factor affecting outcome in these patients [22].…”

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confidence: 99%

“…How this factors in the metastatic setting is less clear. In general, the thought process is that patients who are obese tend to fare poorly due to several factors including: receipt of inadequate anti-cancer therapy; presence of other comorbidities; and higher postoperative adverse events and longer hospital stay after colorectal surgery [13,14]. With respect to diabetes, for example, colon cancer patients were noted have higher rates of recurrence and mortality [15].…”

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confidence: 99%

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Is obesity an advantage in patients with colorectal cancer?

Kasi

Zafar²,

Grothey

2015

Expert Review of Gastroenterology & Hepatology

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Association of BMI with overall survival in patients with mCRC who received chemotherapy versus EGFR and VEGF‐targeted therapies

et al. 2015

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Although a raised body mass index (BMI) is associated with increased risk of colorectal cancer (CRC) and recurrence after adjuvant treatment, data in the metastatic setting is limited. We compared overall survival (OS) across BMI groups for metastatic CRC, and specifically examined the effect of BMI within the group of patients treated with targeted therapies (TT). Retrospective data were obtained from the South Australian Registry for mCRC from February 2006 to October 2012. The BMI at first treatment was grouped as underweight <18.5 kg/m2, Normal = 18.5 to <25 kg/m2, Overweight = 25 to <30 kg/m2, Obese I = 30 to <35 kg/m2, Obese II ≥35 kg/m2. Of 1174 patients, 42 were underweight, 462 overweight, 175 Obese I, and 77 Obese II. The OS was shorter for patients who were underweight and overweight compared to normal (OS 13.7 and 22.3 vs. 24.1 months, respectively, hazard ratio [HR] 2.21 and 1.23). The adjusted median OS was longer for normal versus overweight or obese I patients receiving chemotherapy + targeted therapy (35.7 vs 25.1 or 22.8 months, HR 1.59 and 1.63, respectively) with no difference in OS for chemotherapy alone. On breakdown by type of targeted therapy, overweight and obese I patients had a poorer outcome with Bevacizumab. The BMI is predictive of a poorer outcome for underweight and overweight patients in the whole population. Of those receiving chemotherapy and targeted therapy, BMI is an independent predictor for OS for overweight and obese I patients, specifically for those treated with Bevacizumab. Patients who are overweight or obese (group I) may be a target group for lifestyle and nutrition advice to improve OS with TT.

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Influence of body mass index on outcome in advanced colorectal cancer patients receiving chemotherapy with or without targeted therapy

Cited by 83 publications

References 25 publications

Quantitative measurement of adiposity using CT images to predict the benefit of bevacizumab-based chemotherapy in epithelial ovarian cancer patients

Quantitative measurement of adiposity using CT images to predict the benefit of bevacizumab-based chemotherapy in epithelial ovarian cancer patients

Is obesity an advantage in patients with colorectal cancer?

Association of BMI with overall survival in patients with mCRC who received chemotherapy versus EGFR and VEGF‐targeted therapies

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