title: Relationship between body mass index and preoperative treatment response to aromatase inhibitor exemestane in postmenopausal patients with primary breast cancer.
abstract: BACKGROUND
  Some studies have shown that high body mass index (BMI) is associated with inferior outcome after adjuvant therapy with anastrozole in breast cancer patients. We aimed to investigate predictive effect of BMI on clinical response to neoadjuvant therapy with exemestane in postmenopausal patients with primary breast cancer.
  
  
  METHODS
  The study group consisted of 109 patients from the JFMC 34-0601 neoadjuvant endocrine therapy trial. Patients were categorized into three groups according to BMI: low (BMI < 22 kg/m(2)), intermediate (22 ≤ BMI < 25 kg/m(2)) and high (BMI ≥ 25 kg/m(2)). Statistical analyses were performed to explore the predictive effect of BMI on clinical response.
  
  
  RESULTS
  Higher BMI correlated with positive progesterone receptor status (p < 0.01) and low Ki-67 index (p = 0.03). Objective response rates (ORR) were 21.7% in low BMI, 56.0% in intermediate BMI and 60.6% in high BMI, respectively (p = 0.01). In a multivariate analysis, low BMI was an independent negative predictor of clinical response.
  
  
  CONCLUSIONS
  Low BMI was associated with a decreased ORR to neoadjuvant endocrine therapy with exemestane. Our results may suggest that the predictive effect of BMI varies according to the type of aromatase inhibitor and objective outcome.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takada
authors.forename: Shigehira
authors.initials: S
authors.lastname: Saji
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Kuroi
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takei
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Ohno
authors.forename: Hiroko
authors.initials: H
authors.lastname: Yamashita
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Hisamatsu
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Aogi
authors.forename: Hiroji
authors.initials: H
authors.lastname: Iwata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ueno
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Masakazu
authors.initials: M
authors.lastname: Toi
mesh_terms: D000368:Aged; D000730:Androstadienes / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017698:Postmenopause; D011300:Preoperative Care; D016896:Treatment Outcome
chemical_list: D000730:Androstadienes; D047072:Aromatase Inhibitors; C056516:exemestane