title: 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.
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.|Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Barba
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pizzuti
authors.affiliation: Biostatistics Unit, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.affiliation: Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Natoli
authors.affiliation: Medical Oncology Unit-ASL Frosinone, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Gamucci
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Sergi
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Lauro
authors.affiliation: Medical Oncology Unit, Belcolle Hospital, Viterbo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Moscetti
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Fiorentino
authors.initials: F
authors.lastname: Izzo
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rinaldi
authors.affiliation: Medical Oncology Unit-ASL Frosinone, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mentuccia
authors.affiliation: Medical Oncology Unit-ASL Frosinone, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Vaccaro
authors.affiliation: Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Iezzi
authors.affiliation: Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio", Chieti, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Grassadonia
authors.affiliation: Oncology Unit I, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Michelotti
authors.affiliation: Oncology Unit I, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Landucci
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Perracchio
authors.affiliation: Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Pescarmona
authors.affiliation: Surgery Division A, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Di Filippo
authors.affiliation: Sbarro Institute for Cancer Research and Molecular Medicine e del Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, Pennsylvania.|Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Giordano
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.|Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maugeri-Saccà
authors.affiliation: Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Vici
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005663:Furans / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007659:Ketones / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011960:Receptors, Estrogen / Q000378:metabolism; D016896:Treatment Outcome; D000095662:Polyether Polyketides
chemical_list: D005663:Furans; D007659:Ketones; D011960:Receptors, Estrogen; C490954:eribulin; D000095662:Polyether Polyketides