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Trastuzumab improved long-term outcomes in obese patients with breast cancer
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2011 San Antonio Breast Cancer Symposium
SAN ANTONIO — Overweight and obese patients with HER-2–positive breast cancer appear to have worse outcomes compared with normal-weight patients. New data suggest, however, that adding trastuzumab to chemotherapy may increase DFS among obese patients with the disease.
“While other studies have looked at the effect of body weight on treatment outcome for ER-positive breast cancer, no one has examined this variable in the HER-2–positive subtype, which accounts for about one-third of all breast cancers,” Jennifer Crozier, MD, medical resident at Mayo Clinic, Jacksonville, Fla., said in a press release.
To examine this relationship, Crozier and colleagues examined data on 3,017 patients enrolled in the phase 3 North Central Cancer Treatment Group N9831 clinical trial. In the study, patients with early HER-2–positive breast cancer were randomly assigned to treatment with chemotherapy alone; chemotherapy followed by trastuzumab (Herceptin, Genentech); or chemotherapy with concurrent trastuzumab.
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According to study results, obese patients (BMI >30) had significantly larger tumors (>2 cm) and more positive lymph nodes than nonobese patients (P=.002 and P=.02, respectively). Among patients receiving chemotherapy alone, overweight (BMI between 25 and 29) and obese patients had lower DFS rates vs. normal-weight patients after 7 years (65.9% and 70.6%, respectively vs. 74.7%). However, nonobese patients receiving sequential trastuzumab or concurrent trastuzumab demonstrated improved DFS compared with those receiving chemotherapy alone (P=.001 and P<.0001, respectively). Similar results were seen in obese patients, with DFS improving most in those receiving concurrent trastuzumab vs. chemotherapy alone (P=.008). These data suggest that adding trastuzumab, particularly concurrent with chemotherapy, may potentially equalize DFS rates, leading to 5-year rates of 85% for normal-weight and overweight patients and 82.6% for obese patients, the researchers said.
“Overall, we can see in the trends that weight management is going to be important in treating HER-2–positive breast cancer,” Crozier said. “The next step is to examine how weight management during different stages of treatment affects outcomes.”
For more information:
- Crozier JA. #P2-12-02. Presented at: the 2011 CTRC-AACR San Antonio Breast Cancer Symposium; Dec. 6-10, 2011; San Antonio.
Disclosure: Dr. Crozier reports no relevant financial disclosures.
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