Diabetes may worsen longer-term survival for adults with breast cancer
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ATLANTA — Presence of diabetes and worse glycemic control were not associated with breast cancer outcomes until 8 years of follow-up, when survival rates worsened for patients with diabetes, according to study data.
“In the first 5 years, glycemic control may not be a major contributor to mortality or cancer progression in most individuals with metastatic breast cancer,” Y.M. Melody Cheung, MD, an endocrinology fellow at Brigham and Women’s Hospital, Harvard Medical School, said during a press briefing. “However, specifically in long-term survivors, diabetes and poor glycemic control were indeed associated with worse survival.”
Cheung and colleagues at the Dana-Farber Cancer Institute identified patients with metastatic breast cancer between 2010 and 2021 at a single center and determined their diabetes status using the Research Patient Data Registry. The study included data from 244 patients with breast cancer and diabetes (median age, 57.6 years; 99.6% women; 84.4% white) matched 1:1 for age, sex, ethnicity and hormone-receptor status with patients with breast cancer and no diabetes.
Among those with diabetes, 1.2% had type 1 diabetes, 49.2% had type 2 diabetes and 15.2% had diabetes associated with cancer therapies; diabetes type was unknown for the remainder of the cohort.
At 2 years, the proportion of patients who initiated a second-line cancer regimen did not differ between those with and without diabetes. Similarly, overall survival at 5 years did not differ between the groups (54% with diabetes and 56% without).
A subgroup analysis revealed that beginning at 8 years of follow-up, overall survival was lower for those with diabetes (67%) than those without diabetes (87%; P = .047 at 10 years). Furthermore, poor glycemic control (glucose level > 180 mg/dL at least twice in a month), compared with good control, was associated with a trend toward lower likelihood of freedom from second-line cancer therapies at 2 years, but no difference in overall survival at 5 years.
“As the clinical impact of diabetes might only be felt over this longer period of time, active management of glycemic control may be most relevant for patients who have better prognoses,” Cheung said. “Individualized diabetes goals and strategies taking into account patient prognosis should therefore be considered in patients with metastatic breast cancer.”
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Cheung YMM, et al. RF28 | PSUN185. Presented at: ENDO Annual Meeting; June 11-14, 2022; Atlanta (hybrid meeting).
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