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Obese women with ER-positive/HER2-negative breast cancer had poorer survival

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33rd Annual San Antonio Breast Cancer Symposium

SAN ANTONIO — Researchers have concluded that obese women with ER-positive, HER2-negative breast cancer had worse OS and disease-free survival compared with fitter patients.

Obesity has been associated with worse OS and disease-free survival in women with operable breast cancer treated with adjuvant chemotherapy, but this is the first time researchers have seen this result specifically in this subset of patients, said Joseph A. Sparano, MD, professor of medicine and women’s health at Albert Einstein Medical College of Medicine and associate chairman of the department of oncology at Montefiore Medical Center in Bronx, N.Y.

“We were surprised to find that there was no evidence that this finding played out in the other breast cancer subtypes — it’s mainly a phenomenon that we seem to be seeing in those with ER-positive/HER2-negative disease,” Sparano said in a press release. “Our results may be explained by the fact that obesity is associated with hyperinsulinemia, which may drive the growth of estrogen-dependent tumors.”

Sparano presented the results Thursday at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium.

Sparano and colleagues retrospectively reviewed ECOG trials E1199, E5188 and E3189 to evaluate the effect of obesity on survival.

Researchers found a non-significant trend toward inferior disease-free survival (HR=1.10; 95% CI, 0.96-1.26) and OS (HR=1.13; 95% CI, 0.96-1.33) for obese patients in E1199. However, further evaluation by breast cancer subtype showed that obese patients with ER-positive/HER2-negative and/or PR-positive/HER2-negative disease had both poorer OS (HR=1.42) and disease-free survival compared with normal-weight patients.

Researchers did not see the same effect in HER2-positive or triple negative disease

The findings from E5188 and E31899 upheld the results from E1199.

“If validated in other studies, this finding provides strong rationale for trying to identify potential causes, and prospectively evaluate intervention strategies designed to reduce their risk of recurrence,” Sparano said.

For more information:

• Sparano JA. #SA-1. Presented at: The 33rd Annual San Antonio Breast Cancer Symposium; Dec. 8-12, 2010; San Antonio.

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