- Title
- Differential benefit of adjuvant docetaxel-based chemotherapy in patients with early breast cancer according to baseline body mass index
- Creator
- Desmedt, Christine; Fornili, Marco; Sotiriou, Christos; Piccart, Martine; Biganzoli, Elia; Clatot, Florian; Demicheli, Romano; De Bortoli, Davido; Di Leo, Angelo; Viale, Giuseppe; de Azambuja, Evandro; Crown, John; Francis, Prudence A.
- Relation
- Journal of Clinical Oncology Vol. 38, Issue 25, p. 2883-2891
- Publisher Link
- http://dx.doi.org/10.1200/JCO.19.01771
- Publisher
- American Society of Clinical Oncology (ASCO)
- Resource Type
- journal article
- Date
- 2020
- Description
- Purpose: Lipophilic drugs, such as taxanes, have a high affinity for adipose tissue and a resulting higher volume of distribution. Here, we reanalyzed clinical trial data to investigate whether the efficacy of docetaxel-based chemotherapy differs from non-docetaxel–based chemotherapy in patients with breast cancer according to their baseline body mass index (BMI). Patients and Methods: We retrospectively analyzed data from all of the patients in the adjuvant BIG 2-98 trial (ClinicalTrials.gov identifier: NCT00174655; N = 2,887) comparing non-docetaxel– to docetaxel-containing chemotherapy. BMI (kg/m2) was categorized as follows: 18.5 to < 25, lean; 25 to < 30, overweight; and ≥ 30, obese. Disease-free survival (DFS) was the primary endpoint, and overall survival (OS) was the secondary endpoint. A second-order interaction was assessed among treatment, BMI, and estrogen receptor (ER) status. Results: There was no difference in DFS or OS according to BMI in the non-docetaxel group, while reduced DFS and OS were observed with increasing BMI category in the docetaxel group. Adjusted hazard ratios for DFS and OS were, respectively, 1.12 (95% CI, 0.98 to 1.50; P = .21) and 1.27 (95% CI, 1.01 to 1.60; P = .04) for overweight versus lean groups and were 1.32 (95% CI, 1.08 to 1.62; P = .007) and 1.63 (95% CI, 1.27 to 2.09; P < .001), respectively, for obese versus lean groups. Similar results were obtained when considering ER-negative and ER-positive tumors separately and when considering only patients who received a relative dose intensity ≥ 85% for docetaxel. A joint modifying role of BMI and ER status on treatment effect was evident for DFS (adjusted P = .06) and OS (adjusted P = .04). Conclusion: This retrospective analysis of a large adjuvant trial highlights a differential response to docetaxel according to BMI, which calls for a body composition–based re-evaluation of the risk-benefit ratio of the use of taxanes in breast cancer. These results now must be confirmed in additional series.
- Subject
- non-docetaxel–based chemotherapy; docetaxel-based chemotherapy; breast cancer; body mass index; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1464984
- Identifier
- uon:47165
- Identifier
- ISSN:0732-183X
- Language
- eng
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