Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy; Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy.
Clin Colorectal Cancer. 2022 Sep;21(3):220-228. doi: 10.1016/j.clcc.2022.02.003. Epub 2022 Feb 19.
Obesity is associated with an increased risk of development and recurrence of colorectal cancer. The role of obesity in metastatic colorectal cancer patients (pts) is still unclear, especially in those treated with triplet plus bevacizumab (bev). The aim of our study was to evaluate the prognostic and predictive role of BMI in metastatic colorectal cancer pts treated with FOLFOXIRI plus bev or FOLFIRI/FOLFOX plus bev in the TRIBE and TRIBE-2 trial.
A total of 1160 pts enrolled in TRIBE and TRIBE-2 trials were included. Baseline height and weight were used to assign pts to one of the following BMI categories: underweight (group A = BMI <18.5 kg/m; 52 pts), normal (group B = BMI 18.5-29.9 kg/m; 952 pts) and obese (group C > 30 kg/m; 156 pts).
In our population, no differences in terms of PFS (P = .43) or OS (P = .99) resulted between 3 groups. No interaction effect between treatment arm and BMI was evident in terms of PFS (Group A HR: 0.65 [95%CI: 0.36-1.16]; Group B HR: 0.77 [95%CI: 0.67-0.88]; Group C HR: 0.67 [95%CI: 0.48-0.93]; P for interaction = .75) or OS (Group A HR: 0.57 [95%CI: 0.29-1.12]; Group B HR: 0.85 [95%CI: 0.73-0.99];Group C HR: 0.69 [95%CI: 0.48-1.01] P for interaction = .36). No statistically significant difference in terms of dose reductions due to toxicities were found according to BMI in the overall population (P = .48) and in pts treated with FOLFOXIRI plus bev (P = .57).
BMI was neither prognostic or predictive for PFS and OS in our population. Our analyses showed that the advantage of FOLFOXIRI plus bev versus FOLFIRI/FOLFOX plus bev was independent from BMI.
肥胖与结直肠癌的发展和复发风险增加有关。肥胖在转移性结直肠癌患者（pts）中的作用尚不清楚，尤其是在接受三联加贝伐珠单抗（bev）治疗的患者中。我们的研究目的是评估在 TRIBE 和 TRIBE-2 试验中，接受 FOLFOXIRI 加 bev 或 FOLFIRI/FOLFOX 加 bev 治疗的转移性结直肠癌 pts 中 BMI 的预后和预测作用。
共纳入 1160 例参加 TRIBE 和 TRIBE-2 试验的 pts。根据基线身高和体重，将 pts 分为以下 BMI 类别之一：体重不足（组 A=BMI<18.5 kg/m；52 例）、正常（组 B=BMI 18.5-29.9 kg/m；952 例）和肥胖（组 C>30 kg/m；156 例）。
在我们的人群中，3 组之间在 PFS（P=0.43）或 OS（P=0.99）方面无差异。在 PFS 方面，治疗臂和 BMI 之间没有明显的交互作用（组 A HR：0.65[95%CI：0.36-1.16]；组 B HR：0.77[95%CI：0.67-0.88]；组 C HR：0.67[95%CI：0.48-0.93]；P 交互作用=0.75）或 OS（组 A HR：0.57[95%CI：0.29-1.12]；组 B HR：0.85[95%CI：0.73-0.99]；组 C HR：0.69[95%CI：0.48-1.01]；P 交互作用=0.36）。根据 BMI，在总体人群（P=0.48）和接受 FOLFOXIRI 加 bev 治疗的 pts（P=0.57）中，因毒性导致的剂量减少没有统计学上的显著差异。
在我们的人群中，BMI 既不是 PFS 和 OS 的预后因素，也不是预测因素。我们的分析表明，FOLFOXIRI 加 bev 与 FOLFIRI/FOLFOX 加 bev 相比的优势独立于 BMI。
