Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Department of Internal Medicine, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Breast Cancer Res Treat. 2022 Oct;195(3):325-331. doi: 10.1007/s10549-022-06681-6. Epub 2022 Aug 16.
To investigate the influence of body mass index (BMI) on the tolerability and effectiveness of full-weight-based paclitaxel chemotherapy in early breast cancer patients.
Early-stage breast cancer patients who received (neo)adjuvant weekly paclitaxel 80 mg/m chemotherapy were included in this retrospective study. Patients were divided into three groups based on their BMI: lean, overweight, and obese. Logistic regression was used to assess for association between BMI with administered relative dose intensity (RDI) < 85%. The occurrence of treatment modifications and the pathological response on neoadjuvant chemotherapy were compared between BMI categories.
Four hundred (400) patients were included in this study; 200 (50%) lean, 125 (31%) overweight, and 75 (19%) obese patients. The adjusted odds ratio to receive RDI < 85% for BMI was 1.02 (p value, .263). Treatment modifications occurred in 115 (58%), 82 (66%), and 52 (69%) patients in the respective BMI categories (p value = .132). Peripheral neuropathy was observed in 79 (40%), 58 (46%), and 41 (55%) patients in the lean, overweight, and obese group (p value = .069), whereas hematologic toxicity was observed in 31 (16%), 10 (8%), and 4 (5%) patients (p value = .025). Pathological complete response was observed in 22 (17%), 11 (14%), and 6 (13%) patients in the respective BMI categories (p value = .799).
BMI did not significantly influence the tolerability and effectiveness of full-weight-based paclitaxel chemotherapy. Therefore, the results of this study align with current guideline recommendations of using full-weight-based paclitaxel chemotherapy in obese patients.
研究体质量指数(BMI)对早期乳腺癌患者全剂量紫杉醇化疗的耐受性和有效性的影响。
本回顾性研究纳入接受(新)辅助每周紫杉醇 80mg/m2 化疗的早期乳腺癌患者。根据 BMI 将患者分为三组:瘦、超重和肥胖。采用 logistic 回归评估 BMI 与接受相对剂量强度(RDI)<85%之间的关联。比较 BMI 类别之间治疗方案调整和新辅助化疗的病理反应。
本研究纳入 400 例患者;200 例(50%)瘦,125 例(31%)超重,75 例(19%)肥胖患者。BMI 的调整后比值比(OR)为 1.02(p 值,.263),提示接受 RDI<85%的几率。在各自的 BMI 类别中,有 115 例(58%)、82 例(66%)和 52 例(69%)患者需要进行治疗方案调整(p 值=.132)。在瘦、超重和肥胖组中,外周神经病变分别为 79 例(40%)、58 例(46%)和 41 例(55%)(p 值=.069),而贫血毒性分别为 31 例(16%)、10 例(8%)和 4 例(5%)(p 值=.025)。在各自的 BMI 类别中,病理完全缓解率分别为 22 例(17%)、11 例(14%)和 6 例(13%)(p 值=.799)。
BMI 对全剂量紫杉醇化疗的耐受性和有效性没有显著影响。因此,本研究结果与当前使用全剂量紫杉醇治疗肥胖患者的指南建议一致。