Body mass index as a predictive factor for efficacy of adjuvant taxane-based chemotherapy in early-stage breast cancer patients: A pooled analysis from adjuvant GEICAM Spanish Breast Cancer Group and TRIO Translational Research in Oncology Group studies
Por:
García-Saenz J, Spera G, Pollán M, Bermejo B, Ruiz-Borrego M, Chan A, Martín M, Guerrero-Zotano A, Calvo L, Rodríguez-Lescure A, Marín M, Chap L, Crown J, Pienkowski T, Bee V, Casas M, Polonio O, Bezares S, Slamon D
Publicada:
15 ago 2025
Ahead of Print:
1 abr 2025
Resumen:
Adjuvant anthracyclines and taxanes reduce recurrence and death in early-stage breast cancer (EBC) patients, but toxicity is a concern. Studies show conflicting results on the correlation between body mass index (BMI) and outcomes. Limited data exist on the efficacy of adjuvant taxanes among BMI categories and the impact of different taxane-based chemotherapies (paclitaxel vs. docetaxel) on disease recurrence. Here, we present a pooled analysis of 13,486 EBC patients treated with adjuvant anthracyclines +/- taxanes from seven GEICAM and TRIO trials (1996-2008) conducted. Patients were classified into four BMI categories: normal (<25.0), overweight (25.0-29.9), obese (30.0-34.9), and severely obese (>= 35.0). BMI was evaluated as a predictive factor for the efficacy and toxicity of taxane-based chemotherapy. Our results show the following findings: patients' distribution by BMI was 44% normal, 33% overweight, 16% obese, and 8% severely obese. Seventy-nine percent received taxane-based chemotherapy. Ten-year invasive disease-free survival (iDFS) was 71%, 70%, 68%, and 64% for normal, overweight, obese, and severely obese patients, respectively. Obese and severely obese patients had significantly worse outcomes (HR 1.15 and 1.29, respectively). Invasive disease-free survival with docetaxel vs. non-docetaxel was significant in the normal BMI group, while iDFS with paclitaxel was significant in the obese group. Relevant toxicity was observed in 5%, 5.5%, 5.9%, and 9.3% of normal, overweight, obese, and severely obese patients who received docetaxel. In conclusion, heavier EBC patients had a worse prognosis with adjuvant taxane-based chemotherapy. Normal BMI patients benefited more from docetaxel, while obese patients benefited more from paclitaxel.
Filiaciones:
García-Saenz J:
Hosp Clin San Carlos, Inst Invest Sanitaria San Carlos IdISSC, Madrid, Spain
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Spera G:
Translat Res Oncol, Med Affairs, Montevideo, Uruguay
Pollán M:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Inst Salud Carlos III, Ctr Nacl Epidemiol, Madrid, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBER, Madrid, Spain
Bermejo B:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Hosp Clin Univ Valencia, Univ Med Valencia, INCLIVA Inst Invest Sanitaria, Valencia, Spain
Ruiz-Borrego M:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Hosp Univ Virgen Rocio, Seville, Spain
Chan A:
Curtin Med Sch, Fac Hlth Sci, Perth, Australia
Martín M:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Inst Salud Carlos III, Ctr Nacl Epidemiol, Madrid, Spain
Univ Complutense, Hosp Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IiSGM, Madrid, Spain
Guerrero-Zotano A:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Inst Valenciano Oncol, Valencia, Spain
Calvo L:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Complejo Hosp Univ Coruna, La Coruna, Spain
Rodríguez-Lescure A:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Hosp Gen Univ Elche, Elche, Spain
Marín M:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Consorci Sanitari Terrassa, Terrassa, Spain
Chap L:
Beverly Hills Canc, Beverly Hills, Los Angeles, CA USA
Crown J:
St Vincents Univ Hosp, Dept Med Oncol, Dublin, Ireland
Pienkowski T:
Postgrad Med Educ Ctr, Warsaw, Poland
Bee V:
Translat Res Oncol, Project Management, Paris, France
Casas M:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Polonio O:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Bezares S:
GEICAM, Spanish Breast Canc Grp, Madrid, Spain
Slamon D:
Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Hematol Oncol, Los Angeles, CA USA
Green Submitted, hybrid
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