Impact of body mass index (BMI) on endocrine therapy in premenopausal breast cancer patients: An analysis of the ABCSG-12 trial
Abstract
512 Background: Aromatase inhibitors (AIs) are effective as adjuvant endocrine treatment in breast cancer (BC) patients. According to the hypothesis that overweight patients have higher levels of aromatase enzyme availability, BMI might have impact on the efficacy of AIs. In this retrospective analysis of ABCSG-12, we investigated the influence of BMI on the effectiveness of adjuvant endocrine therapy (tamoxifen versus anastrozole in combination with goserelin) in premenopausal BC patients. Methods: ABCSG-12 examined the efficacy of ovarian suppression using goserelin (3.6 mg q28d SC) in combination with anastrozole (ANA) or tamoxifen (TAM) ± zoledronic acid (ZOL, (4 mg IV q6mo) in premenopausal women with endocrine-responsive BC. BMI was calculated using the prospectively collected data on patients's height and weight at study entry. BMI definitions of the WHO were used: normal 18.5-24.9 kg/m2; overweight: BMI ≥ 25 kg/m2, underweight BMI ≤ 18.5 kg/m2). Disease-free survival (DFS) and overall survival (OS) were calculated by Kaplan-Meier method, results were compared by using the log-rank test and Cox proportional hazard modelling. Results: 1,111 (64.0%) patients were normal weight and 573 (33.0%) were overweight. Fifty-two (3.0%) underweight patients were excluded from further analyses. At a median follow-up of 5 years, overweight patients treated with ANA showed significantly shorter DFS (HR 1.60, 95%CI 1.064 2.412 p = 0.02) and OS (HR 2.284, 95%CI 1.217 4.289 p = 0.008)…
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