Research Papers:
Impact of BMI on the outcome of metastatic breast cancer patients treated with everolimus: a retrospective exploratory analysis of the BALLET study
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Abstract
Silvia P. Corona1, Fabiola Giudici1,2, Guy Jerusalem3, Eva Ciruelos4, Carla Strina5, Marianna Sirico6, Ottavia Bernocchi1, Manuela Milani5, Martina Dester5, Nicoletta Ziglioli5, Giuseppina Barbieri5, Valeria Cervoni5, Filippo Montemurro7 and Daniele Generali1,5
1 Department of Medicine, Surgery and Health Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy
2 Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
3 CHU Sart Tilman Liège and Liège University, Liège, Belgium
4 Hospital Universitario 12 de Octubre, Madrid, Spain
5 Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, Cremona, Italy
6 Università Cattolica del Sacro Cuore, Roma, Italy
7 Multidisciplinary Outpatient Oncology Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
Correspondence to:
Silvia P. Corona, | email: |
[email protected], [email protected] |
Keywords: BMI; weight; everolimus; metastatic breast cancer; outcomes
Received: January 08, 2020 Accepted: May 01, 2020 Published: June 09, 2020
ABSTRACT
Introduction: Reliable biomarkers of response to mTOR inhibition are yet to be identified. As mTOR is heavily implicated in cell-metabolism, we investigated the relation between BMI variation and outcomes in metastatic breast cancer (mBC) patients treated with everolimus.
Results: we found a linear correlation between everolimus exposure duration and BMI/weight decrease. Patients exhibiting >2 kg weight loss or >3% BMI decrease from baseline at the end of treatment (EOT) had a statistically significant improvement in PFS. Interestingly, a similar BMI/weight decrease within the first 8 weeks of therapy identified patients at higher risk of progression.
Patients and methods: we performed a retrospective analysis of patients enrolled in the BALLET trial who progressed during the study. Primary end-point was progression-free survival (PFS). Secondary end-point was the identification of other predictors of response.
Conclusion: A >3% weight loss at EOT is associated with better outcome in mBC patients treated with everolimus. On the contrary, a significant early weight loss represents a predictor of poor survival and could therefore be used as an early negative prognostic marker. As PI3K-inhibition also converges onto mTOR, these findings might extend to patients treated with selective PI3K inhibitors and warrant further investigation
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