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  • br Authors br Luca Cantini Mirco Pistelli Filippo

    2020-08-18


    Authors
    Luca Cantini1, Mirco Pistelli1, Filippo Merloni1, Andrea Fontana2, Ilaria Bertolini2, Claudia De Angelis2, Lucia Bastianelli1, Arianna Della Mora1, Alfredo Santinelli3, Agnese Savini1, Elena Maccaroni1, Lucrezia Diodati2, Alfredo Falcone2, Rossana Berardi1
    1Clinica Oncologica, Università Politecnica delle Ma rche, AOU Ospedali Riuniti, Via Conca 71, 60126, Ancona, Italy
    2Oncology Unit II, Azienda Ospedaliera Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy
    3Anatomia Patologica e Citologia, AO Ospedali Riuniti Marche Nord, Piazzale Cinelli 1, 61121, Pesaro, Italy
    Corresponding author
    Rossana Berardi, MD, Prof
    Clinica Oncologica, Università Politecnica delle Ma rche, AOU Ospedali Riuniti, Via Conca 71,60126 Ancona, Italy
    E-mail: [email protected], [email protected]
    ACCEPTED MANUSCRIPT
    Title page
    Title
    Body mass index and hormone BYL-719 status influence recurrence risk in HER-2 positive early breast cancer patients
    Authors
    Luca Cantini1, Mirco Pistelli1, Filippo Merloni1, Andrea Fontana2, Ilaria Bertolini2, Claudia De Angelis2, Lucia Bastianelli1, Arianna Della Mora1, Alfredo Santinelli3, Agnese Savini1, Elena Maccaroni1, Lucrezia Diodati2, Alfredo Falcone2, Rossana Berardi1
    1Clinica Oncologica, Università Politecnica delle Ma rche, AOU Ospedali Riuniti, Via Conca 71, 60126, Ancona, Italy
    2Oncology Unit II, Azienda Ospedaliera Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy
    3Anatomia Patologica e Citologia, AO Ospedali Riuniti Marche Nord, Piazzale Cinelli 1, 61121, Pesaro, Italy
    Corresponding author
    Rossana Berardi, MD, Prof
    Clinica Oncologica, Università Politecnica delle Ma rche, AOU Ospedali Riuniti, Via Conca 71,60126 Ancona, Italy
    E-mail: [email protected], [email protected]
    ACCEPTED MANUSCRIPT
    Conflict of interest Page
    The authors declare that they have no conflict of interest.
    ACCEPTED MANUSCRIPT
    MicroAbstract
    HER2+ early breast cancer is a heterogenous disease. We assessed the role of body mass index (BMI) and hormone receptors (HR) in 238 women who completed adjuvant chemotherapy (CHT) and 1 year of Trastuzumab. Three-years recurrence risk resulted higher for HR-/BMI≥25 patients compared to HR+/BMI<25, suggesting that this particular sub-population of patients might benefit from escalation approaches in adjuvant treatment.
    Abstract
    Introduction
    A reliable risk stratification based on tumor biology and host factors of HER-2 positive early breast cancer (eBC) patients (pts) is needed. Aim of our study was to assess the prognostic role of body mass index (BMI) and hormone receptor (HR) expression in this setting.
    Methods
    We retrospectively evaluated 238 women with stage I to III HER-2 positive BC who completed adjuvant chemotherapy (CHT) and 1 year of Trastuzumab. The endpoint was 3 years distant disease-free survival (3yDDFS). Survival analysis was evaluated by Kaplan-Meier method. Multivariate analysis was performed by Cox-Model adjusting for HR status, BMI, tumor staging, size, nodal status and type of adjuvant CHT. Association among categorical variables was assessed by Chi-square test.
    Results
    Conclusions
    Our real-life data highlight a different risk of eBC recurrence after grouping patients by HR status and BMI. These results might help clinicians to identify correct treatment strategies. HR-/BMI³25 patients might benefit from escalation approaches, while HR+/BMI<25 ones might be eligible for a shorter duration of adjuvant treatment with anti HER-2 agents.
    Keywords
    Body mass index; Hormone receptors; Early breast cancer; HER-2; Trastuzumab
    ACCEPTED MANUSCRIPT
    Introduction
    Human epidermal growth factor-2 (HER2) is overexpressed or amplified in 20% of early breast cancers (eBC) and is associated with a worse prognosis.1 Prior to the introduction of modern adjuvant systemic therapies, even node-negative HER2-positive (HER2+) cancers smaller than 2 cm in diameter showed a 20-30% risk for distance relapse.2 As compared to luminal subtypes, HER2+ BC typically recurs at visceral sites.3
    Trastuzumab is an anti–HER2 monoclonal antibody whi ch binds to the transmembrane domain, inhibiting HER2 dimerization. Added to adjuvant chemotherapy, it significantly improved outcomes among patients with HER2+ eBC4 and today, it represents the standard in this setting. About one half of HER2+ tumors also express hormone receptors (HR)5 and patients with HR–positive disease (HR+/HER2+) usually receive standard endocrine therapy starting at the end of chemotherapy for at least 5 years.