Lower Survival in Patients with High BMI and HER2+ Metastatic Breast Cancer Treated with Pertuzumab and Trastuzumab

An international team of researchers found that high BMI correlates to lower survival in patients with HER2+ metastatic breast cancer, even among patients showing initial positive response to new anti-HER2 agents pertuzumab and trastuzumab. 

The study, “Impact of BMI on HER2+ metastatic breast cancer patients treated with Pertuzumab and/or Trastuzumab-emtansine. Real-world evidence,” was recently published in the international peer-reviewed scientific journal Journal of Cellular Physiology. The authors belong to a multidisciplinary Italian-American team, lead by Prof. Antonio Giordano, M.D., Ph.D., founder and Director of the Sbarro Institute for Cancer Research and the Sbarro Health Research Organization (SHRO) in Philadelphia.

“Breast cancer is a heterogeneous disease. The overexpression of the human epidermal growth factor receptor 2 (HER2) or the amplification of the inherent gene is associated with a particularly aggressive behavior, which reaches its acme in the metastatic setting. In this particularly challenging battlefield, namely, in the HER2+ metastatic breast cancer, a well-depicted patient profile, including details on body mass index and its prognostic relevance, can help inform therapeutic decisions, “says Dr. Eriseld Krasniqi, medical oncologist of the IRCCS Regina Elena National Cancer Institute of Rome, Central Italy.

In this study, researchers focused on the role of generalized obesity expressed by body mass index (BMI) on treatment outcomes in a group of 709 patients diagnosed with HER2+ metastatic breast cancer and treated with new anti-HER2 agents pertuzumab and trastuzumab emtansine (T-DM1), at 45 cancer centers. In the overall study population, BMI≥30 was associated with worse overall survival (OS) (p = 0.003). In patients who progressed during or after first-line treatment, higher BMI values predicted worse overall survival outcomes in the presence of a lower metastatic load (p = 0.001). 

“To our knowledge, no previous studies have tested the role of BMI in such a large cohort of patients with HER2+ metastatic breast cancer and there is no preliminary evidence on the association of interest regarding the use of these new anti-HER2 agents,” says Prof. Patrizia Vici, director and head of the Division of Medical Oncology Division 2 at the IRCCS-Regina Elena, Rome. “Most importantly, no author has considered the extent of metastatic involvement in influencing survival outcomes in the population of interest.”

“From a pathogenetic point of view, several hypotheses and underlying mechanisms may prove the effects of overweight and obesity on breast cancer prognosis, including a higher serum level of insulin estrogen and insulin-like growth factors and inflammatory cytokines,” adds Giordano, senior scientist and scientific supervisor for the entire project. “Understanding of the mechanisms and underlying pathways can increase significantly to improve the results of this subgroup of patients,” Giordano concludes.

About the Sbarro Health Research Organization

The Sbarro Health Research Organization (SHRO) is non-profit charity committed to funding excellence in basic genetic research to cure and diagnose cancer, cardiovascular diseases, diabetes and other chronic illnesses and to foster the training of young doctors in a spirit of professionalism and humanism. To learn more about the SHRO please visit www.shro.org

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