Prognostic role of body mass index (BMI) in patients with metastatic castration resistant prostate cancer (mCRPC) receiving chemotherapy: Preliminary results from a retrospective Italian multicenter study

342

Background: Body mass index (BMI) is linked to an increased risk of cancers and a poorer prognosis. However, the evidence on the relationship between high BMI and metastatic castration resistant prostate cancer (mCRPC) is not entirely consistent and the data are conflicting. The aim of this observational, retrospective, multicenter study was to evaluate the correlation between BMI and progression-free survival (PFS) and overall survival (OS) in patients (pts) with mCRPC treated with chemotherapy. Methods: We collected mCRPC pts who received docetaxel 75 mg/m2 every 21 days as first line therapy in6 Italian Cancer Centers from 2005 to 2015. We classified BMI group according with the World Health Organization definition : normal weight BMI < 25kg/m2, overweight 25 ≤ BMI < 30kg/m2, and obese BMI ≥ 30kg/m2. Baseline characteristics and treatment information has been recorded in an anonymized excel file. Results: We collected 113 pts with a median age of 70.7 years (62 to 87) at the time of mCRPC diagnosis. In our cohort 33.6% of pts were normal weight at the HRPC diagnosis, 50.9% were overweight, and 15.5% were obese. At the baseline, 83.3% of obese pts had at least 1 co-morbidity versus 64.9% of normal/overweight pts. Moreover, 27.8% of obese pts needed a docetaxel dose reduction versus 17.5% normal/overweight pts. Only a non-significant trend for the detrimental effect of high BMI on PFS and OS has been documented. Median PFS in obese pts 6.4 months vs 7.0 months in of normal/overweight pts (p = 0.439); median OS in obese pts 38.8 months vs 43.4 months in of normal/overweight pts (p = 0.157). Conclusions: The relationship between BMI and mCRPC is extremely complex and unclear. Even if in this preliminary analysis we failed to confirm a significant association between BMI and survival, the data suggests that obesity may be associated with a lower tolerance to chemotherapy. Overall, we expected to enroll approximately 500 pts and data collection is currently ongoing.

Abstract P3-14-18: Dose-dense neoadjuvant chemotherapy in locally advanced breast cancer. Long term results of a cooperative retrospective study

BACKGROUND: Dose-dense chemotherapy results in better overall (OS) and disease free survival (DFS) in women with hormone receptor-negative early breast cancer as shown with a systematic review and meta-analysis by Bonilla et al (JNCI 2010). Aim of our study was to compare neoadjuvant dose-dense chemotherapy with standard dose schedule in T4 patients in terms of DFS and OS, according to hormone-receptor status.

PATIENTS AND METHODS: we analysed, retrospectively, 160 consecutive T4 patients, of median age 52 ys (range 29-73) who received neoadjuvant anthra-based chemotherapy with and without taxanes, observed from 1989 to 2009; 74 patients (46%) received dose-dense schedule (q14) and 86 (54%) conventional dose (q21); 68 (42%) patients were ER-negative (32 q14; 36 q21) and 92 (58%) patients were ER-positive (42 q14; 50 q21). No Trastuzumab was allowed during neoadjuvant treatment.

RESULTS: at a median follow-up of 130 months (range 8-241 months), overall, 10 y DFS was 41.9% and 30.2% on q14 and q21 schedules, respectively (p = 0.085); 10 y OS was 48.6% on q14 and 44.2% on q21 schedule, (p = 0.343). ER-negative patients who received q14 schedule had better DFS (46.9%) than those on q21 schedule (16.7%), (p = 0.007) [Relative Risk 0,63 and Odds Ratio 0,22] and better OS (50%) than those on q21 schedule (30.6%) (p = 0.083) [Relative Risk 0,61 and Odds Ratio 0,44]. DFS and OS did not differ on q14 and q21 schedules in ER- positive patients.

CONCLUSIONS: Our findings are consistent with published data and suggest that there is no appreciable survival benefit from increasing dose density among T4 ER-positive patients. Dose-dense neoadjuvant chemotherapy may be justified in LABC patients with T4 ER-negative tumors.

 DFS OS  q 14q 21pq 14q 21pER-46,9%16,7%0.00750%30,6%0.083ER+38,1%40,0%0.51247,6%54,0%0.344

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-14-18.