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Impact of a change of body mass index (BMI) on outcome following adjuvant endocrine therapy, chemotherapy, or trastuzumab for breast cancer.

513 Background: Pre-treatment BMI has been found to impact early breast cancer (EBC) outcomes and observational studies suggest that increasing BMI after diagnosis is detrimental. We hypothesize that changes in BMI after initial treatment of EBC are associated with breast cancer outcomes.


METHODS
We determined the effects of changes in BMI after initial treatment of EBC on disease outcomes in a series of NCIC CTG EBC clinical trials employing investigational therapies: chemotherapy (MA.5, MA.21), endocrine therapy (MA.12, MA.27), or biological therapy such as insulin-like growth factor pathway (MA.14) or trastuzumab therapy (MA24/HERA). Taking into account differing trial designs we created common operable definitions for investigative factors (BMI change at 1-, 3-, 5- years; age; ECOG performance status; menopausal status; race; T; nodal status; hormone receptor status; endocrine therapy; chemotherapy; anthracycline; trastuzumab) and STEEP endpoints. MA.14 and MA.27 results are provided here for breast cancer-free interval (BCFI), defined as the time from randomization until recurrence: first local invasive or DCIS; regional, or distant; contralateral invasive or DCIS; or death from breast cancer. Stratified Cox regression was used to assess the effect of continuous BMI changes on BCFI.


RESULTS
Preliminary results are as follows with a median FU of 9.8 years for MA14 and 4.1 years for MA27. There was no significant interaction between BMI changes and trial therapy (tamoxifen +/- octreotide LAR) in MA.14.


CONCLUSIONS
In this analysis, increases in BMI at 1- and 5- years were associated with improved prognosis in MA14, with no difference based on treatment arm. BMI changes were not associated with BCFI in the MA.27 trial comparing aromatase inhibitors. At ASCO we will report results for all trials and endpoints. This data may impact our understanding of the role of BMI and breast cancer recurrence. [Table: see text].