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Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study

BACKGROUND: In patients treated with cardiotoxic chemotherapies, the presence of cardiovascular risk factors and previous cardiac disease have been strongly correlated to the onset of cardiotoxicity. The influence of overweight and obesity as risk factors in the development of treatment-related card...

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Autores principales: Kaboré, Elisé G., Guenancia, Charles, Vaz-Luis, Ines, Di Meglio, Antonio, Pistilli, Barbara, Coutant, Charles, Cottu, Paul, Lesur, Anne, Petit, Thierry, Dalenc, Florence, Rouanet, Philippe, Arnaud, Antoine, Arsene, Olivier, Ibrahim, Mahmoud, Wassermann, Johanna, Boileau-Jolimoy, Geneviève, Martin, Anne-Laure, Lemonnier, Jérôme, André, Fabrice, Arveux, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927582/
https://www.ncbi.nlm.nih.gov/pubmed/31869400
http://dx.doi.org/10.1371/journal.pmed.1002989
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author Kaboré, Elisé G.
Guenancia, Charles
Vaz-Luis, Ines
Di Meglio, Antonio
Pistilli, Barbara
Coutant, Charles
Cottu, Paul
Lesur, Anne
Petit, Thierry
Dalenc, Florence
Rouanet, Philippe
Arnaud, Antoine
Arsene, Olivier
Ibrahim, Mahmoud
Wassermann, Johanna
Boileau-Jolimoy, Geneviève
Martin, Anne-Laure
Lemonnier, Jérôme
André, Fabrice
Arveux, Patrick
author_facet Kaboré, Elisé G.
Guenancia, Charles
Vaz-Luis, Ines
Di Meglio, Antonio
Pistilli, Barbara
Coutant, Charles
Cottu, Paul
Lesur, Anne
Petit, Thierry
Dalenc, Florence
Rouanet, Philippe
Arnaud, Antoine
Arsene, Olivier
Ibrahim, Mahmoud
Wassermann, Johanna
Boileau-Jolimoy, Geneviève
Martin, Anne-Laure
Lemonnier, Jérôme
André, Fabrice
Arveux, Patrick
author_sort Kaboré, Elisé G.
collection PubMed
description BACKGROUND: In patients treated with cardiotoxic chemotherapies, the presence of cardiovascular risk factors and previous cardiac disease have been strongly correlated to the onset of cardiotoxicity. The influence of overweight and obesity as risk factors in the development of treatment-related cardiotoxicity in breast cancer (BC) was recently suggested. However, due to meta-analysis design, it was not possible to take into account associated cardiac risk factors or other classic risk factors for anthracycline (antineoplastic antibiotic) and trastuzumab (monoclonal antibody) cardiotoxicity. METHODS AND FINDINGS: Using prospective data collected from 2012–2014 in the French national multicenter prospective CANTO (CANcer TOxicities) study of 26 French cancer centers, we aimed to examine the association of body mass index (BMI) and cardiotoxicity (defined as a reduction in left ventricular ejection fraction [LVEF] > 10 percentage points from baseline to LVEF < 50%). In total, 929 patients with stage I–III BC (mean age 52 ± 11 years, mean BMI 25.6 ± 5.1 kg/m(2), 42% with 1 or more cardiovascular risk factors) treated with anthracycline (86% epirubicin, 7% doxorubicin) and/or trastuzumab (36%), with LVEF measurement at baseline and at least 1 assessment post-chemotherapy were eligible in this interim analysis. We analyzed associations between BMI and cardiotoxicity using multivariate logistic regression. At baseline, nearly 50% of the study population was overweight or obese. During a mean follow-up of 22 ± 2 months following treatment completion, cardiotoxicity occurred in 29 patients (3.2%). The obese group was more prone to cardiotoxicity than the normal-weight group (9/171 versus 8/466; p = 0.01). In multivariate analysis, obesity (odds ratio [OR] 3.02; 95% CI 1.10–8.25; p = 0.03) and administration of trastuzumab (OR 12.12; 95% CI 3.6–40.4; p < 0.001) were independently associated with cardiotoxicity. Selection bias and relatively short follow-up are potential limitations of this national multicenter observational cohort. CONCLUSIONS: In BC patients, obesity appears to be associated with an important increase in risk-related cardiotoxicity (CANTO, ClinicalTrials.gov registry ID: NCT01993498). TRIAL REGISTRATION: ClinicalTrials.gov NCT01993498.
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spelling pubmed-69275822020-01-07 Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study Kaboré, Elisé G. Guenancia, Charles Vaz-Luis, Ines Di Meglio, Antonio Pistilli, Barbara Coutant, Charles Cottu, Paul Lesur, Anne Petit, Thierry Dalenc, Florence Rouanet, Philippe Arnaud, Antoine Arsene, Olivier Ibrahim, Mahmoud Wassermann, Johanna Boileau-Jolimoy, Geneviève Martin, Anne-Laure Lemonnier, Jérôme André, Fabrice Arveux, Patrick PLoS Med Research Article BACKGROUND: In patients treated with cardiotoxic chemotherapies, the presence of cardiovascular risk factors and previous cardiac disease have been strongly correlated to the onset of cardiotoxicity. The influence of overweight and obesity as risk factors in the development of treatment-related cardiotoxicity in breast cancer (BC) was recently suggested. However, due to meta-analysis design, it was not possible to take into account associated cardiac risk factors or other classic risk factors for anthracycline (antineoplastic antibiotic) and trastuzumab (monoclonal antibody) cardiotoxicity. METHODS AND FINDINGS: Using prospective data collected from 2012–2014 in the French national multicenter prospective CANTO (CANcer TOxicities) study of 26 French cancer centers, we aimed to examine the association of body mass index (BMI) and cardiotoxicity (defined as a reduction in left ventricular ejection fraction [LVEF] > 10 percentage points from baseline to LVEF < 50%). In total, 929 patients with stage I–III BC (mean age 52 ± 11 years, mean BMI 25.6 ± 5.1 kg/m(2), 42% with 1 or more cardiovascular risk factors) treated with anthracycline (86% epirubicin, 7% doxorubicin) and/or trastuzumab (36%), with LVEF measurement at baseline and at least 1 assessment post-chemotherapy were eligible in this interim analysis. We analyzed associations between BMI and cardiotoxicity using multivariate logistic regression. At baseline, nearly 50% of the study population was overweight or obese. During a mean follow-up of 22 ± 2 months following treatment completion, cardiotoxicity occurred in 29 patients (3.2%). The obese group was more prone to cardiotoxicity than the normal-weight group (9/171 versus 8/466; p = 0.01). In multivariate analysis, obesity (odds ratio [OR] 3.02; 95% CI 1.10–8.25; p = 0.03) and administration of trastuzumab (OR 12.12; 95% CI 3.6–40.4; p < 0.001) were independently associated with cardiotoxicity. Selection bias and relatively short follow-up are potential limitations of this national multicenter observational cohort. CONCLUSIONS: In BC patients, obesity appears to be associated with an important increase in risk-related cardiotoxicity (CANTO, ClinicalTrials.gov registry ID: NCT01993498). TRIAL REGISTRATION: ClinicalTrials.gov NCT01993498. Public Library of Science 2019-12-23 /pmc/articles/PMC6927582/ /pubmed/31869400 http://dx.doi.org/10.1371/journal.pmed.1002989 Text en © 2019 Kaboré et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kaboré, Elisé G.
Guenancia, Charles
Vaz-Luis, Ines
Di Meglio, Antonio
Pistilli, Barbara
Coutant, Charles
Cottu, Paul
Lesur, Anne
Petit, Thierry
Dalenc, Florence
Rouanet, Philippe
Arnaud, Antoine
Arsene, Olivier
Ibrahim, Mahmoud
Wassermann, Johanna
Boileau-Jolimoy, Geneviève
Martin, Anne-Laure
Lemonnier, Jérôme
André, Fabrice
Arveux, Patrick
Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study
title Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study
title_full Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study
title_fullStr Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study
title_full_unstemmed Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study
title_short Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study
title_sort association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: french canto cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927582/
https://www.ncbi.nlm.nih.gov/pubmed/31869400
http://dx.doi.org/10.1371/journal.pmed.1002989
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