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Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy

INTRODUCTION: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in mCRC is unclear. We aimed to assess efficacy outcomes according to BMI in patient with metastatic colorectal...

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Autores principales: Cybulska-Stopa, Bożena, Ługowska, Iwona, Wiśniowski, Rafał, Domagała-Haduch, Małgorzata, Rajczykowski, Marcin, Piejko, Karolina, Bar-Letkiewicz, Ilona, Suwiński, Rafał, Regulski, Krzysztof, Mackiewicz, Jacek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265962/
https://www.ncbi.nlm.nih.gov/pubmed/32514236
http://dx.doi.org/10.5114/wo.2020.94728
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author Cybulska-Stopa, Bożena
Ługowska, Iwona
Wiśniowski, Rafał
Domagała-Haduch, Małgorzata
Rajczykowski, Marcin
Piejko, Karolina
Bar-Letkiewicz, Ilona
Suwiński, Rafał
Regulski, Krzysztof
Mackiewicz, Jacek
author_facet Cybulska-Stopa, Bożena
Ługowska, Iwona
Wiśniowski, Rafał
Domagała-Haduch, Małgorzata
Rajczykowski, Marcin
Piejko, Karolina
Bar-Letkiewicz, Ilona
Suwiński, Rafał
Regulski, Krzysztof
Mackiewicz, Jacek
author_sort Cybulska-Stopa, Bożena
collection PubMed
description INTRODUCTION: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in mCRC is unclear. We aimed to assess efficacy outcomes according to BMI in patient with metastatic colorectal cancer treated with bevacizumab plus FOLFOX chemotherapy regimen in second-line treatment. MATERIAL AND METHODS: The analysis of 237 patients with metastatic colorectal cancer treated with bevacizumab plus FOLFOX in the second line (treated from January 2014 to August 2018) in 4 reference oncological centers in Poland. RESULTS: The median age of the patients was 65 years (range 34–82). The median overall survival (OS) and progression-free survival (PFS) of the all 237 patient was 14.6 and 8.8 months, respectively. Comparison of obese patient (BMI > 30 kg/m(2)) vs. overweight patients (BMI ≥ 25 to < 30 kg/m(2)) vs. normal BMI range patients revealed a significant improvement of median OS (17.5 vs. 14.3 vs. 13.1 months, p = 0.01) and median PFS (9.4 vs. 9.1 vs. 7.3 months, p = 0.03). The Cox hazard model showed that the BMI class is an important risk factor. However, the Cox model also showed that the significance of the BMI class applies only to patients with BMI < 25 kg/m(2). This rule applies to both OS and PFS. The regression analysis also confirmed that there is a statistically significant relationship between the length of OS and PFS and the BMI value. Higher BMI was associated with a better prognosis. There were no differences in responses to treatment bevacizumab and FOLFOX chemotherapy and number adverse events according to BMI values. CONCLUSIONS: Patients with mCRC treated with chemotherapy with bevacizumab in second-line treatment with higher BMI compared with normal weight patients have better prognosis in terms of PFS and OS. In this group, we found no evidence of changes in safety profile depending on BMI. Nevertheless, further large randomized studies are needed to assess the body weight on the effectiveness of chemotherapy in combination with bevacizumab.
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spelling pubmed-72659622020-06-07 Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy Cybulska-Stopa, Bożena Ługowska, Iwona Wiśniowski, Rafał Domagała-Haduch, Małgorzata Rajczykowski, Marcin Piejko, Karolina Bar-Letkiewicz, Ilona Suwiński, Rafał Regulski, Krzysztof Mackiewicz, Jacek Contemp Oncol (Pozn) Original Paper INTRODUCTION: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in mCRC is unclear. We aimed to assess efficacy outcomes according to BMI in patient with metastatic colorectal cancer treated with bevacizumab plus FOLFOX chemotherapy regimen in second-line treatment. MATERIAL AND METHODS: The analysis of 237 patients with metastatic colorectal cancer treated with bevacizumab plus FOLFOX in the second line (treated from January 2014 to August 2018) in 4 reference oncological centers in Poland. RESULTS: The median age of the patients was 65 years (range 34–82). The median overall survival (OS) and progression-free survival (PFS) of the all 237 patient was 14.6 and 8.8 months, respectively. Comparison of obese patient (BMI > 30 kg/m(2)) vs. overweight patients (BMI ≥ 25 to < 30 kg/m(2)) vs. normal BMI range patients revealed a significant improvement of median OS (17.5 vs. 14.3 vs. 13.1 months, p = 0.01) and median PFS (9.4 vs. 9.1 vs. 7.3 months, p = 0.03). The Cox hazard model showed that the BMI class is an important risk factor. However, the Cox model also showed that the significance of the BMI class applies only to patients with BMI < 25 kg/m(2). This rule applies to both OS and PFS. The regression analysis also confirmed that there is a statistically significant relationship between the length of OS and PFS and the BMI value. Higher BMI was associated with a better prognosis. There were no differences in responses to treatment bevacizumab and FOLFOX chemotherapy and number adverse events according to BMI values. CONCLUSIONS: Patients with mCRC treated with chemotherapy with bevacizumab in second-line treatment with higher BMI compared with normal weight patients have better prognosis in terms of PFS and OS. In this group, we found no evidence of changes in safety profile depending on BMI. Nevertheless, further large randomized studies are needed to assess the body weight on the effectiveness of chemotherapy in combination with bevacizumab. Termedia Publishing House 2020-03-30 2020 /pmc/articles/PMC7265962/ /pubmed/32514236 http://dx.doi.org/10.5114/wo.2020.94728 Text en Copyright: © 2020 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Cybulska-Stopa, Bożena
Ługowska, Iwona
Wiśniowski, Rafał
Domagała-Haduch, Małgorzata
Rajczykowski, Marcin
Piejko, Karolina
Bar-Letkiewicz, Ilona
Suwiński, Rafał
Regulski, Krzysztof
Mackiewicz, Jacek
Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy
title Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy
title_full Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy
title_fullStr Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy
title_full_unstemmed Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy
title_short Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy
title_sort overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus folfox chemotherapy
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265962/
https://www.ncbi.nlm.nih.gov/pubmed/32514236
http://dx.doi.org/10.5114/wo.2020.94728
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