Impact of BMI on HER2+ metastatic breast cancer patients treated with pertuzumab and/or trastuzumab emtansine. Real-world evidence

Emilio Bria, Gualtiero Ricciardi, Ruggero De Maria Marchiano, Angela Ida Villa, Alessandro Giordano, Gerolamo Tonini, Ascanio Giuseppe Vaccaro, Domenico Cristiano Corsi, Ida Paris, Daniele Generali, Eriseld Krasniqi, Laura Pizzuti, Giacomo Barchiesi, Domenico Sergi, Silvia Carpano, Claudio Botti, Ramy Kayal, Giuseppe Sanguineti, Andrea Botticelli, Daniele MarinelliTeresa Gamucci, Antonino Grassadonia, Nicola Tinari, Silverio Tomao, Giuseppe Tonini, Aandrea Michelotti, Lucia Mentuccia, Aangela Vaccaro, Emanuela Magnolfi, Alain Gelibter, Valentina Magri, Enrico Cortesi, Loretta D’Onofrio, Marina Cazzaniga, Luca Moscetti, Agnese Fabbri, Angelo Fedele Scinto, Pia Di Stefano, Rossana Mirabelli, Enzo Veltri, Francesco Giotta, Vito Lorusso, Elisa Landucci, Corrado Ficorella, Mario Roselli, Vincenzo Adamo, Giuseppina Ricciardi, Antonio Russo, Maria Rosaria Valerio, Rossana Berardi, Mirco Pistelli, Katia Cannita, Claudio Zamagni, Ornella Garrone, Editta Baldini, Lorenzo Livi, Icro Meattini, Pietro Del Medico, Emanuela Risi, Gennaro Ciliberto, Isabella Sperduti, Marco Mazzotta, Maddalena Barba, Patrizia Vici

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5 Citations (Scopus)


Body mass index (BMI) is a main indicator of obesity and its association with breast cancer is well established. However, little is known in the metastatic setting, especially in HER2-positive patients. We assessed the influence of BMI on clinical outcomes of patients treated with pertuzumab and/or trastuzumab emtansine (T-DM1) for HER2+ metastatic breast cancer (mBC). BMI was addressed as a categorical variable, being classified on the basis of the following ranges, that is, 18.5–24.9, 25–29.9, and 30.0–34.9, namely, normal weight, overweight, and Class I obesity. The outcomes chosen were progression-free survival to first-line chemotherapy (PFS1) and overall survival (OS). Overall (N = 709), no impact of BMI was observed on PFS1 (p =.15), while BMI ≥ 30 was associated with worse OS (p =.003). In subjects who progressed to first line (N = 575), analyzing data across PFS1 quartiles and strata of disease burden, BMI predicted lower PFS1 in patients within the I PFS1 quartile and with the lowest disease burden (p =.001). Univariate analysis showed a detrimental effect of BMI ≥ 30 on OS for women within the I PFS1 quartile (p =.03). Results were confirmed in multivariate analysis. According to PFS1 quartiles a higher percentage of patients with high BMI and low disease burden progressed within 6 months of therapy. The effect of BMI on prognosis was also confirmed in multivariate analysis of OS for overall population. In our cohort, a BMI ≥ 30 correlated with worse OS in patients with HER2+ mBC who received pertuzumab and/or T-DM1 but had no impact on PFS to first line. BMI predicted worse I PFS1 quartile.
Original languageEnglish
Pages (from-to)7900-7910
Number of pages11
JournalJournal of Cellular Physiology
Publication statusPublished - 2020


  • HER2-positive metastatic breast cancer
  • body mass index
  • pertuzumab
  • trastuzumab emtansine


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