Document Detail

Obesity and risk of recurrence or death after adjuvant endocrine therapy with letrozole or tamoxifen in the breast international group 1-98 trial.
MedLine Citation:
PMID:  23045588     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To examine the association of baseline body mass index (BMI) with the risk of recurrence or death in postmenopausal women with early-stage breast cancer receiving adjuvant tamoxifen or letrozole in the Breast International Group (BIG) 1-98 trial at 8.7 years of median follow-up.
PATIENTS AND METHODS: This report analyzes 4,760 patients with breast cancer randomly assigned to 5 years of monotherapy with letrozole or tamoxifen in the BIG 1-98 trial with available information on BMI at randomization. Multivariable Cox modeling assessed the association of BMI with disease-free survival, overall survival (OS), breast cancer-free interval, and distant recurrence-free interval and tested for treatment-by-BMI interaction. Median follow-up was 8.7 years.
RESULTS: Seventeen percent of patients have died. Obese patients (BMI ≥ 30 kg/m(2)) had slightly poorer OS (hazard ratio [HR] = 1.19; 95% CI, 0.99 to 1.44) than patients with normal BMI (< 25 kg/m(2)), whereas no trend in OS was observed in overweight (BMI 25 to < 30 kg/m(2)) versus normal-weight patients (HR = 1.02; 95% CI, 0.86 to 1.20). Treatment-by-BMI interactions were not statistically significant. The HRs for OS comparing obese versus normal BMI were HR = 1.22 (95% CI, 0.93 to 1.60) and HR = 1.18 (95% CI, 0.91 to 1.52) in the letrozole and tamoxifen groups, respectively.
CONCLUSION: There was no evidence that the benefit of letrozole over tamoxifen differed according to patients' BMI.
Marianne Ewertz; Kathryn P Gray; Meredith M Regan; Bent Ejlertsen; Karen N Price; Beat Thürlimann; Hervé Bonnefoi; John F Forbes; Robert J Paridaens; Manuela Rabaglio; Richard D Gelber; Marco Colleoni; István Láng; Ian E Smith; Alan S Coates; Aron Goldhirsch; Henning T Mouridsen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-08
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  30     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-09     Completed Date:  2013-01-17     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3967-75     Citation Subset:  IM    
Department of Oncology (ME), Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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MeSH Terms
Antineoplastic Agents, Hormonal / therapeutic use*
Aromatase Inhibitors / therapeutic use
Body Mass Index*
Breast Neoplasms / drug therapy*,  mortality*,  surgery
Chemotherapy, Adjuvant
Disease-Free Survival
Estrogen Receptor Modulators / therapeutic use
Follow-Up Studies
Kaplan-Meier Estimate
Middle Aged
Neoplasm Recurrence, Local / etiology*
Nitriles / therapeutic use*
Obesity / complications*
Odds Ratio
Predictive Value of Tests
Proportional Hazards Models
Risk Assessment
Risk Factors
Tamoxifen / therapeutic use*
Treatment Outcome
Triazoles / therapeutic use*
Grant Support
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Aromatase Inhibitors; 0/Estrogen Receptor Modulators; 0/Nitriles; 0/Triazoles; 10540-29-1/Tamoxifen; 112809-51-5/letrozole

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