Influence of body mass index on outcome in advanced colorectal cancer patients receiving chemotherapy with or without targeted therapy

• DOI: 10.1016/j.ejca.2011.06.038
• Publication Date: 2011-08-02T07:51:49Z
• Authors: Lieke H.J. Simkens; Miriam Koopman; Linda Mol; Gerrit Jan Veldhuis; Daan Ten Bokkel H...; Erik W. Muller; Veerle A. Derleyn; Steven Teerenstra; Cornelis J.A. Punt
• Keywords: Adult; Male; Cancer Research; Organoplatinum Compounds; Irinotecan; Deoxycytidine; Body Mass Index; Targeted therapy; 03 medical and health sciences; 0302 clinical medicine; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy; Humans; NCEBP 2: Evaluation of complex medical interventions; Molecular Targeted Therapy; Obesity; Body mass index; Capecitabine; Aged; Aged, 80 and over; 2. Zero hunger; NCEBP 6: Quality of nursing and allied health care; Prognostic factor; Middle Aged; Colorectal cancer; 3. Good health; Bevacizumab; Oxaliplatin; ONCOL 3: Translational research; Oncology; Chemotherapy, Adjuvant; Camptothecin; Female; Fluorouracil; Colorectal Neoplasms

Obesity is associated with an increased risk of development and recurrence of colorectal cancer. However, the role of obesity in advanced colorectal cancer (ACC) patients is unknown. We investigated the effect of body mass index (BMI) on overall survival (OS) in ACC patients receiving systemic treatment in two large phase III studies (CAIRO and CAIRO2).Treatment data were obtained and analysed from 796 ACC patients who were treated with chemotherapy in the CAIRO study, and from 730 ACC patients who were treated with chemotherapy plus targeted therapy in the CAIRO2 study. Baseline height and weight were used to assign patients to one of the following BMI categories: A (<18.5 kg/m(2)), B (18.5-24.9 kg/m(2)), C (25.0-29.9 kg/m(2)) and D (≥30.0 kg/m(2)).In 796 patients of the CAIRO study a high BMI was associated with better median OS (8.0, 14.9, 18.4 and 19.5 months for BMI categories A, B, C, and D, respectively; P=0.001), and was an independent prognostic factor for OS in a multivariate analysis. BMI was not associated with OS in 730 patients who participated in the CAIRO2 study, although a trend was observed.These results show that BMI is an independent prognostic factor for survival in patients receiving chemotherapy, but not in patients receiving chemotherapy and targeted therapy. The possible decreased efficacy of bevacizumab in obese patients may explain this discrepant result. The role of BMI in patients receiving targeted therapy should be further tested.