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

التفاصيل البيبلوغرافية
العنوان: Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study.
المؤلفون: Elisé G Kaboré, Charles Guenancia, Ines Vaz-Luis, Antonio Di Meglio, Barbara Pistilli, Charles Coutant, Paul Cottu, Anne Lesur, Thierry Petit, Florence Dalenc, Philippe Rouanet, Antoine Arnaud, Olivier Arsene, Mahmoud Ibrahim, Johanna Wassermann, Geneviève Boileau-Jolimoy, Anne-Laure Martin, Jérôme Lemonnier, Fabrice André, Patrick Arveux
المصدر: PLoS Medicine, Vol 16, Iss 12, p e1002989 (2019)
بيانات النشر: Public Library of Science (PLoS), 2019.
سنة النشر: 2019
المجموعة: LCC:Medicine
مصطلحات موضوعية: Medicine
الوصف: BackgroundIn 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 findingsUsing 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/m2, 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.ConclusionsIn BC patients, obesity appears to be associated with an important increase in risk-related cardiotoxicity (CANTO, ClinicalTrials.gov registry ID: NCT01993498).Trial registrationClinicalTrials.gov NCT01993498.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1549-1277
1549-1676
Relation: https://doaj.org/toc/1549-1277; https://doaj.org/toc/1549-1676
DOI: 10.1371/journal.pmed.1002989
URL الوصول: https://doaj.org/article/136a26b1f63746c7afe294583eb6a4fe
رقم الأكسشن: edsdoj.136a26b1f63746c7afe294583eb6a4fe
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:15491277
15491676
DOI:10.1371/journal.pmed.1002989