Toxicity and tolerability of adjuvant breast cancer chemotherapy in obese women

Abstract

The purpose of this study was to compare toxicity rates and types between obese and non-obese women during adjuvant chemotherapy for breast cancer, adjusting for regimen type and received dose. We conducted a retrospective cohort study of 537 women receiving chemotherapy, initially treated between 2007 and 2010 at two tertiary hospitals in Brisbane, Australia. Demographic, chemotherapy and toxicity data were extracted from patient charts and analyzed using multivariate logistic regression. Three hundred and seventy-four women were eligible for inclusion. Obese women (body mass index (BMI) > 30 kg/m(2); mean age 52.58 ± 9.49) were older than non-obese women (BMI ≤ 29.9 kg/m(2); mean age 50.19 ± 11.15, P = 0.05) and had more comorbidities (P < 0.01). After adjustment for potential confounders, obesity was not statistically related to chemotherapy-related admission risk (OR 1.27; 95 % CI 0.78-2.09) or febrile neutropenia risk (OR 0.56; 95% CI 0.28-1.21). However, obese women received chemotherapy with proportionally lower mean relative dose intensity than non-obese women (94 vs. 97% of reference dose, P = 0.03). Eighteen (15.8%) obese and zero non-obese women (P < 0.01) had their chemotherapy dose capped at an arbitrary body surface area. Compared with non-obese women, obese women receive different chemotherapy regimens and relatively lower chemotherapy doses. There was no significant evidence of increased toxicity among obese women with either full or adjusted chemotherapy doses. Full body surface areas-based dosing appears to be tolerated as well in obese as in lean women.

Toxicity profile differences of adjuvant docetaxel/cyclophosphamide (TC) between Asian and Caucasian breast cancer patients

“…The correlation of obesity and hematological toxicities have been supported in results throughout research, but still warrant further analysis for modern chemotherapy protocols . Our previous study on the toxicity of FEC 100 demonstrated that normal or underweight women (BMI <25) were 2.6 times more likely to experience grade 3 or higher hematological toxicities than obese patients (BMI ≥30) .…”

OPTIMA prelim: a randomised feasibility study of personalised care in the treatment of women with early breast cancer

“…Rates of admission to hospital with serious complications have mostly been reported to be in the range 20% to 25% [5][6][7] and there is a small risk of early death from treatment, reported to be in the range 0.2% to 0.3% in recent studies. 8,9 Patients are frequently unable to work both during treatment and for some time thereafter, 10 which has considerable cost to society.…”

Reactive Oxygen Species-Manipulated Drug Release from a Smart Envelope-Type Mesoporous Titanium Nanovehicle for Tumor Sonodynamic-Chemotherapy

“…Furthermore, DTX also caused the significant decrease of the white blood cells and platelets after treatment for 15 days ( Figure 8F), and this hematologic toxicity is the main side effect of DTX. 45,46 Figure 8, panel F also shows the numbers of white blood cell (WBC), red blood cell (RBC), and platelet (PLT) in tumor-bearing mice treated with DTX-loaded MTNs for 15 days, and MTN@DTX-CD did not lead to the significant decrease of WBC and PLT numbers after treatment. Overall, after injection of MTN@DTX-CD into a tumor-bearing mouse, MTN@DTX-CD could efficiently accumulate in tumor via enhanced permeability and retention effect.…”