4.6 Article

The association between adiposity and anti-proliferative response to neoadjuvant endocrine therapy with letrozole in post-menopausal patients with estrogen receptor positive breast cancer

Journal

NPJ BREAST CANCER
Volume 8, Issue 1, Pages -

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41523-022-00453-7

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Funding

  1. Belgian Cancer Foundation [FAF-C/2018/1302]
  2. Luxemburg Cancer Foundation [FC/2018/07]
  3. FWO
  4. KU Leuven Fund Nadine de Beauffort
  5. ERC [101003153]
  6. Fondazione AIRC IG [21761]
  7. 5x1000 IRCCS grant (Ospedale Policlinico San Martino)
  8. University of Genoa CURIOSITY grant
  9. European Research Council (ERC) [101003153] Funding Source: European Research Council (ERC)

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The impact of adiposity on the efficacy of endocrine treatment in patients with estrogen receptor positive breast cancer was investigated retrospectively. It was found that obesity and larger adipocyte diameter are associated with a higher likelihood of anti-proliferative response in neoadjuvant treatment.
The impact of adiposity on the efficacy of endocrine treatment in patients with estrogen receptor positive breast cancer is poorly investigated. Here, we retrospectively investigated in a cohort of 56 patients whether body mass index and/or mammary adiposity are associated with anti-proliferative response in the neoadjuvant setting. Anti-proliferative response was defined as high Ki67 at baseline (Ki67(bl)) and low Ki67 at surgery (Ki67(srg)), using the 14% cut-off. Mammary adipocyte size was assessed on hematoxylin and eosin slides from the surgical samples using digital pathology. A higher proportion of tumors with an anti-proliferative response was observed in patients with obesity (54.5%) as compared to patients with normal weight (9.0%) and patients with overweight (40.0%) (p = 0.031), confirmed by multivariable regression analysis adjusted for baseline Ki67 (OR, obese vs normal weight: 13.76, 95%Cl: 1.49-207.63, p = 0.020). Larger adipocyte diameter was identified as predictor of anti-proliferative response (OR per increase in diameter of 5 pm for adipocytes distant from the tumor: 2.24, 95%Cl: 1.01-14.32, p = 0.046). This study suggests that anti-proliferative response to neoadjuvant letrozole might be more frequent in patients with increased systemic or mammary adiposity.

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