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<p>Historically, breast cancer patients with obesity have been more likely than normal-weight patients to receive dose-reduced chemotherapy, although contemporary dosing practices of patients with obesity remain unclear. Among 9708 women treated with adjuvant chemotherapy for stage I-IIIA breast cancer at two integrated healthcare delivery systems (2005–2019), we used generalized linear models to estimate adjusted prevalence ratios between body mass index (BMI) and comorbidity and chemotherapy dosing (first cycle dose reduction (FCDR), dose proportion &lt; 90%) and average relative dose intensity (ARDI) &lt; 90%). A strong, independent association was observed between BMI and FCDR (PR<sub>BMI:40+ vs 18.5-&lt;25</sub>: 9.74; 95% CI: 7.43–12.8; p-trend &lt; 0.001) and ARDI &lt; 90% (PR<sub>BMI:40+ vs 18.5-&lt;25</sub>: 2.69; 95% CI: 2.35–3.09; p-trend &lt; 0.001). This association weakened over time, although remained significant, particularly in the heaviest patients. Charlson Comorbidity Index (CCI) was associated with FCDR (PR<sub>CCI:3+ vs 0</sub>: 1.58; 95% CI: 1.19–2.11; p-trend = 0.009) and ARDI &lt; 90% (p-trend &lt; 0.001), as were individual comorbidities. Understanding dose reductions and their impact will be critical to optimizing care and improving survivorship.</p>

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Understanding the association between body mass index and chemotherapy dose reductions in women treated for stage I-IIIA breast cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月29日

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  • Jenna Bhimani,
  • Kelli O’Connell,
  • Grace B. Gallagher,
  • Victoria S. Blinder,
  • Rachael Burganowski,
  • Isaac J. Ergas,
  • Jennifer J. Griggs,
  • Narre Heon,
  • Sankeerth Jinna,
  • Tatjana Kolevska,
  • Yuriy Kotsurovskyy,
  • Candyce H. Kroenke,
  • Cecile. A. Laurent,
  • Raymond Liu,
  • Kanichi G. Nakata,
  • Sonia Persaud,
  • Janise M. Roh,
  • Sara Tabatabai,
  • Emily Valice,
  • Peng Wang,
  • Elisa V. Bandera,
  • Erin J. Aiello Bowles,
  • Lawrence H. Kushi,
  • Elizabeth D. Kantor

摘要

Historically, breast cancer patients with obesity have been more likely than normal-weight patients to receive dose-reduced chemotherapy, although contemporary dosing practices of patients with obesity remain unclear. Among 9708 women treated with adjuvant chemotherapy for stage I-IIIA breast cancer at two integrated healthcare delivery systems (2005–2019), we used generalized linear models to estimate adjusted prevalence ratios between body mass index (BMI) and comorbidity and chemotherapy dosing (first cycle dose reduction (FCDR), dose proportion < 90%) and average relative dose intensity (ARDI) < 90%). A strong, independent association was observed between BMI and FCDR (PRBMI:40+ vs 18.5-<25: 9.74; 95% CI: 7.43–12.8; p-trend < 0.001) and ARDI < 90% (PRBMI:40+ vs 18.5-<25: 2.69; 95% CI: 2.35–3.09; p-trend < 0.001). This association weakened over time, although remained significant, particularly in the heaviest patients. Charlson Comorbidity Index (CCI) was associated with FCDR (PRCCI:3+ vs 0: 1.58; 95% CI: 1.19–2.11; p-trend = 0.009) and ARDI < 90% (p-trend < 0.001), as were individual comorbidities. Understanding dose reductions and their impact will be critical to optimizing care and improving survivorship.