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<p>Obesity has been associated with inferior outcomes in early-stage breast cancer, but its clinical relevance in metastatic disease treated with CDK4/6 inhibitors remains uncertain. We retrospectively analyzed 332 patients with hormone receptor-positive/HER2-negative metastatic breast cancer who received first-line ribociclib or palbociclib plus endocrine therapy between 2018 and 2023. Patients were stratified by baseline BMI: &lt;30&#xa0;kg/m<sup>2</sup> (<i>n</i> = 221) and ≥ 30&#xa0;kg/m<sup>2</sup> (<i>n</i> = 111). Survival outcomes were estimated using Kaplan–Meier and Cox models, and treatment-related adverse events were compared between the groups. The median follow-up duration was 23.1 months. The median PFS was significantly longer in patients with a BMI ≥ 30&#xa0;kg/m<sup>2</sup> than in those with a BMI &lt; 30&#xa0;kg/m<sup>2</sup> (46.5 vs. 23.8 months; <i>p</i> = 0.016). In multivariate analysis, BMI ≥ 30&#xa0;kg/m<sup>2</sup> remained significantly associated with longer PFS (HR, 0.679; 95% CI, 0.468–0.985; <i>p</i> = 0.041). The median OS was not reached in either group. Patients with a BMI ≥ 30&#xa0;kg/m<sup>2</sup> experienced lower rates of any-grade toxicity and dose-reducing TRAEs. These findings suggest a potential association between BMI and clinical outcomes in this treatment setting. Prospective studies that integrate body composition and pharmacokinetics are required for validation.</p>

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Association between obesity and outcomes of first-line CDK4/6 inhibitor therapy in metastatic breast cancer: a multicenter real-world study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Murat Günaltılı,
  • Murad Guliyev,
  • Zeliha Birsin,
  • Emir Çerme,
  • Vali Aliyev,
  • Gülin Alkan Şen,
  • Ali Kaan Güren,
  • Emre Özge,
  • İlkay Gültürk,
  • Rumeysa Çolak,
  • Mesut Yılmaz,
  • Özkan Alan,
  • İbrahim Vedat Bayoğlu,
  • Zeynep Hande Turna,
  • Nebi Serkan Demirci

摘要

Obesity has been associated with inferior outcomes in early-stage breast cancer, but its clinical relevance in metastatic disease treated with CDK4/6 inhibitors remains uncertain. We retrospectively analyzed 332 patients with hormone receptor-positive/HER2-negative metastatic breast cancer who received first-line ribociclib or palbociclib plus endocrine therapy between 2018 and 2023. Patients were stratified by baseline BMI: <30 kg/m2 (n = 221) and ≥ 30 kg/m2 (n = 111). Survival outcomes were estimated using Kaplan–Meier and Cox models, and treatment-related adverse events were compared between the groups. The median follow-up duration was 23.1 months. The median PFS was significantly longer in patients with a BMI ≥ 30 kg/m2 than in those with a BMI < 30 kg/m2 (46.5 vs. 23.8 months; p = 0.016). In multivariate analysis, BMI ≥ 30 kg/m2 remained significantly associated with longer PFS (HR, 0.679; 95% CI, 0.468–0.985; p = 0.041). The median OS was not reached in either group. Patients with a BMI ≥ 30 kg/m2 experienced lower rates of any-grade toxicity and dose-reducing TRAEs. These findings suggest a potential association between BMI and clinical outcomes in this treatment setting. Prospective studies that integrate body composition and pharmacokinetics are required for validation.