Efficacy of antiobesity medications among breast cancer survivors taking aromatase inhibitors.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI:10.1007/s10549-024-07450-3

Sima Fansa, Wissam Ghusn, Elif Tama, Bryan Nicolalde, Diego Anazco, Stacy D ' Andre, Stephanie S Faubion, Chrisandra L Shufelt, Andres Acosta, Maria D Hurtado Andrade

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引用次数: 0

Abstract

Purpose: Aromatase inhibitors (AI) block estrogen synthesis and are used as long-term adjuvant treatment for breast cancer in postmenopausal women. AI use can be associated with weight gain that can lead to increased cardiometabolic risk. The response to anti-obesity medications (AOM) in patients using AI has yet to be studied. We sought to investigate weight loss outcomes of AOM in patients taking AI for breast cancer treatment.

Methods: This is a matched retrospective cohort study of breast cancer survivors on AI using AOM (AOM/AI group). We compared their weight loss outcomes with a group of female patients with obesity, without a history of breast cancer or AI use, on AOM (AOM group). The primary endpoint was total body weight loss percentage (TBWL %) at the last follow-up. We performed mixed linear regression models, including diabetes status at baseline, to assess associations between use of AOM with/without AI with total body weight loss percentage (TBWL%).

Results: We included 124 patients: 62 in the AOM/AI group (63.6 ± 10 years, body mass index [BMI] 34.3 ± 7.1 kg/m²) and 62 in the AOM group (62.8 ± 9.9 years, BMI 34.6 ± 6.5 kg/m²). The mean time of follow up was 9.3 ± 3.5 months, with no differences among the two groups. The AOM/AI group had a lower TBWL% compared to the AOM group at the last follow-up -5.3 ± 5.0 vs. -8.2 ± 6.3 (p = 0.005). The results remained significant after adjusting for diabetes status (p = 0.0002). At 12 months, the AOM/AI group had a lower TBWL% compared to the AOM group 6.4 ± 0.8% vs. 9.8 ± 0.9% (p = 0.04). The percentage of patients achieving ≥ 5%, ≥ 10%, and ≥ 15% of weight loss at 12 months was greater in the AOM compared to the AOM/AI group. Although the weight loss response was suboptimal, patients in the AOM/AI group had improvement in fasting glucose, glycated hemoglobin, systolic blood pressure, and low-density lipoprotein cholesterol.

Conclusions: The use of AI in breast cancer survivors is associated with less weight loss response to AOM compared to patients without breast cancer history and who do not take AI. Studies are needed to assess the mechanisms behind the differential weight loss response to AOM in women taking AI.

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服用芳香化酶抑制剂的乳腺癌幸存者服用抗肥胖药物的疗效。

目的：芳香化酶抑制剂（AI）可阻断雌激素的合成，是绝经后妇女乳腺癌的长期辅助治疗药物。使用 AI 可能会导致体重增加，从而增加心脏代谢风险。目前尚未研究使用 AI 的患者对抗肥胖药物（AOM）的反应。我们试图研究服用抗肥胖药物治疗乳腺癌患者的减肥效果：这是一项匹配的回顾性队列研究，研究对象是使用 AOM 的 AI 乳腺癌幸存者（AOM/AI 组）。我们将她们的体重减轻结果与一组没有乳腺癌病史或使用过 AI 的肥胖女性患者（AOM 组）进行了比较。主要终点是最后一次随访时的总体重减轻百分比（TBWL %）。我们建立了混合线性回归模型，包括基线时的糖尿病状况，以评估使用AOM（含/不含AI）与总体重减轻百分比（TBWL%）之间的关系：我们共纳入了 124 名患者：AOM/AI组62人（63.6 ± 10岁，体重指数[BMI] 34.3 ± 7.1 kg/m2），AOM组62人（62.8 ± 9.9岁，体重指数34.6 ± 6.5 kg/m2）。平均随访时间为 9.3 ± 3.5 个月，两组之间无差异。在最后一次随访时，AOM/AI 组的 TBWL% 比 AOM 组低 -5.3 ± 5.0 vs. -8.2 ± 6.3（p = 0.005）。在调整糖尿病状态后，结果仍然显著（p = 0.0002）。12个月时，AOM/AI组的TBWL%低于AOM组（6.4 ± 0.8% vs. 9.8 ± 0.9%）（p = 0.04）。与AOM/AI组相比，AOM组在12个月内体重减轻≥5%、≥10%和≥15%的患者比例更高。虽然体重减轻反应不理想，但AOM/AI组患者的空腹血糖、糖化血红蛋白、收缩压和低密度脂蛋白胆固醇均有所改善：结论：与无乳腺癌病史且未服用人工受体阻断剂的患者相比，乳腺癌幸存者服用人工受体阻断剂后对AOM的体重减轻反应较小。需要进行研究，以评估服用AI的妇女对AOM的不同减肥反应背后的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.