To the Editor,
I wish to congratulate Liu and colleagues for their article [1] in which they tried to find out an association between obesity and survival in the neoadjuvant breast cancer receiving adriamycin/taxane-based chemotherapy. They reported that obesity may negatively impact survival, with differences among tumor subtypes. However, the authors did not report about the adjustment of the chemotherapy dose to the patients’ exact body surface area (BSA) values. Karatas et al. recently reported that obesity had an adverse effect on pathological complete response (pCR) among women with neoadjuvant chemotherapy (NAC) [2]. However, study by Karatas et al. did not uniformly adjust the dose to the patients’ exact BSA values, limiting them at a lower level of 2 m2 to prevent side effects. Contrary to Karatas et al. study, Farr et al. found that obese women receiving full uncapped doses of anthracycline-taxane-based NAC have increased pCR and favorable progression-free survival. They concluded that this could result from increased dose intensity with increased efficacy and toxicity [3]. Taken all together, dose adjustment in obese breast cancer patients receiving NAC might have an impact on survival.
References
Liu YL, Saraf A, Catanese B, Lee SM, Zhang Y, Connolly EP, Kalinsky K (2017) Obesity and survival in the neoadjuvant breast cancer setting: role of tumor subtype in an ethnically diverse population. Breast Cancer Res Treat. doi:10.1007/s10549-017-4507-y
Karatas F, Erdem GU, Sahin S, Aytekin A, Yuce D, Sever AR, Babacan T, Ates O, Ozisik Y, Altundag K (2017) Obesity is an independent prognostic factor of decreased pathological complete response to neoadjuvant chemotherapy in breast cancer patients. Breast 32:237–244. doi:10.1016/j.breast.2016.05.013 Epub 2016 Jun 16
Farr A, Stolz M, Baumann L, Bago-Horvath Z, Oppolzer E, Pfeiler G, Seifert M, Singer CF (2017) The effect of obesity on pathological complete response and survival in breast cancer patients receiving uncapped doses of neoadjuvant anthracycline-taxane-based chemotherapy. Breast 33:153–158. doi:10.1016/j.breast.2017.04.001 Epub 2017 Apr 7
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Altundag, K. Dose adjustment in obese breast cancer patients receiving neoadjuvant chemotherapy might have an impact on survival. Breast Cancer Res Treat 167, 821 (2018). https://doi.org/10.1007/s10549-017-4544-6
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DOI: https://doi.org/10.1007/s10549-017-4544-6