Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials

Thomas T. Aparicio (1, 2) , Michel Ducreux (3, 4) , Roger Faroux (5) , Emilie Barbier (6, 7) , Sylvain Manfredi (8, 7, 9) , Thierry Lecomte (10) , Pierre-Luc Etienne (11) , Laurent Bedenne (9, 8, 7) , Jaafar Bennouna (12) , Jean-Marc Phélip (13, 14) , Eric François (15) , Pierre Michel (16) , Jean-Louis Legoux (17) , Mohamed Gasmi (18) , Gilles Breysacher (19) , Philippe Rougier (20) , Aimery de Gramont (21) , Come Lepage (8, 7, 9) , Olivier Bouché (22) , Jean-François Seitz (23) , Antoine Adenis , A Alessio , A Aouakli , A Azzedine , A Bedjaoui , A Bidault , A Blanchi , A Botton , A Cadier-Lagnes , A Fatisse , A Gagnaire , A Gilbert , A Gueye , A Hollebecque , A Lemaire , A Mahamat , A Marre , A Patenotte , A Rotenberg , A Roussel , A Thirot-Bidault , A Votte , A Weber , A Zaanan , Ac Dupont-Gossart , Al Villing , Am Queuniet , B Coudert , B Denis , B Garcia , B Lafforgue , B Landi , B Leduc , B Linot , B Paillot , B Rhein , B Winkfield , C Barberis , C Becht , C Belletier , C. Berger , C Bineau , C Borel , C Brezault , C Buffet , C Cornila , C Couffon , C de La Fouchardière , C Giraud , C Lecaille , C Lepere , C Lobry , C Locher , C Lombard-Bohas , C Paoletti , C Platini , C Rebischung , C Sarda , C Vilain , C Briac-Levaché , D Auby , D Baudet-Klepping , D Bechade , D Besson , D Cleau , D Festin , D Gargot , D Genet , D Goldfain , D Luet , D Malka , D Peré-Vergé , D Pillon , D Sevin-Robiche , D Smith , D Soubrane , D Tougeron , D Zylberait , E Carola , E Cuillerier , E Dorval Danquechin , E Echinard , E Janssen , E Maillard , E Mitry , E Norguet-Monnereau , E Suc , E Terrebonne , E Zrihen , Ea Pariente , F Almaric , F Audemar , F Bonnetain , F Desseigne , F Dewaele , F Di Fiore , F Ghiringhelli , F Husseini , F Khemissa , F Kikolski , F Morvan , F Petit-Laurent , F Riot , F Subtil , F Zerouala-Boussaha , Fx Caroli-Bosc , G Boilleau-Jolimoy , G Bordes , G Cavaglione , G Coulanjon , G Deplanque , G Gatineau-Saillant , G Goujon , G Medinger , G Roquin , H Brixi-Benmansour , H Castanie , H Lacroix , H Maechel , H Perrier , H Salloum , H Senellart , I Baumgaertner , I Cumin , I Graber , I Trouilloud , J Boutin , J Butel , J Charneau , J Cretin , J Dauba , J Deguiral , J Egreteau , J Ezenfis , J Forestier , J Goineau , J Lacourt , J Lafon , J Martin , J Meunier , J Moreau , J Provencal , J Taieb , J Thaury , J Tuaillon , J Vergniol , J Villand , J Vincent , J Volet , Jb Bachet , Jc Barbare , Jc Souquet , Jd Grangé , Jf Dor , Jf Paitel , Jl Jouve , Jl Raoul , Jm Cheula , Jm Gornet , Jm Sabate , Jm Vantelon , Jn Vaillant , Jp Aucouturier , Jp Barbieux , Jp Herr , Jp Lafargue , Jp Lagasse , Jp Latrive , Jp Plachot , Jp Ramain , Jp Robin , Jp Spano , Jy Douillard , K Beerblock , K Bouhier-Leporrier , K Slimane Fawzi , L Cany , L Chone , L Dahan , L Gasnault , L Rob , L Wander , M Baconnier , M Ben Abdelghani , M Benchalal , M Blasquez , M Carreiro , M Charbit , M Combe , M Duluc , M Fayolle , M Gignoux , M Giovannini , M Glikmanas , M Mabro , M Mignot , M Mornet , M Mousseau , M Mozer , M Pauwels , M Pelletier , M Porneuf , M Ramdani , M Schnee , M Tissot , M Zawadi , Mc Clavero-Fabri , Mc Gouttebel , Mc Kaminsky , Mp Galais , N Abdelli , N Barrière , N Bouaria , N Bouarioua , N Delas , N Gérardin , N Hess-Laurens , N Stremsdoerfer , O Berthelet , O Boulat , O Capitain , O Favre , P Amoyal , P Bergerault , P Burtin , P Cassan , P Chatrenet , P Chiappa , P Claudé , P Couzigou , P Feydy , P Follana , P Geoffroy , P Godeau , P Hammel , P Laplaige , P Lehair , P Martin , P Novello , P Pantioni , P Pienkowski , P Pouderoux , P Prost , P Ruszniewski , P Souillac , P Texereau , P Thévenet , Pa Haineaux , R Benoit , R Coriat , R Lamy , R Mackiewicz , S Beorchia , S Chaussade , S Hiret , S Jacquot , S Lavau Denes , S Montembault , S Nahon , S Nasca , Son Nguyen , S Oddou-Lagraniere , S Pesque-Penaud , Sp Fratte , T Chatellier , T Mansourbakht , T Morin , T Walter , V Boige , V Bourgeois , V Derias , V Guérin-Meyer , V Hautefeuille , V Jestin Le Tallec , V Lorgis , V Quentin , V Sebbagh , V Veuillez , X Adhoute , X Coulaud , Y Becouarn , Y Coscas , Y Courouble , Y Le Bricquir , Y Molin , Y Rinaldi , Yh Lam , Z. Ladhib

1 Service d'hépato-gastro-entérologie [Hôpital Saint-Louis]
2 USPC - Université Sorbonne Paris Cité
3 Université Paris-Saclay
4 Oncologie digestive
5 Service de gastroentérologie (CHD Vendee - Hopital Les Oudairies, La Roche Sur Yon)
6 Fédération Francophone de la Cancérologie Digestive, FFCD
7 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
8 UBFC - Université Bourgogne Franche-Comté [COMUE]
9 Service d'Hépato-Gastro-Entérologie (CHU de Dijon)
10 Département d'Hépato-Gastroentérologie [Hôpital Trousseau, Tours]
11 HPCA - Hôpital Privé des Côtes d'Armor
12 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
13 Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne]
14 Institut de Cancérologie de la Loire [Saint-Priest en Jarez]
15 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
16 Service d'Hépato-Gastroentérologie [CHU Rouen]
17 Service d'hépato-gastro-entérologie et oncologie digestive [CHR Orléans]
18 Service De Gastroenterologie, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille
19 CH Colmar - Hôpital Louis Pasteur [Colmar]
20 Département d'hépato-gastro-entérologie [CHU Nantes]
21 Service d'oncologie [Institut Hospitalier Franco-Britannique : Levallois-Perret]
22 Hôpital universitaire Robert Debré [Reims]
23 Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM]

BACKGROUND: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI was associated with worse prognosis in metastatic CRC (mCRC). We aimed to assess efficacy outcomes according to BMI. PATIENTS AND METHODS: A pooled analysis of individual data from 2085 patients enrolled in eight FFCD first-line mCRC trials from 1991 to 2013 was performed. Comparisons were made according to the BMI cut-off: Obese (BMI ≥30), overweight patients (BMI ≥ 25), normal BMI patients (BMI: 18.5-24) and thin patients (BMI <18.5). Interaction tests were performed between BMI effect and sex, age and the addition of antiangiogenics to chemotherapy. RESULTS: The rate of BMI ≥25 patients was 41.5%, ranging from 37.6% (1991-1999 period) to 41.5% (2000-2006 period) and 44.8% (2007-2013 period). Comparison of overweight patients versus normal BMI range patients revealed a significant improvement of median overall survival (OS) (18.5 versus 16.3 months, HR = 0.88 [0.80-0.98] p = 0.02) and objective response rate (ORR) (42% versus 36% OR = 1.23 [1.01-1.50] p = 0.04) but a comparable median progression-free survival (PFS) (7.8 versus 7.2 months, HR = 0.96 [0.87-1.05] p = 0.35). Subgroup analyses revealed that overweight was significantly associated with better OS in men. OS and PFS were significantly shorter in thin patients. CONCLUSION: Overweight patients had a prolonged OS compared with normal weight patients with mCRC. The association of overweight with better OS was only observed in men. The pejorative prognosis of BMI <18.5 was confirmed. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved

Mots clés: Overweight; Pooled analysis; Prognostic factor; Colorectal cancer; Bevacizumab

Domaines: Cancer; Hépatologie et Gastroentérologie

Thomas T. Aparicio, Michel Ducreux, Roger Faroux, Emilie Barbier, Sylvain Manfredi, et al.. Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials. European Journal of Cancer, 2018, 98, pp.1-9. ⟨10.1016/j.ejca.2018.03.031⟩. ⟨hal-01983308⟩