Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2018 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
The impact of body composition on vertebral fractures during aromatase inhibitors therapy: A cross-sectional study.
2018 ASCO Annual Meeting
J Clin Oncol 36, 2018 (suppl; abstr e12504)
Author(s): Rebecca Pedersini, Sara Monteverdi, Filippo Maffezzoni, Antonella Turla, Lucia Vassalli, Melanie Claps, Filippo Rodella, Vito Amoroso, Elisa Roca, Gherardo Mazziotti, Roberto Maroldi, Andrea Giustina, Alfredo Berruti, Edda Simoncini; Breast Unit-Oncology, Spedali Civili Hospital, Ghedi, Italy; Spedali Civili, Brescia, Italy; Endocrinologia, spedali civili, Brescia, Brescia, Italy; Oncology department, Brescia, Italy; Breast Unit- Oncology, Spedali Civili di Brescia, Brescia, Italy; Oncologia, Spedali Civili, Brescia, Italy; Spedali Civili di Brescia, Brescia, Italy; Oncology department, spedali civili hospital, Brescia, Italy; Endocrinology, Carlo Poma hospital, Mantova, Italy; University of Brescia, Brescia, Italy; Medical Oncology, University of Brescia, Spedali Civili Hospital, Brescia, Italy; AZ. OSPEDALIERA SPEDALI CIVILI, Brescia, Italy
Background: Aromatase-inhibitors (AIs) decrease the bone mineral density (BMD) and increase the risk of clinical fractures but the mechanism underlying the increased fracture risk (FR) is not fully elucidated. In healthy post menopausal women obesity is associated with lower FR due the protective effect of elevated estrogen levels. However this mechanism cannot be extended to AI treated pts since estrogens are deeply inhibited. We designed a cross sectional study to explore the effect of Fat body mass (FBM) on the risk of morphometric vertebral fracture (VF) in postmenopausal estrogen receptor positive breast carcinoma (BC) submitted to adjuvant AI therapy. Methods: From October 2013 to May 2017 315 EBC patients (pts) were recruited. All pts underwent a dual-energy X-ray absorptiometry (DXA) for the assessment of BMD, morphometric evaluation of VFs and body composition at baseline and after at least one year of AI therapy. Results: 187 pts were AI naive and 128 AI treated, and the prevalence of VFs was 21,9% and 31.2%, respectively. VFs in AI naïve pts were associated with older age (68 vs 62 years, p = 0.000) and lower BMD values at femoral neck (0.656 vs 0.698 gr/cm2, p = 0.02). Conversely, they were associated with higher Body Mass Index (27.26 vs 24.97, p = 0,046) and Fat Body Mass (29296.6 vs 23605.6 g, p = 0,022) in AI-treated patients. Conclusions: A high prevalence of radiological VFs was detected in EBC pts on AIs. Contrary to expectation VFs were associated with BMI and FBM but not with BMD. These data suggest a major contribution of altered bone quality in the fracture risk in AI treated pts. Data on trabecular bone score (a parameter of bone quality) TBS will be available at the meeting
1. TAILORx: Phase III trial of chemoendocrine therapy versus endocrine therapy alone in hormone receptor-positive, HER2-negative, node-negative breast cancer and an intermediate prognosis 21-gene recurrence score.