Body mass index and body weight change during adjuvant chemotherapy in colon cancer patients: results from the AVANT trial

Dae-Won Lee,Sooyoung Cho,Aesun Shin,Tae-You Kim,Sae-Won Han

doi:10.1038/s41598-020-76643-9

Dae-Won Lee, Sooyoung Cho + Show 3 more

Open Access

https://doi.org/10.1038/s41598-020-76643-9

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Abstract

While obesity increases colorectal cancer incidence, there are inconsistent results in the prognostic role of obesity or body weight change on survival. This study investigated the prognostic impact of body weight and weight change in stage III or high risk stage II colon cancer patients. We used data from patients enrolled in the phase III AVANT trial. The AVANT trial investigated the efficacy of adding bevacizumab to standard adjuvant chemotherapy (FOFOX or XELOX). Weight change during the first 6 months of adjuvant chemotherapy was measured. Cox proportional hazard model was used to assess the prognostic influence of body weight and weight change. Among 3451 intention-to-treat population, body weight and weight change was measured in 3449 (99.9%) and 2455 (71.1%) patients, respectively. Among 2455 patients, 651 (26.5%) had weight gain over 5 kg and 179 (7.3%) had weight loss over 5 kg. Weight gain was more frequently observed in Asian and male. Neither baseline BMI nor weight change affected recurrence or survival in the Cox proportional hazard model.

Highlights

Development of colorectal cancer is a heterogeneous process affected by hereditary factor, diet, and gut microbiome[1,2]
We examined the prognostic role of body weight and weight change in patients who participated in a phase III AVANT trial
Baseline characteristics and survival outcome according to baseline Body mass index (BMI)

Summary

Introduction

Development of colorectal cancer is a heterogeneous process affected by hereditary factor, diet, and gut microbiome[1,2]. 35% of United States adults are obese and obesity prevalence is increasing in many developing countries that adopt Western lifestyle[5,6] These findings may partially attribute to the increase of colorectal cancer incidence in developing c ountries[7,8]. Obesity may have negative prognostic role in colorectal cancer patients treated with adjuvant c hemotherapy[12,13]. Negative prognostic role of obesity was shown in men but not in women in the Adjuvant Colon Cancer Endpoints database, which 25,291 colon cancer patients were a nalyzed[12]. Only few studies have evaluated the association between body weight change and colorectal cancer outcome. We examined the prognostic role of body weight and weight change in patients who participated in a phase III AVANT trial. AVANT trial investigated adding bevacizumab with either 5-fluorouracil/ leucovorin/oxaliplatin (FOLFOX) or capecitabine/oxaliplatin (XELOX) in curatively resected stage III or highrisk stage II colon cancer patients[18]

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