Dose-Dense Chemotherapy Preferred for Node-Positive Breast Cancer Patients Regardless of BMI

The phase III GIM2 trial demonstrated that adjuvant dose-dense (DD) chemotherapy significantly improves disease-free survival (DFS) and overall survival (OS) compared to standard-interval (SI) chemotherapy in women with node-positive early-stage breast cancer (BC). This exploratory analysis aimed to assess the impact of body mass index (BMI) on the efficacy of these chemotherapy schedules.

Out of 2091 patients enrolled, 1925 with known baseline BMI were included in the analysis. The study found that 31.6% of the patients were overweight and 19.3% were obese. Overweight and obesity were significantly associated with postmenopausal status and larger tumor sizes (pT >2 and pN >2).

After a median follow-up of 15.0 years, the analysis showed no significant association between different BMI categories and DFS or OS outcomes. The survival benefit of DD chemotherapy was consistent across all BMI categories, with a more pronounced benefit observed in overweight and obese patients. The study concluded that in node-positive BC patients, the DD schedule should be the preferred treatment option, regardless of BMI.

This finding underscores the importance of considering DD chemotherapy as a standard treatment for node-positive breast cancer patients, highlighting its effectiveness across a diverse patient population.