Key result
High subcutaneous adipose tissue area increased the likelihood of trastuzumab deruxtecan dose reductions compared to low subcutaneous adipose tissue area.
Why the study?
Skeletal muscle loss and high adiposity are linked to poorer cancer prognosis, but how body composition affects trastuzumab deruxtecan efficacy was unclarified.
Do body composition metrics (high SAT, VAT, and BMI) predict trastuzumab deruxtecan related toxicity and dose reductions in women with metastatic breast cancer?
Cohort (n=48)
No
Do body composition metrics (high SAT, VAT, and BMI) predict trastuzumab deruxtecan related toxicity and dose reductions in women with metastatic breast cancer?
Answers are grounded in this paper and cite their sources.
High adiposity, indicated by elevated subcutaneous and visceral adipose tissue areas and BMI >25, is significantly associated with increased toxicity and dose reductions of trastuzumab deruxtecan in women with metastatic breast cancer.
Body composition is an important predictor in cancer patients, with skeletal muscle loss and high adiposity associated with poorer prognosis. This study evaluated how body composition affects treatment efficacy in 48 women with metastatic breast cancer receiving trastuzumab deruxtecan. Using computed tomography, skeletal muscle, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were assessed within 60 days before initiating treatment. High SAT and VAT areas were significantly associated with a higher likelihood of dose reductions (Odds Ratio [OR] = 5.34, p = .032 and OR = 5.52, p = 0.032, respectively). Higher SAT areas correlated with a lower objective response rate (OR = 0.22, p = 0.047). Medium SAT and low/medium VAT densities increased the risk of dose reductions. A body mass index over 25 kg/m 2 was linked to higher dose reductions (OR = 4.97, p = 0.016). These findings emphasize the need for personalized treatment strategies based on body composition.
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Kessner et al. (2025) conducted a cohort in HER2-positive or HER2-low metastatic breast cancer (n=48). High subcutaneous adipose tissue (SAT) area vs. Low SAT area was evaluated on Dose reduction of trastuzumab deruxtecan (OR 5.34, 95% CI 1.15-24.39, p=0.032). High subcutaneous adipose tissue area increased the likelihood of trastuzumab deruxtecan dose reductions compared to low subcutaneous adipose tissue area.
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