ONCOmmunity

Impact of obesity on chemotherapy dosing of carboplatin and survival of women with ovarian cancer.

By: Alexandra L Martin, Christelle M Colin-Leitzinger, Sweta K Sinha, Jing-Yi Chern, Lauren C Peres

H. Lee Moffitt Cancer Center and Research Institute, Department of Gynecologic Oncology, 12902 Magnolia Dr, Tampa, FL, 33612, USA.
2022-11-7; doi: 10.1038/s41416-023-02259-1

Abstract

Background

The study objective is to examine the impact of obesity on frontline carboplatin dosing in the neoadjuvant and adjuvant settings and to evaluate the association of dosing with survival among epithelial ovarian cancer (EOC) patients.

Methods

We selected 1527 women diagnosed with EOC from January 1, 2011 to October 20, 2021 from a nationwide electronic health record-derived de-identified database. The dose reduction of frontline carboplatin was defined as a relative dose intensity (RDI) < 0.85. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of RDI with survival overall and by histology.

Results

Women with a BMI ≥ 30 kg/m² versus <30 kg/m² were more likely to be underdosed (RDI < 0.85) with frontline carboplatin. Underdosing of carboplatin in the neoadjuvant setting was associated with worse survival among women with serous tumours (HR = 1.98, 95% CI = 1.15, 3.42). Underdosing of carboplatin in the adjuvant setting was not associated with survival.

Discussion

In the real-world setting, underdosing of carboplatin in the neoadjuvant setting was associated with inferior survival among women with serous tumours. With the increasing utilisation of neoadjuvant chemotherapy in EOC, actual weight-based dosing of carboplatin may be important to improve outcomes in this patient population.