Health
Diabetes threatens long-term survival of metastatic breast cancer
In patients with metastatic breast cancer, diabetes appeared to impair outcomes only among long-term survivors, the researchers reported.
In a retrospective study of patients with metastatic breast cancer, diabetes was not associated with increased mortality at a 5-year follow-up, according to Brigham’s YMMelody Cheung, MBBS (54% vs. without diabetes). 56%). Boston Women’s Hospital, and her colleagues.
The time to the next treatment for cancer was similar, with 56% of both groups attempting another treatment a year later, Cheung reported in Atlanta: Endo 2022The annual meeting of the Endocrine Society.
“These data provide reassurance that glycemic control may not be a major factor in the overall mortality or cancer progression of most individuals with metastatic breast cancer during the first 5 years. “Cheung explained at a press conference.
Subgroup analysis also showed that overall survival at 5 years was also between the group with good glycemic control (Hb A1c <7%) and the group with poor glycemic control (Hb A1c> 7%). It was shown that there was no difference. A total of 69% of these groups survived until the fifth year.
Similarly, 58% and 53%, or groups with good and poor glycemic control, tried different treatments by the first year, respectively.
However, when measured according to the random glycemic (RBG) test, at 5 years, decreased glycemic control tended to reduce survival.
- 55% with good glycemic control (median RBG ≤ 180 mg / dL)
- 48% of poor glycemic control (median RBG 180-200 mg / dL)
- Very poor glycemic control 23% (median RBG 200+ mg / dL)
The same trend emerged at the time of the next treatment, with 57%, 47%, and 27% of good, bad, and very bad glycemic control groups trying different treatments by the first year.
Interestingly, certain differences began to emerge among long-term survivors.
In a breakthrough analysis of patients with metastatic breast cancer who survived more than 8 years, diabetes was significantly associated with reduced survival. In the 10th year, 67% of diabetics survived, compared to 87% of diabetics (P= 0.047). Similarly, 83% of people with good glycemic control (RBG ≤ 180 mg / dL) achieved 10-year survival, whereas 63% of people with poor glycemic control (RBG> 180 mg / dL) survived 10 years. Achieved.
“Because the clinical effects of diabetes can only be felt over this long period of time, active management of glycemic control may be most relevant to patients with a better prognosis,” Cheung suggests. did.
“Therefore, patients with metastatic breast cancer need to consider individual diabetes goals and strategies that take into account the patient’s prognosis,” she added.
The analysis included 244 patients with diabetes and 244 in the control group and were displayed in the facility database of Brigham Hospital and Dana-Farber Cancer Institute. Case-control pairs were matched 1: 1 based on age, gender, and ethnicity.
The average age of participants was 57 years, 99.6% were female and 84% were Caucasian. The majority are HER2- / HR + metastatic breast cancer (62.5%), followed by triple-negative breast cancer (16.4%), HER2 + / HR + (11.7%), HER2 + / HR- (7.6%), and unknown. Receptor status (1.9%).
In terms of type of diabetes, half of diabetics were type 2 (49%), followed by unknown type (33%), drug-related (15%), and type 1 diabetes (1%). Median HbA1c was 6.6% and median RBG was 123 mg / dL in diabetic patients.
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Disclosure
This study was funded by Lily.
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