%0 Journal Article %T Obesity As a Risk Factor for Anthracyclines and Trastuzumab Cardiotoxicity in Breast Cancer: A Systematic Review and Meta-Analysis %+ CHU Dijon %+ Lipides - Nutrition - Cancer (U866) (LNC) %+ Centre Hospitalier Universitaire de Reims (CHU Reims) %+ European Institute of Oncology [Milan] (ESMO) %+ Memorial Sloane Kettering Cancer Center [New York] %+ Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL) %A Guenancia, Charles %A Lefebvre, Annick %A Cardinale, Daniela %A Yu, Anthony, F. %A Ladoire, Sylvain %A Ghiringhelli, François %A Zeller, Marianne %A Rochette, Luc %A Cottin, Yves %A Vergely, Catherine %< avec comité de lecture %@ 0732-183X %J Journal of Clinical Oncology %I American Society of Clinical Oncology %V 34 %N 26 %P 3157 - 3165 %8 2016-09-10 %D 2016 %R 10.1200/JCO.2016.67.4846 %M 27458291 %K Body-Mass Index %K Doxorubicin-Induced Cardiotoxicity %K Adjuvant Study-Group %K Cardiac Dysfunction %K Clinical-Trials %K Cardiovascular-Disease %K Heart-Failure %K Chemotherapy %K Therapy %K Population %Z Life Sciences [q-bio]/CancerJournal articles %X PurposePatients with metabolic syndrome have a greater risk of cardiovascular disease, although their susceptibility to chemotherapy-induced cardiac disease is not well documented. The aim of this meta-analysis was to assess associations between obesity or being overweight and cardiotoxicity from anthracyclines and sequential anthracyclines and trastuzumab in patients with breast cancer.MethodsWe performed a random-effects analysis and a network meta-analysis and assessed publication bias. We included 15 studies and 8,745 patients with breast cancers who were treated with anthracyclines and sequential anthracyclines and trastuzumab.ResultsCombination of obesity and being overweight was significantly associated with a greater risk of developing cardiotoxicity after anthracyclines and a sequential anthracyclines and trastuzumab regimen in patients with breast cancer. Pooled odds ratio for cardiotoxicity was 1.38 (95% CI, 1.06 to 1.80; I-2 = 43%; N = 8,745) for overweight or obesity (body mass index. 25 kg/m(2)), 1.47 (95% CI, 0.95 to 2.28; I-2 = 47%; n = 2,615) for obesity, and 1.15 (95% CI, 0.83 to 1.58; I-2 = 27%; n = 2,708) for overweight. Associations were independent of study design, year of publication, drug regimen (anthracyclines alone v sequential anthracyclines and trastuzumab), or definitions of cardiotoxicity and of overweight or obesity. There was no evidence of publication bias; however, we could not separate the contributions of obesity-related cardiovascular risk factors, such as diabetes and hypertension, from that of obesity itself in this largely unadjusted analysis.ConclusionOur findings in a largely unadjusted analysis suggest that overweight and obesity are risk factors for cardiotoxicity from anthracyclines and sequential anthracyclines and trastuzumab. %G English %L hal-01413012 %U https://u-bourgogne.hal.science/hal-01413012 %~ UNIV-BOURGOGNE %~ FNCLCC %~ CGFL %~ LNC-UMR866 %~ AGREENIUM %~ AGROSUP-DIJON %~ ENSBANA