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William J. Gradishar, MD, FACP, FASCO

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Do Diabetes and Glycemic Control Impact Outcomes in Patients With Metastatic Breast Cancer?

By: Julia Fiederlein
Posted: Friday, June 17, 2022

According to Y.M. Melody Cheung, MD, of Harvard Medical School, Boston, and colleagues, in most patients with metastatic breast cancer, hyperglycemia may not be a major contributor to overall mortality in the first 5 years; however, in longer-term survivors, diabetes was found to be associated with worse survival outcomes. These findings, which were presented in poster format during the 2022 Endocrine Society Annual Meeting (ENDO 2022; Abstract PSUN185), highlighted the need to consider individualized diabetes and glycemic goals in clinical practice.

Using the Metastatic Breast Cancer Database, the investigators identified patients with metastatic breast cancer from a single academic center. The Research Patient Data Registry was subsequently used to determine the diabetes status of each patient. A total of 244 individuals had diabetes, and 244 individuals served as age-, sex-, ethnicity-, and hormone receptor status–matched controls.

Overall survival at 5 years (those with diabetes: 54%; controls: 56%; P = .65) and freedom from initiating a second-line regimen at 2 years (those with diabetes: 43%; controls: 44%; P = .33) did not seem to statistically differ between the groups. However, in an 8-year landmark subgroup analysis, the rate of overall survival was improved in the control group versus the group with diabetes (87% vs. 67%, respectively; P = .047 at 10 years).

Poor glycemic control did not seem to be associated with increased mortality at 5 years; however, when compared with good glycemic control, it was found to be associated with a trend toward worse freedom from initiating a second-line regimen at 2 years. In a subgroup analysis based on hormone receptor status, neither overall survival at 5 years nor freedom from initiating a second-line regimen at 2 years seemed to differ between the two glycemic groups (≤ 180 mg/dL vs. > 180 mg/dL on at least two occasions in a month) in any of the hormone receptor subgroups.

Disclosure: For full disclosures of study authors, visit endo2022.endocrine.org.


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