Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data

Abstract Obesity is a known risk factor for poor breast cancer outcomes, but its impact on endocrine therapy efficacy remains unclear. While the ATAC trial suggests reduced effectiveness of aromatase inhibitors (AIs) in women with obesity, the BIG 1–98 trial found no significant differences. Clinica...

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Main Authors: Sixten Harborg, Signe Borgquist
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Oncology
Online Access:https://doi.org/10.1007/s12672-025-02857-w
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author Sixten Harborg
Signe Borgquist
author_facet Sixten Harborg
Signe Borgquist
author_sort Sixten Harborg
collection DOAJ
description Abstract Obesity is a known risk factor for poor breast cancer outcomes, but its impact on endocrine therapy efficacy remains unclear. While the ATAC trial suggests reduced effectiveness of aromatase inhibitors (AIs) in women with obesity, the BIG 1–98 trial found no significant differences. Clinical and biological evidence indicates that obesity may impair AI efficacy by increasing aromatase activity and altering drug metabolism, whereas tamoxifen remains largely unaffected. Pooling data from these trials would enable detailed analyses across body composition categories, addressing discrepancies and potentially guide personalized treatment strategies. Understanding the interaction between obesity and endocrine therapy is crucial for optimizing breast cancer care.
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spelling doaj-art-d3f6f915f874402abd8a18fd0b1afdc72025-08-20T03:45:31ZengSpringerDiscover Oncology2730-60112025-07-011611510.1007/s12672-025-02857-wUnderstanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial dataSixten Harborg0Signe Borgquist1Department of Oncology, Aarhus University, Aarhus University HospitalDepartment of Oncology, Aarhus University, Aarhus University HospitalAbstract Obesity is a known risk factor for poor breast cancer outcomes, but its impact on endocrine therapy efficacy remains unclear. While the ATAC trial suggests reduced effectiveness of aromatase inhibitors (AIs) in women with obesity, the BIG 1–98 trial found no significant differences. Clinical and biological evidence indicates that obesity may impair AI efficacy by increasing aromatase activity and altering drug metabolism, whereas tamoxifen remains largely unaffected. Pooling data from these trials would enable detailed analyses across body composition categories, addressing discrepancies and potentially guide personalized treatment strategies. Understanding the interaction between obesity and endocrine therapy is crucial for optimizing breast cancer care.https://doi.org/10.1007/s12672-025-02857-w
spellingShingle Sixten Harborg
Signe Borgquist
Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data
Discover Oncology
title Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data
title_full Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data
title_fullStr Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data
title_full_unstemmed Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data
title_short Understanding the role of obesity in endocrine therapy for postmenopausal breast cancer: significance of the BIG 1–98 and ATAC trial data
title_sort understanding the role of obesity in endocrine therapy for postmenopausal breast cancer significance of the big 1 98 and atac trial data
url https://doi.org/10.1007/s12672-025-02857-w
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