Hojouj M. The rationale for the effectiveness of systemic treatment of breast cancer depending on the body weight index

The thesis is devoted to the solution of the actual oncology problem – increasing the results of neoadjuvant systemic antitumor therapy in patients with breast cancer and body mass index greater than 30 kg/m2, due to the theoretically and clinically grounded application of levocarnitine in combination with NSAT for the correction of metabolic disorders as the main pathogenetic link of obesity. The study is based on a study of the results of treatment of 108 patients with breast cancer and a BMI> 30 kg/m2, who underwent standard neoadjuvant systemic antitumor therapy (comparison group, n = 58) or standard neoadjuvant antitumor therapy with the appointment of levocarnitine (observation group, n = 50) in 2010 – 2018. It was established that the use of levocarnitine in patients with breast cancer with a BMI> 30kg/m2, in conjunction with preoperative systemic antitumor therapy, compared with patients with a BMI> 30 kg/m2 who received standard neoadjuvant drug treatment, increases the incidence of clinically complete tumor regression by 12.8% (p <0,05) and partial regression by 13.1% (p <0,05) and the number of patients with complete morphological regression of the tumor (V degree of therapeutic pathomorphism) by 77.8% (p <0,05). It was proved that taking levocarnitine during NSAT leads to a decrease in the incidence of breast cancer progression on the background of cytostatic treatment by 15,5% (p <0,05) and to an increase in the number of clinically significant responses to treatment (complete regression + partial regression) by 25, 9% (р <0,05) and, as a consequence, to an increase in the frequency of performance of functionally justified organ-preserving operations by 53,8% (р <0,05) in patients of the observation group. The administration of Levocarnitine in neoadjuvant regimen in patients with breast cancer with a BMI> 30 kg/m2 (with observation 18,1 ± 1,5 months), does not affect the parameters of total and disease-free survival (p> 0,05).