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Introduction: The optimal time from surgery to commencing chemotherapy in early breast cancer (EBC) remains unclear. We assessed the influence of time to initiation of adjuvant chemotherapy (TTC) on the outcome of EBC patients enrolled onto a phase III clinical trial (NCT01031030). Methods: The relationship between TTC, calculated as the time (in weeks) from definitive surgery to initiation of adjuvant chemotherapy, and disease-free (DFS) or overall survival (OS) was assessed in 1066 EBC patients with rapidly proliferating tumors (thymidine labeling index > 3% or G3 or Ki67 > 20%), randomized to receive adjuvant chemotherapy with or without anthracyclines (epirubicin → CMF vs CMF → epirubicin vs CMF). DFS, OS and their 95% confidence intervals (95% CI) were calculated by the Kaplan-Meier method. Multivariate Cox analysis was performed in relation to nodal involvement, estrogen receptor and HER2 status, Ki67 value, type of adjuvant chemotherapy, menopausal status and tumor size. Results: Information on TTC was available for 713 women. At a median follow-up of 105 months (range 2-188), a prolonged TTC resulted in a significant increase of 16% in the risk of relapse (95% CI 1.03–1.30, p = 0.016) in a multivariable Cox regression model (Table 1). The impact on OS was not significant. Using a backward elimination procedure, TTC, tumor size and nodal involvement remained significantly associated with DFS (Hazard ratio [HR] = 1.15, 95% CI 1.02-1.29, p = 0.018; HR = 1.44, 95% CI 1.08-1.92, p = 0.012; HR = 1.44, 95% CI 1.08-1.92, p = 0.012, respectively). Again, nodal involvement and Ki67 were associated with OS (HR = 1.66, 95% CI 1.11-2.49, p = 0.014; HR = 1.63, 95% CI 1.03-2.59, p = 0.039, respectively). DFS OS HR (95% CI) p HR (95% CI) p TTC 1.16 (1.03–1.30) 0.016 1.14 (0.97–1.35) 0.121 Age 0.99 (0.97–1.02) 0.829 0.99 (0.96–1.03) 0.615 ER Positive 1.00 1.00 Negative 1.20 (0.89–1.61) 0.242 1.20 (0.78–1.84) 0.397 HER2 Positive 1.00 1.00 Negative 0.99 (0.73–1.33) 0.929 0.92 (0.60–1.42) 0.713 Lymph node status Negative 1.00 1.00 Positive 1.53 (1.14–2.04) 0.004 1.71 (1.13–2.59) 0.011 Menopausal status Premenopausal 1.00 1.00 Postmenopausal 1.32 (0.85–2.04) 0.219 1.56 (0.82–2.97) 0.177 Tumor size 1.00 1.00 ≥2 cm 1.41 (1.05–1.88) 0.020 1.44 (0.95–2.18) 0.085 Ki67 ≤20% 1.00 1.00 >20% 1.06 (0.77–1.44) 0.724 1.54 (0.96–2.48) 0.073 Treatment arm E»CMF 0.72 (0.49–1.04) 0.079 0.69 (0.41–1.16) 0.161 CMF»E 0.79 (0.55–1.14) 0.202 0.75 (0.45–1.25) 0.273 CMF 1.00 1.00 Conclusions: Our results suggest that patients with rapidly proliferating EBC should be treated as soon as possible once their recovery from surgery is complete. Disclosure: All authors have declared no conflicts of interest.

Aim: Although high body mass index (BMI) has been associated with advanced colorectal cancer (ACC) prognosis, this effect is not consistent across different studies. As bevacizumab is the backbone therapy of ACC and obesity is associated with increased serum levels of vascular endothelial growth factor (VEGF), the aim of this study was to evaluate the impact of BMI on prognosis in ACC patients enrolled onto a phase III randomized clinical (NCT01878422). Methods: The relationship between baseline BMI and progression-free (PFS) and overall survival (OS) was assessed in 376 patients randomized to receive FOLFOX4 or FOLFIRI with or without bevacizumab. BMI was defined as follows: normal Results: Information on BMI at baseline was available in 368 ACC patients. Of these, 198 (53.8%) showed normal weight, 133 (36.1%) were overweight and 37 (10.1%) were obese. At a median follow up of 36 months (range 1-65), median PFS was 8.9 months (95% CI 8.0-9.6), 8.9 months (95% CI 7.4-9.9) and 7.8 months (95% CI 4.7-9.7) in normal, overweight and obese patients, respectively (p 0.251). Median OS was 21.3 months (95% CI 18.4-23.6), 21.0 months (95% CI 17.5-25.4) and 21.7 months (95% CI 14.0-28.8), respectively (p 0.461). Of the 368 patients, 175 received first-line chemotherapy with bevacizumab and 193 underwent chemotherapy alone. No statistically significant differences in terms of mPFS or mOS were observed in the two arms with regard of BMI (see table). Conclusions: Chemotherapy + bevacizumab Chemotherapy BMI Category No. of patients No. of events Median PFS (95% CI) No. of patients No. of events Median PFS (95% CI) p 87 83 9.7 (8.1-11.3) 111 106 8.3 (7.0-9.0) 0.409 25-29.9 66 58 9.8 (7.4-13.1) 67 59 8.6 (6.3-9.5) 0.436 ≥30 22 21 7.8 (4.6-11.3) 15 14 6.5 (2.3-9.7) 0.843 p 0.261 0.681 BMI Category No. of patients No. of Events Median OS (95% CI) No. of patients No. of Events Median OS (95% CI) p 87 62 21.8 (16.3-27.4) 111 86 20.8 (18.4-23.5) 0.844 25-29.9 66 49 19.3 (12.7-24.8) 67 46 24.3 (18.2-29.1) 0.287 ≥30 22 20 20.5 (10.4-25.2) 15 11 24.9 (11.5-29.6) 0.265 p 0.230 0.612 BMI at baseline was not associated with the prognosis of ACC patients. Although adipose tissue may release angiogenic factors, obesity does not seem to be a predictive factor for response to a first-line bevacizumab- based therapy in ACC patients. Disclosure: All authors have declared no conflicts of interest.