Obesity Increases Risk of MM Precursor, While Weight Loss Indicates Risk of Cancer Diagnosis

Weight can play an important factor in cancer, and 2 abstracts being presented at the American Association for Cancer Research Annual Meeting, which will be held April 8-13 in New Orleans, review the impact of obesity on a premalignant condition of multiple myeloma (MM) and of weight loss on the risk of cancer diagnosis.

The first abstract evaluated risk factors for monoclonal gammopathy of undetermined significance (MGUS), the precursor to MM using ultrasensitive mass spectrometry results captured in the PROMISE nationwide screening study.¹

A total of 1893 participants who were 40 years or younger, Black ,and/or have a first-degree relative with a blood cancer or MM precursor condition, as well as participants 18 years or older who had 2 or more first-degree relatives completed a survey about their metabolic comorbidities and lifestyle. They were also screened for monoclonal gammopathy. M-protein concentrations of ≥ 0.02 g/dL were considered MGUS, while M-proteins < 0.02 g/dL were monoclonal gammopathy of indeterminate potential (MGIP).

After adjusting for sex, age at screening, income, and education, researchers found:

• MGUS was detected in 13.4% of Black participants and MGIP in 22.0%
• MGUS was detected in 8.6% of participants with family history and MGIP in 26.7%
• Body mass index (BMI) of at least 30 was associated with MGUS vs BMI below 30
• Hypertension and diabetes were also associated with MGUS
• Sleeping ≤ 6 hours a day was associated with MGUS
• There were no risk factor associations for MGIP

High cholesterol, high triglycerides, heart disease, myocardial infarction, stroke, physical activity, smoking status, and alcohol consumption had no significant associations with MGUS.

“None of these exposures were associated with MGIP despite finding a high prevalence of MGIP in Blacks and individuals with family history, suggesting that these risk factors may not be etiologically involved in MGIP development but possibly its clonal expansion to more advanced stages,” the authors concluded.

The second abstract evaluated the association of weight loss with subsequent 2-year cancer diagnosis and found recent weight loss can predict elevated cancer diagnosis risk in certain cancers.² They undertook the study because although weight loss is common among patients with cancer, little is known about weight loss preceding cancer diagnosis.

The analysis used 2 large prospective cohorts: women from the Nurses’ Health Study (n = 111,891) and men from the Health Professional Follow-up Study (n = 45,498). The women’s study had enrolled participants in 1987 and the men’s study in 1988, and they were both followed through 2012. When they enrolled, participants did not have cancer and were 40 years or older.

The study documented 30,441 incident cancers during the follow-up. Compared with people who recorded no weight loss, those with a weight loss of 5% to 10% had a multivariable-adjusted HR for total cancer of 1.09 (95% CI, 1.04-1.13) and people with weight loss greater than 10% had a HR of 1.17 (95% CI, 1.10-1.24).

Weight loss was associated with a subsequent cancer diagnosis of esophagus, liver, pancreas, leukemia, stomach, myeloma, lung, colorectal, and non-Hodgkin lymphoma. Most weight loss occurred in the 2 years prior to cancer diagnosis and it increased as time to diagnosis drew closer, according to the 20-year trajectory of BMI.

References

1. Lee DJ, El-Khoury H, Alberge J-B, et al. Obesity, metabolic comorbidities, and lifestyle factors and their association with monoclonal gammopathies in a high-risk screened population: Results of the PROMISE study. Presented at: AACR Annual Meeting; April 8-10, 2022; New Orleans, Louisiana. Abstract 3651/1.

2. Wang Q-L, Babic A, Rosenthal MH, et al. Weight loss and subsequent cancer diagnosis: A prospective cohort study. Presented at: AACR Annual Meeting; April 8-10, 2022; New Orleans, Louisiana. Abstract 5934.