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Obesity and Cancer—Opportunities to Break the Link

  • Translational Research (T King and E Mittendorf, Section Editors)
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Abstract

Obesity is a major global health problem with a rising worldwide burden. In addition to its association with several diseases, obesity is associated with increased incidence and worse prognosis for many malignances. Many possible mechanisms that contribute to the obesity-cancer link have been proposed, but key pathways likely include steroid hormone signaling, altered gut microbiota, insulin and insulin growth factor interactions, levels of circulating adipokines, and local and systemic inflammation. By understanding these mechanisms and their interactions, we may be able to intervene to improve the public health burden imposed by obesity. Equally critical to the development of targeted intervention strategies is the identification of accurate biomarkers to better detect populations that are more or less likely to benefit from specific interventions.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Shah NR, Braverman ER. Measuring adiposity in patients: the utility of body mass index (BMI), percent body fat, and leptin. PLoS One. 2012;7(4), e33308. doi:10.1371/journal.pone.0033308.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377(9765):557–67. doi:10.1016/S0140-6736(10)62037-5.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81. doi:10.1016/S0140-6736(14)60460-8.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Stevens GA, Singh GM, Lu Y, Danaei G, Lin JK, Finucane MM, et al. National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metrics. 2012;10(1):22. doi:10.1186/1478-7954-10-22.

    Article  Google Scholar 

  5. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91. doi:10.1038/nrc1408.

    Article  CAS  PubMed  Google Scholar 

  6. van Kruijsdijk RC, van der Wall E, Visseren FL. Obesity and cancer: the role of dysfunctional adipose tissue. Cancer Epidemiology, Biomarkers Prev : Publ Am Assoc Cancer Res, Cosponsored Am Soc Prev Oncol. 2009;18(10):2569–78. doi:10.1158/1055-9965.EPI-09-0372.

    Article  CAS  Google Scholar 

  7. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78. doi:10.1016/S0140-6736(08)60269-X.

    Article  PubMed  Google Scholar 

  8. Beason T, Colditz G. Obesity and Multiple Myeloma. In: Mittelman SD, Berger NA, editors. Energy Balance and Hematologic Malignancies. 1st ed. Energy Balance and Cancer, vol 5: Springer US; 2012. p. 71–95.

  9. Terras LR, Patel AV. The Epidemiology of Obesity and Hematologic Malignancies. In: Mittelman SD, Berger NA, editors. Energy Balance and Hematologic Malignancies. 1st ed. Energy Balance and Cancer, vol 5: Springer US; 2012. p. 1–30.

  10. Li CI, Daling JR, Porter PL, Tang MT, Malone KE. Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor-positive invasive breast cancer. J Clin Oncol : Off J Am Soc Clin Oncol. 2009;27(32):5312–8. doi:10.1200/JCO.2009.23.1597.

    Article  Google Scholar 

  11. Li D, Morris JS, Liu J, Hassan MM, Day RS, Bondy ML, et al. Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA. 2009;301(24):2553–62. doi:10.1001/jama.2009.886.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Park JS, Choi GS, Jang YS, Jun SH, Kang H. Influence of obesity on the serum carcinoembryonic antigen value in patients with colorectal cancer. Cancer Epidemiology, Biomarkers Prev : Publ Am Assoc Cancer Res, Cosponsored Am Soc Prev Oncol. 2010;19(10):2461–8. doi:10.1158/1055-9965.EPI-10-0569.

    Article  CAS  Google Scholar 

  13. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38. doi:10.1056/NEJMoa021423.

    Article  PubMed  Google Scholar 

  14. Iyengar NM, Hudis CA, Dannenberg AJ. Obesity and inflammation: new insights into breast cancer development and progression. American Society of Clinical Oncology educational book / ASCO American Society of Clinical Oncology Meeting. 2013:46–51. doi:10.1200/EdBook_AM.2013.33.46.

  15. Yoon HH, Lewis MA, Shi Q, Khan M, Cassivi SD, Diasio RB, et al. Prognostic impact of body mass index stratified by smoking status in patients with esophageal adenocarcinoma. J Clin Oncol : Off J Am Soc Clin Oncol. 2011;29(34):4561–7. doi:10.1200/JCO.2011.37.1260.

    Article  Google Scholar 

  16. National Cancer Institute. 2012. Obesity and cancer risk. http://www.cancer.gov/cancertopics/causes-prevention/risk/weight-activity/obesity-fact-sheet. Accessed 01 Sept 2015.

  17. Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C, et al. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst. 2003;95(16):1218–26.

    Article  CAS  PubMed  Google Scholar 

  18. Kaaks R, Rinaldi S, Key TJ, Berrino F, Peeters PH, Biessy C, et al. Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer. 2005;12(4):1071–82. doi:10.1677/erc.1.01038.

    Article  CAS  PubMed  Google Scholar 

  19. Travis RC, Key TJ. Oestrogen exposure and breast cancer risk. Breast Cancer Res : BCR. 2003;5(5):239–47. doi:10.1186/bcr628.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Yager JD, Davidson NE. Estrogen carcinogenesis in breast cancer. N Engl J Med. 2006;354(3):270–82. doi:10.1056/NEJMra050776.

    Article  CAS  PubMed  Google Scholar 

  21. Pequeux C, Raymond-Letron I, Blacher S, Boudou F, Adlanmerini M, Fouque MJ, et al. Stromal estrogen receptor-alpha promotes tumor growth by normalizing an increased angiogenesis. Cancer Res. 2012;72(12):3010–9. doi:10.1158/0008-5472.CAN-11-3768.

    Article  CAS  PubMed  Google Scholar 

  22. Cleary MP, Grossmann ME. Minireview: obesity and breast cancer: the estrogen connection. Endocrinology. 2009;150(6):2537–42. doi:10.1210/en.2009-0070.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. McTiernan A, Wu L, Chen C, Chlebowski R, Mossavar-Rahmani Y, Modugno F, et al. Relation of BMI and physical activity to sex hormones in postmenopausal women. Obesity. 2006;14(9):1662–77. doi:10.1038/oby.2006.191.

    Article  CAS  PubMed  Google Scholar 

  24. Bezemer ID, Rinaldi S, Dossus L, Gils CH, Peeters PH, Noord PA, et al. C-peptide, IGF-I, sex-steroid hormones and adiposity: a cross-sectional study in healthy women within the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control. 2005;16(5):561–72. doi:10.1007/s10552-004-7472-9.

    Article  PubMed  Google Scholar 

  25. Lukanova A, Lundin E, Zeleniuch-Jacquotte A, Muti P, Mure A, Rinaldi S, et al. Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women. Eur J Endocrinol / Eur Fed Endocr Soc. 2004;150(2):161–71.

    Article  CAS  Google Scholar 

  26. Madigan MP, Troisi R, Potischman N, Dorgan JF, Brinton LA, Hoover RN. Serum hormone levels in relation to reproductive and lifestyle factors in postmenopausal women (United States). Cancer Causes Control. 1998;9(2):199–207.

    Article  CAS  PubMed  Google Scholar 

  27. Hankinson SE, Willett WC, Manson JE, Hunter DJ, Colditz GA, Stampfer MJ, et al. Alcohol, height, and adiposity in relation to estrogen and prolactin levels in postmenopausal women. J Natl Cancer Inst. 1995;87(17):1297–302.

    Article  CAS  PubMed  Google Scholar 

  28. Cauley JA, Gutai JP, Kuller LH, LeDonne D, Powell JG. The epidemiology of serum sex hormones in postmenopausal women. Am J Epidemiol. 1989;129(6):1120–31.

    CAS  PubMed  Google Scholar 

  29. Li CI, Daling JR, Malone KE. Incidence of invasive breast cancer by hormone receptor status from 1992 to 1998. J Clin Oncol : Off J Am Soc Clin Oncol. 2003;21(1):28–34.

    Article  CAS  Google Scholar 

  30. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA: Cancer J Clin. 2012;62(1):10–29. doi:10.3322/caac.20138.

    Google Scholar 

  31. Subbaramaiah K, Howe LR, Bhardwaj P, Du B, Gravaghi C, Yantiss RK, et al. Obesity is associated with inflammation and elevated aromatase expression in the mouse mammary gland. Cancer Prev Res. 2011;4(3):329–46. doi:10.1158/1940-6207.CAPR-10-0381.

    Article  CAS  Google Scholar 

  32. Morris PG, Hudis CA, Giri D, Morrow M, Falcone DJ, Zhou XK, et al. Inflammation and increased aromatase expression occur in the breast tissue of obese women with breast cancer. Cancer Prev Res. 2011;4(7):1021–9. doi:10.1158/1940-6207.CAPR-11-0110.

    Article  CAS  Google Scholar 

  33. Argenta PA, Thomas SG, Judson PL, Downs Jr LS, Geller MA, Carson LF, et al. A phase II study of fulvestrant in the treatment of multiply-recurrent epithelial ovarian cancer. Gynecol Oncol. 2009;113(2):205–9. doi:10.1016/j.ygyno.2009.01.012.

    Article  CAS  PubMed  Google Scholar 

  34. Smyth JF, Gourley C, Walker G, MacKean MJ, Stevenson A, Williams AR, et al. Antiestrogen therapy is active in selected ovarian cancer cases: the use of letrozole in estrogen receptor-positive patients. Clin Cancer Res : Off J Am Assoc Cancer Res. 2007;13(12):3617–22. doi:10.1158/1078-0432.CCR-06-2878.

    Article  CAS  Google Scholar 

  35. Williams CJ. Tamoxifen for relapse of ovarian cancer. Cochrane Database Syst Rev. 2001;1, CD001034. doi:10.1002/14651858.CD001034.

    PubMed  Google Scholar 

  36. Singh M, Zaino RJ, Filiaci VJ, Leslie KK. Relationship of estrogen and progesterone receptors to clinical outcome in metastatic endometrial carcinoma: a Gynecologic Oncology Group Study. Gynecol Oncol. 2007;106(2):325–33. doi:10.1016/j.ygyno.2007.03.042.

    Article  CAS  PubMed  Google Scholar 

  37. Decruze SB, Green JA. Hormone therapy in advanced and recurrent endometrial cancer: a systematic review. Int J Gynecol Cancer : Off J Int Gynecol Cancer Soc. 2007;17(5):964–78. doi:10.1111/j.1525-1438.2007.00897.x.

    Article  CAS  Google Scholar 

  38. Fiorica JV, Brunetto VL, Hanjani P, Lentz SS, Mannel R, Andersen W, et al. Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004;92(1):10–4.

    Article  CAS  PubMed  Google Scholar 

  39. Early Breast Cancer Trialists’ Collaborative G. Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet. 2015. doi:10.1016/S0140-6736(15)61074-1.

    Google Scholar 

  40. Early Breast Cancer Trialists’ Collaborative G, Davies C, Godwin J, Gray R, Clarke M, Cutter D, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011;378(9793):771–84. doi:10.1016/S0140-6736(11)60993-8.

    Article  CAS  Google Scholar 

  41. Di Leo A, Jerusalem G, Petruzelka L, Torres R, Bondarenko IN, Khasanov R, et al. Final overall survival: fulvestrant 500 mg vs 250 mg in the randomized CONFIRM trial. J Natl Cancer Inst. 2014;106(1), djt337. doi:10.1093/jnci/djt337.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Mauri D, Pavlidis N, Polyzos NP, Ioannidis JP. Survival with aromatase inhibitors and inactivators versus standard hormonal therapy in advanced breast cancer: meta-analysis. J Natl Cancer Inst. 2006;98(18):1285–91. doi:10.1093/jnci/djj357.

    Article  CAS  PubMed  Google Scholar 

  43. Sunderland MC, Osborne CK. Tamoxifen in premenopausal patients with metastatic breast cancer: a review. J Clin Oncol : Off J Am Soc Clin Oncol. 1991;9(7):1283–97.

    CAS  Google Scholar 

  44. Cuzick J, Sestak I, Forbes JF, Dowsett M, Knox J, Cawthorn S, et al. Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet. 2014;383(9922):1041–8. doi:10.1016/S0140-6736(13)62292-8.

    Article  CAS  PubMed  Google Scholar 

  45. Nelson HD, Smith ME, Griffin JC, Fu R. Use of medications to reduce risk for primary breast cancer: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;158(8):604–14. doi:10.7326/0003-4819-158-8-201304160-00005.

    Article  PubMed  Google Scholar 

  46. Goss PE, Ingle JN, Ales-Martinez JE, Cheung AM, Chlebowski RT, Wactawski-Wende J, et al. Exemestane for breast-cancer prevention in postmenopausal women. N Engl J Med. 2011;364(25):2381–91. doi:10.1056/NEJMoa1103507.

    Article  CAS  PubMed  Google Scholar 

  47. Ioannides SJ, Barlow PL, Elwood JM, Porter D. Effect of obesity on aromatase inhibitor efficacy in postmenopausal, hormone receptor-positive breast cancer: a systematic review. Breast Cancer Res Treat. 2014;147(2):237–48. doi:10.1007/s10549-014-3091-7.

    Article  CAS  PubMed  Google Scholar 

  48. Derby CA, Zilber S, Brambilla D, Morales KH, McKinlay JB. Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing Study. Clin Endocrinol (Oxf). 2006;65(1):125–31. doi:10.1111/j.1365-2265.2006.02560.x.

    Article  CAS  Google Scholar 

  49. Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010;33(6):1186–92. doi:10.2337/dc09-1649.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Giovannucci E, Rimm EB, Liu Y, Leitzmann M, Wu K, Stampfer MJ, et al. Body mass index and risk of prostate cancer in U.S. health professionals. J Natl Cancer Inst. 2003;95(16):1240–4.

    Article  PubMed  Google Scholar 

  51. Parker AS, Thiel DD, Bergstralh E, Carlson RE, Rangel LJ, Joseph RW, et al. Obese men have more advanced and more aggressive prostate cancer at time of surgery than non-obese men after adjusting for screening PSA level and age: results from two independent nested case–control studies. Prostate Cancer Prostatic Dis. 2013;16(4):352–6. doi:10.1038/pcan.2013.27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Lonergan PE, Tindall DJ. Androgen receptor signaling in prostate cancer development and progression. J Carcinog. 2011;10:20. doi:10.4103/1477-3163.83937.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Andriole GL, Bostwick DG, Brawley OW, Gomella LG, Marberger M, Montorsi F, et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med. 2010;362(13):1192–202. doi:10.1056/NEJMoa0908127.

    Article  CAS  PubMed  Google Scholar 

  54. Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003;349(3):215–24. doi:10.1056/NEJMoa030660.

    Article  CAS  PubMed  Google Scholar 

  55. Arce-Salinas C, Riesco-Martinez MC, Hanna W, Bedard P, Warner E. Complete response of metastatic androgen receptor-positive breast cancer to bicalutamide: case report and review of the literature. J Clin Oncol : Off J Am Soc Clin Oncol. 2014. doi:10.1200/JCO.2013.49.8899.

    Google Scholar 

  56. Gucalp A, Tolaney S, Isakoff SJ, Ingle JN, Liu MC, Carey LA, et al. Phase II trial of bicalutamide in patients with androgen receptor-positive, estrogen receptor-negative metastatic breast cancer. Clin Cancer Res : Off J Am Assoc Cancer Res. 2013;19(19):5505–12. doi:10.1158/1078-0432.CCR-12-3327.

    Article  CAS  Google Scholar 

  57. Giovannucci E. Insulin and colon cancer. Cancer Causes Control. 1995;6(2):164–79.

    Article  CAS  PubMed  Google Scholar 

  58. McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomarkers Prev : Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 1994;3(8):687–95.

    CAS  Google Scholar 

  59. Khandekar MJ, Cohen P, Spiegelman BM. Molecular mechanisms of cancer development in obesity. Nat Rev Cancer. 2011;11(12):886–95. doi:10.1038/nrc3174.

    Article  CAS  PubMed  Google Scholar 

  60. Pollak MN, Schernhammer ES, Hankinson SE. Insulin-like growth factors and neoplasia. Nat Rev Cancer. 2004;4(7):505–18. doi:10.1038/nrc1387.

    Article  CAS  PubMed  Google Scholar 

  61. Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Madarnas Y, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol : Off J Am Soc Clin Oncol. 2002;20(1):42–51.

    Article  CAS  Google Scholar 

  62. Barone BB, Yeh HC, Snyder CF, Peairs KS, Stein KB, Derr RL, et al. Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis. JAMA. 2008;300(23):2754–64. doi:10.1001/jama.2008.824.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Clayton PE, Banerjee I, Murray PG, Renehan AG. Growth hormone, the insulin-like growth factor axis, insulin and cancer risk. Nat Rev Endocrinol. 2011;7(1):11–24. doi:10.1038/nrendo.2010.171.

    Article  CAS  PubMed  Google Scholar 

  64. Renehan AG, Zwahlen M, Minder C, O’Dwyer ST, Shalet SM, Egger M. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet. 2004;363(9418):1346–53. doi:10.1016/S0140-6736(04)16044-3.

    Article  CAS  PubMed  Google Scholar 

  65. Belfiore A. The role of insulin receptor isoforms and hybrid insulin/IGF-I receptors in human cancer. Curr Pharm Des. 2007;13(7):671–86.

    Article  CAS  PubMed  Google Scholar 

  66. Bowers LW, Rossi EL, O’Flanagan CH, de Graffenried LA, Hursting SD. The role of the Insulin/IGF system in cancer: lessons learned from clinical trials and the energy balance-cancer link. Front Endocrinol. 2015;6:77. doi:10.3389/fendo.2015.00077.

    Google Scholar 

  67. Lueprasitsakul P, Latour D, Longcope C. Aromatase activity in human adipose tissue stromal cells: effect of growth factors. Steroids. 1990;55(12):540–4.

    Article  CAS  PubMed  Google Scholar 

  68. Decensi A, Puntoni M, Goodwin P, Cazzaniga M, Gennari A, Bonanni B, et al. Metformin and cancer risk in diabetic patients: a systematic review and meta-analysis. Cancer Prev Res. 2010;3(11):1451–61. doi:10.1158/1940-6207.CAPR-10-0157.

    Article  CAS  Google Scholar 

  69. Morales DR, Morris AD. Metformin in cancer treatment and prevention. Annu Rev Med. 2015;66:17–29. doi:10.1146/annurev-med-062613-093128.

    Article  CAS  PubMed  Google Scholar 

  70. Fischer-Posovszky P, Wabitsch M, Hochberg Z. Endocrinology of adipose tissue—an update. Horm Metab Res. 2007;39(5):314–21. doi:10.1055/s-2007-976539.

    Article  CAS  PubMed  Google Scholar 

  71. Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6(10):772–83. doi:10.1038/nri1937.

    Article  CAS  PubMed  Google Scholar 

  72. Hursting SD, Digiovanni J, Dannenberg AJ, Azrad M, Leroith D, Demark-Wahnefried W, et al. Obesity, energy balance, and cancer: new opportunities for prevention. Cancer Prev Res. 2012;5(11):1260–72. doi:10.1158/1940-6207.CAPR-12-0140.

    Article  CAS  Google Scholar 

  73. Goodwin PJ, Stambolic V. Impact of the obesity epidemic on cancer. Annu Rev Med. 2015;66:281–96. doi:10.1146/annurev-med-051613-012328.

    Article  CAS  PubMed  Google Scholar 

  74. Vansaun MN. Molecular pathways: adiponectin and leptin signaling in cancer. Clin Cancer Res : Off J Am Assoc Cancer Res. 2013;19(8):1926–32. doi:10.1158/1078-0432.CCR-12-0930.

    Article  CAS  Google Scholar 

  75. Delort L, Rossary A, Farges MC, Vasson MP, Caldefie-Chezet F. Leptin, adipocytes and breast cancer: focus on inflammation and anti-tumor immunity. Life Sci. 2015. doi:10.1016/j.lfs.2015.04.012.

    PubMed  Google Scholar 

  76. Dieudonne MN, Machinal-Quelin F, Serazin-Leroy V, Leneveu MC, Pecquery R, Giudicelli Y. Leptin mediates a proliferative response in human MCF7 breast cancer cells. Biochem Biophys Res Commun. 2002;293(1):622–8. doi:10.1016/S0006-291X(02)00205-X.

    Article  CAS  PubMed  Google Scholar 

  77. Hardwick JC, Van Den Brink GR, Offerhaus GJ, Van Deventer SJ, Peppelenbosch MP. Leptin is a growth factor for colonic epithelial cells. Gastroenterology. 2001;121(1):79–90.

    Article  CAS  PubMed  Google Scholar 

  78. Gialamas SP, Sergentanis TN, Antonopoulos CN, Dessypris N, Chrousos GP, Petridou ET. Circulating leptin levels and risk of colorectal cancer and adenoma: a case–control study and meta-analysis. Cancer Causes Control. 2013;24(12):2129–41. doi:10.1007/s10552-013-0290-1.

    Article  PubMed  Google Scholar 

  79. Renehan AG, Roberts DL, Dive C. Obesity and cancer: pathophysiological and biological mechanisms. Arch Physiol Biochem. 2008;114(1):71–83. doi:10.1080/13813450801954303.

    Article  CAS  PubMed  Google Scholar 

  80. Cleary MP, Ray A, Rogozina OP, Dogan S, Grossmann ME. Targeting the adiponectin:leptin ratio for postmenopausal breast cancer prevention. Front Biosci (Schol Ed). 2009;1:329–57.

    Article  Google Scholar 

  81. Ashizawa N, Yahata T, Quan J, Adachi S, Yoshihara K, Tanaka K. Serum leptin-adiponectin ratio and endometrial cancer risk in postmenopausal female subjects. Gynecol Oncol. 2010;119(1):65–9. doi:10.1016/j.ygyno.2010.07.007.

    Article  CAS  PubMed  Google Scholar 

  82. Renehan AG, Zwahlen M, Egger M. Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer. 2015;15(8):484–98. doi:10.1038/nrc3967.

    Article  CAS  PubMed  Google Scholar 

  83. Kim AY, Lee YS, Kim KH, Lee JH, Lee HK, Jang SH, et al. Adiponectin represses colon cancer cell proliferation via AdipoR1- and -R2-mediated AMPK activation. Mol Endocrinol. 2010;24(7):1441–52. doi:10.1210/me.2009-0498.

    Article  CAS  PubMed  Google Scholar 

  84. Grossmann ME, Nkhata KJ, Mizuno NK, Ray A, Cleary MP. Effects of adiponectin on breast cancer cell growth and signaling. Br J Cancer. 2008;98(2):370–9. doi:10.1038/sj.bjc.6604166.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Cong L, Gasser J, Zhao J, Yang B, Li F, Zhao AZ. Human adiponectin inhibits cell growth and induces apoptosis in human endometrial carcinoma cells, HEC-1-A and RL95 2. Endocr Relat Cancer. 2007;14(3):713–20. doi:10.1677/ERC-07-0065.

    Article  CAS  PubMed  Google Scholar 

  86. Bub JD, Miyazaki T, Iwamoto Y. Adiponectin as a growth inhibitor in prostate cancer cells. Biochem Biophys Res Commun. 2006;340(4):1158–66. doi:10.1016/j.bbrc.2005.12.103.

    Article  CAS  PubMed  Google Scholar 

  87. Ye J, Jia J, Dong S, Zhang C, Yu S, Li L, et al. Circulating adiponectin levels and the risk of breast cancer: a meta-analysis. Eur J Cancer Prev : Off J Eur Cancer Prev Organ. 2014;23(3):158–65. doi:10.1097/CEJ.0b013e328364f293.

    Article  CAS  Google Scholar 

  88. Macis D, Guerrieri-Gonzaga A, Gandini S. Circulating adiponectin and breast cancer risk: a systematic review and meta-analysis. Int J Epidemiol. 2014;43(4):1226–36. doi:10.1093/ije/dyu088.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Liu LY, Wang M, Ma ZB, Yu LX, Zhang Q, Gao DZ, et al. The role of adiponectin in breast cancer: a meta-analysis. PLoS One. 2013;8(8), e73183. doi:10.1371/journal.pone.0073183.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Gross AL, Newschaffer CJ, Hoffman-Bolton J, Rifai N, Visvanathan K. Adipocytokines, inflammation, and breast cancer risk in postmenopausal women: a prospective study. Cancer Epidemiol Biomarkers Prev : Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2013;22(7):1319–24. doi:10.1158/1055-9965.EPI-12-1444. This nested case–control study provides important insights about associations between leptin and adiponectin and breast cancer risk.

    Article  CAS  Google Scholar 

  91. Tworoger SS, Eliassen AH, Kelesidis T, Colditz GA, Willett WC, Mantzoros CS, et al. Plasma adiponectin concentrations and risk of incident breast cancer. J Clin Endocrinol Metab. 2007;92(4):1510–6. doi:10.1210/jc.2006-1975.

    Article  CAS  PubMed  Google Scholar 

  92. Surmacz E, Otvos L. Molecular targeting of obesity pathways in cancer. Horm Mol Biol Clin Investig. 2015;22(2):53–62. doi:10.1515/hmbci-2015-0007.

    CAS  PubMed  Google Scholar 

  93. Ohtani N. Microbiome and cancer. Semin Immunopathol. 2015;37(1):65–72. doi:10.1007/s00281-014-0457-1.

    Article  CAS  PubMed  Google Scholar 

  94. Garrett WS. Cancer and the microbiota. Science. 2015;348(6230):80–6. doi:10.1126/science.aaa4972.

    Article  CAS  PubMed  Google Scholar 

  95. Ley RE, Backhed F, Turnbaugh P, Lozupone CA, Knight RD, Gordon JI. Obesity alters gut microbial ecology. Proc Natl Acad Sci U S A. 2005;102(31):11070–5. doi:10.1073/pnas.0504978102.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444(7122):1022–3. doi:10.1038/4441022a.

    Article  CAS  PubMed  Google Scholar 

  97. Harris K, Kassis A, Major G, Chou CJ. Is the gut microbiota a new factor contributing to obesity and its metabolic disorders? J Obes. 2012;2012:879151. doi:10.1155/2012/879151.

    PubMed  PubMed Central  Google Scholar 

  98. Hur KY, Lee MS. Gut microbiota and metabolic disorders. Diabetes Metab J. 2015;39(3):198–203. doi:10.4093/dmj.2015.39.3.198.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Holmes E, Li JV, Marchesi JR, Nicholson JK. Gut microbiota composition and activity in relation to host metabolic phenotype and disease risk. Cell Metab. 2012;16(5):559–64. doi:10.1016/j.cmet.2012.10.007.

    Article  CAS  PubMed  Google Scholar 

  100. Yoshimoto S, Loo TM, Atarashi K, Kanda H, Sato S, Oyadomari S, et al. Obesity-induced gut microbial metabolite promotes liver cancer through senescence secretome. Nature. 2013;499(7456):97–101. doi:10.1038/nature12347.

    Article  CAS  PubMed  Google Scholar 

  101. Goedert JJ, Jones G, Hua X, Xu X, Yu G, Flores R et al. Investigation of the association between the fecal microbiota and breast cancer in postmenopausal women: a population-based case–control pilot study. J Natl Cancer Inst. 2015;107(8). doi:10.1093/jnci/djv147. This case–control study reports that there is a difference in the fecal microbiota composition between postmenopausal women with and without breast cancer, also suggesting that the gut microbiota may affect breast cancer risk through estrogen-independent pathways.

  102. Schwabe RF, Jobin C. The microbiome and cancer. Nat Rev Cancer. 2013;13(11):800–12. doi:10.1038/nrc3610.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357(9255):539–45. doi:10.1016/S0140-6736(00)04046-0.

    Article  CAS  PubMed  Google Scholar 

  104. Balkwill F, Charles KA, Mantovani A. Smoldering and polarized inflammation in the initiation and promotion of malignant disease. Cancer Cell. 2005;7(3):211–7. doi:10.1016/j.ccr.2005.02.013.

    Article  CAS  PubMed  Google Scholar 

  105. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860–7. doi:10.1038/nature01322.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Cancello R, Henegar C, Viguerie N, Taleb S, Poitou C, Rouault C, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes. 2005;54(8):2277–86.

    Article  CAS  PubMed  Google Scholar 

  107. Cinti S, Mitchell G, Barbatelli G, Murano I, Ceresi E, Faloia E, et al. Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans. J Lipid Res. 2005;46(11):2347–55. doi:10.1194/jlr.M500294-JLR200.

    Article  CAS  PubMed  Google Scholar 

  108. Olefsky JM, Glass CK. Macrophages, inflammation, and insulin resistance. Annu Rev Physiol. 2010;72:219–46. doi:10.1146/annurev-physiol-021909-135846.

    Article  CAS  PubMed  Google Scholar 

  109. Morris PG, Zhou XK, Milne GL, Goldstein D, Hawks LC, Dang CT, et al. Increased levels of urinary PGE-M, a biomarker of inflammation, occur in association with obesity, aging, and lung metastases in patients with breast cancer. Cancer Prev Res. 2013;6(5):428–36. doi:10.1158/1940-6207.CAPR-12-0431. This study demonstrates that levels of urinary prostaglandin E metabolite (PGE-M) are positively correlated with BMI and that the use of NSAIDs is associated with reduced PGE-M levels in patients with breast cancer.

    Article  CAS  Google Scholar 

  110. Iyengar NM, Hudis CA, Dannenberg AJ. Obesity and cancer: local and systemic mechanisms. Annu Rev Med. 2015;66:297–309. doi:10.1146/annurev-med-050913-022228.

    Article  CAS  PubMed  Google Scholar 

  111. Xu H, Barnes GT, Yang Q, Tan G, Yang D, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003;112(12):1821–30. doi:10.1172/JCI19451.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  112. Howe LR, Subbaramaiah K, Hudis CA, Dannenberg AJ. Molecular pathways: adipose inflammation as a mediator of obesity-associated cancer. Clin Cancer Res : Off J Am Assoc Cancer Res. 2013;19(22):6074–83. doi:10.1158/1078-0432.CCR-12-2603.

    Article  CAS  Google Scholar 

  113. Iyengar NM, Morris PG, Zhou XK, Gucalp A, Giri D, Harbus MD, et al. Menopause is a determinant of breast adipose inflammation. Cancer Prev Res. 2015. doi:10.1158/1940-6207.CAPR-14-0243. This study demonstrates that WAT inflammation is correlated with increasing BMI and the post menopausal state, and that WAT inflammation can also occur in up to one third of normal weight women.

    Google Scholar 

  114. Seo MH, Rhee EJ. Metabolic and cardiovascular implications of a metabolically healthy obesity phenotype. Endocrinol Metab (Seoul). 2014;29(4):427–34. doi:10.3803/EnM.2014.29.4.427.

    Article  Google Scholar 

  115. Kloting N, Fasshauer M, Dietrich A, Kovacs P, Schon MR, Kern M, et al. Insulin-sensitive obesity. Am J Physiol Endocrinol Metab. 2010;299(3):E506–15. doi:10.1152/ajpendo.00586.2009.

    Article  PubMed  CAS  Google Scholar 

  116. Chen S, Chen Y, Liu X, Li M, Wu B, Li Y, et al. Insulin resistance and metabolic syndrome in normal-weight individuals. Endocrine. 2014;46(3):496–504. doi:10.1007/s12020-013-0079-8.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Neil M. Iyengar.

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Clifford A. Hudis declares no conflict of interest. Daniel F. Argolo reports grants from Conquer Cancer Foundation of ASCO for 2014 Long-term International Fellowship (LIFe) Award and travel support from Roche for 2014 ASCO. Neil M. Iyengar reports grants from Breast Cancer Research Foundation, from Conquer Cancer Foundation of ASCO.

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Argolo, D.F., Hudis, C.A. & Iyengar, N.M. Obesity and Cancer—Opportunities to Break the Link. Curr Breast Cancer Rep 8, 22–31 (2016). https://doi.org/10.1007/s12609-016-0200-0

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