Prognostic effect of body mass index in patients with advanced NSCLC treated with chemo-immunotherapy combinations
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction: It has been recognised that increasing body mass index (BMI) is associated with improved outcome from immune checkpoint inhibitors (ICI) in patients with various malignancies including NSCLC. However, it is unclear whether baseline BMI may influence outcomes from first-line chemo-immunotherapy combinations.
Methods: In this international multicentre study we evaluated the association between baseline BMI, progression free survival (PFS) and overall survival (OS) in a cohort of patients with stage IV NSCLC consecutively treated with first-line chemo-immunotherapy combinations. BMI was categorized according to World Health Organization criteria.
Results: Among the 853 included patients, 5.3% were underweight, 46.4% were of normal weight, 33.8% were overweight and 14.5% were obese. Overweight and obese patients were more likely aged ≥70 years (p=0.00085), never smokers (p<0.0001), with better baseline ECOG-PS (p=0.0127), lower prevalence of CNS (p=0.0002) and liver metastases (p=0.0395). Univariable analyses showed a significant difference in the median OS across underweight (15.5 months), normal weight (14.6 months), overweight (20.9 months) and obese (16.8 months) patients (log-rank for trend: p = 0.131), whilst no difference was found with respect to the median PFS (log-rank for trend: p = 0.510). Neither OS nor PFS were significantly associated with baseline BMI on multivariable analysis.
Conclusions: In contrast to what observed in the context of chemotherapy free ICI-based regimens, baseline BMI does not affect clinical outcomes from chemo-immunotherapy combinations in patients with advanced NSCLC.
Methods: In this international multicentre study we evaluated the association between baseline BMI, progression free survival (PFS) and overall survival (OS) in a cohort of patients with stage IV NSCLC consecutively treated with first-line chemo-immunotherapy combinations. BMI was categorized according to World Health Organization criteria.
Results: Among the 853 included patients, 5.3% were underweight, 46.4% were of normal weight, 33.8% were overweight and 14.5% were obese. Overweight and obese patients were more likely aged ≥70 years (p=0.00085), never smokers (p<0.0001), with better baseline ECOG-PS (p=0.0127), lower prevalence of CNS (p=0.0002) and liver metastases (p=0.0395). Univariable analyses showed a significant difference in the median OS across underweight (15.5 months), normal weight (14.6 months), overweight (20.9 months) and obese (16.8 months) patients (log-rank for trend: p = 0.131), whilst no difference was found with respect to the median PFS (log-rank for trend: p = 0.510). Neither OS nor PFS were significantly associated with baseline BMI on multivariable analysis.
Conclusions: In contrast to what observed in the context of chemotherapy free ICI-based regimens, baseline BMI does not affect clinical outcomes from chemo-immunotherapy combinations in patients with advanced NSCLC.
Date Issued
2022-02-16
Date Acceptance
2022-01-11
Citation
Journal for ImmunoTherapy of Cancer, 2022, 10 (2), pp.1-10
ISSN
2051-1426
Publisher
BioMed Central
Start Page
1
End Page
10
Journal / Book Title
Journal for ImmunoTherapy of Cancer
Volume
10
Issue
2
Copyright Statement
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.
License URL
Sponsor
Wellcome Trust
Identifier
https://jitc.bmj.com/content/10/2/e004374
Grant Number
097816/Z/11/A
Subjects
immunity
lung neoplasms
metabolic networks and pathways
programmed cell death 1 receptor
Publication Status
Published
Date Publish Online
2022-02-16