Prognostic effect of body mass index in patients with advanced NSCLC treated with chemoimmunotherapy combinations

Alessio Cortellini, Biagio Ricciuti, Victor R. Vaz, Davide Soldato, Joao V. Alessi, Filippo G. Dall'olio, Giuseppe L. Banna, Sethupathi Muthuramalingam, Samuel Chan, Margarita Majem, Aida Piedra, Giuseppe Lamberti, Elisa Andrini, Alfredo Addeo, Alex Friedlaender, Francesco Facchinetti, Teresa Gorriá, Laura Mezquita, Delphine Hoton, Lacroix ValerieFrank Aboubakar Nana, James Artingstall, Charles Comins, Massimo Di Maio, Andrea Caglio, Judith Cave, Hayley McKenzie, Thomas Newsom-Davis, Joanne S. Evans, Marcello Tiseo, Antonio D'Alessio, Claudia A.M. Fulgenzi, Benjamin Besse, Mark M. Awad, David J. Pinato

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    Abstract

    Introduction It has been recognized that increasing body mass index (BMI) is associated with improved outcome from immune checkpoint inhibitors (ICIs) in patients with various malignancies including non-small cell lung cancer (NSCLC). However, it is unclear whether baseline BMI may influence outcomes from first-line chemoimmunotherapy combinations. Methods In this international multicenter 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 chemoimmunotherapy combinations. BMI was categorized according to WHO 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 Eastern Cooperative Oncology Group - Performance Status (p=0.0127), and had lower prevalence of central nervous system (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: p=0.045, log rank test for trend: p=0.131), while no difference was found with respect to the median PFS (log-rank for trend: p=0.510). Neither OS nor PFS was significantly associated with baseline BMI on multivariable analysis. Conclusions In contrast to what was observed in the context of chemotherapy-free ICI-based regimens, baseline BMI does not affect clinical outcomes from chemoimmunotherapy combinations in patients with advanced NSCLC.

    Original languageEnglish
    Article numbere004374
    JournalJournal for ImmunoTherapy of Cancer
    Volume10
    Issue number2
    DOIs
    Publication statusPublished - 16 Feb 2022

    Keywords

    • immunity
    • lung neoplasms
    • metabolic networks and pathways
    • programmed cell death 1 receptor

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