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体质量指数对接受化疗免疫治疗联合方案的晚期 NSCLC 患者的预后影响。

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

机构信息

Department of Surgery and Cancer, Imperial College London, London, UK

Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.

出版信息

J Immunother Cancer. 2022 Feb;10(2). doi: 10.1136/jitc-2021-004374.


DOI:10.1136/jitc-2021-004374
PMID:35173031
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8852707/
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.

摘要

简介:越来越多的研究表明,身体质量指数(BMI)的增加与各种恶性肿瘤患者(包括非小细胞肺癌[NSCLC])接受免疫检查点抑制剂(ICI)治疗后的获益改善相关。然而,基线 BMI 是否会影响一线化疗免疫联合治疗的结果尚不清楚。

方法:本国际多中心研究纳入了连续接受一线化疗免疫联合治疗的 IV 期 NSCLC 患者队列,评估了基线 BMI 与无进展生存期(PFS)和总生存期(OS)之间的相关性。根据世界卫生组织(WHO)标准对 BMI 进行分类。

结果:在纳入的 853 例患者中,5.3%为体重不足;46.4%为体重正常;33.8%为超重;14.5%为肥胖。超重和肥胖患者更有可能年龄≥70 岁(p=0.00085)、从不吸烟(p<0.0001)、基线东部肿瘤协作组体力状况(ECOG-PS)更好(p=0.0127),且中枢神经系统(CNS)转移(p=0.0002)和肝转移(p=0.0395)的发生率较低。单变量分析显示,体重不足(15.5 个月)、体重正常(14.6 个月)、超重(20.9 个月)和肥胖(16.8 个月)患者的中位 OS 存在显著差异(log-rank:p=0.045,log-rank 检验趋势:p=0.131),而 PFS 无差异(趋势检验:p=0.510)。多变量分析时,基线 BMI 与 OS 或 PFS 均无显著相关性。

结论:与化疗免疗方案中观察到的情况相反,基线 BMI 不影响晚期 NSCLC 患者化疗免疫联合治疗的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f6e/8852707/c845f34d12bd/jitc-2021-004374f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f6e/8852707/c845f34d12bd/jitc-2021-004374f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f6e/8852707/c845f34d12bd/jitc-2021-004374f01.jpg

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引用本文的文献

[1]
Ghrelin-induced neuronal NPY promotes brain metastasis in lung cancer patients with low BMI.

Nat Commun. 2025-7-1

[2]
Impact of metabolic and nutritional disorders on the synergy between radiotherapy and immunotherapy in non-small-cell lung cancer.

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[3]
Correlation Between Body Mass Index and Immunotherapy Response in Advanced NSCLC.

Cancers (Basel). 2025-3-29

[4]
First-line pembrolizumab in patients with advanced non-small cell lung cancer and high PD-L1 expression: real-world data from a Spanish multicenter study.

Front Oncol. 2024-12-17

[5]
Predictive biomarkers for immune checkpoint inhibitors therapy in lung cancer.

Hum Vaccin Immunother. 2024-12-31

[6]
Obesity and survival in advanced non-small cell lung cancer patients treated with chemotherapy, immunotherapy, or chemoimmunotherapy: a multicenter cohort study.

BMC Med. 2024-10-14

[7]
Prognostic value of body mass index for first-line chemoimmunotherapy combinations in advanced non-small cell lung cancer in Chinese population.

Heliyon. 2024-5-23

[8]
Effect of body mass index and cholesterol-rich apolipoprotein-B-containing lipoproteins on clinical outcome in NSCLC patients treated with immune checkpoint inhibitors-based therapy: A retrospective analysis.

Cancer Med. 2024-6

[9]
A lack of association between BMI and chemoimmunotherapy efficacy in advanced non-small cell lung cancer: Secondary analysis of the IMpower150 and IMpower130 clinical trials.

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[10]
Body mass index, weight change, and cancer prognosis: a meta-analysis and systematic review of 73 cohort studies.

ESMO Open. 2024-3

本文引用的文献

[1]
Tumour burden and efficacy of immune-checkpoint inhibitors.

Nat Rev Clin Oncol. 2022-2

[2]
Antibiotic-exposed patients with non-small-cell lung cancer preserve efficacy outcomes following first-line chemo-immunotherapy.

Ann Oncol. 2021-11

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J Immunother Cancer. 2021-4

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J Immunother Cancer. 2020-10

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Eur J Cancer. 2020-3-5

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JAMA Oncol. 2020-4-1

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Oncoimmunology. 2019-9-20

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BMC Public Health. 2019-11-1

[10]
The impact of smoking on the effectiveness of immune checkpoint inhibitors - a systematic review and meta-analysis.

Acta Oncol. 2020-1

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