Department of Surgery and Cancer, Imperial College London, London, UK
Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.
J Immunother Cancer. 2022 Feb;10(2). doi: 10.1136/jitc-2021-004374.
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.
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。
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