Ishihara Hiroki, Ishiyama Yudai, Nemoto Yuki, Nakamura Kazutaka, Tachibana Hidekazu, Fukuda Hironori, Yoshida Kazuhiko, Kobayashi Hirohito, Iizuka Junpei, Shimmura Hiroaki, Hashimoto Yasunobu, Tanabe Kazunari, Kondo Tsunenori, Takagi Toshio
Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan.
Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Clin Genitourin Cancer. 2023 Feb;21(1):136-145. doi: 10.1016/j.clgc.2022.08.001. Epub 2022 Aug 6.
To clarify the impact of body mass index (BMI) on treatment outcomes including survival, tumor response, and adverse events (AEs) in patients with advanced renal cell carcinoma (RCC) or urothelial carcinoma (UC) treated with immune checkpoint inhibitors (ICIs) in an Asian population.
We retrospectively evaluated 309 patients with advanced RCC or UC who received ICIs between September 2016 and July 2021. The patients were divided into high- (i.e., ≥25 kg/m) and low-BMI (<25 kg/m) groups according to the BMI at the time of treatment initiation.
Overall, 57 patients (18.4%) were classified into the high-BMI group. In RCC patients treated with ICIs as first-line therapy or UC treated with pembrolizumab, progression-free survival (PFS) (p = 0.309; p = 0.842), overall survival (OS) (p = 0.701; p = 0.983), and objective response rate (ORR) (p = 0.163; p = 0.553) were comparable between the high- and low-BMI groups. In RCC patients treated with nivolumab monotherapy as later-line therapy, OS (p = 0.101) and ORR (p = 0.102) were comparable, but PFS was significantly longer in the high-BMI group (p = 0.0272). Further, multivariate analysis showed that BMI was not an independent factor of PFS or OS in all the treatment groups (any, p>0.05). As for AE profiles, in nivolumab monotherapy, the rate was significantly higher in the high-BMI group (p = 0.0203), whereas in the other two treatments, the rate was comparable.
BMI was not associated with survival or response rates of advanced RCC or UC patients treated with ICIs in an Asian population. AEs might frequently develop in high-BMI patients with RCC in nivolumab monotherapy.
阐明体重指数（BMI）对亚洲人群中接受免疫检查点抑制剂（ICI）治疗的晚期肾细胞癌（RCC）或尿路上皮癌（UC）患者的治疗结局（包括生存率、肿瘤反应和不良事件（AE））的影响。
我们回顾性评估了2016年9月至2021年7月期间接受ICI治疗的309例晚期RCC或UC患者。根据治疗开始时的BMI将患者分为高BMI组（即≥25kg/m²）和低BMI组（<25kg/m²）。
总体而言，57例患者（18.4%）被归类为高BMI组。在接受ICI作为一线治疗的RCC患者或接受帕博利珠单抗治疗的UC患者中，高BMI组和低BMI组之间的无进展生存期（PFS）（p = 0.309；p = 0.842）、总生存期（OS）（p = 0.701；p = 0.983）和客观缓解率（ORR）（p = 0.163；p = 0.553）相当。在接受纳武利尤单抗单药治疗作为后线治疗的RCC患者中，OS（p = 0.101）和ORR（p = 0.102）相当，但高BMI组的PFS明显更长（p = 0.0272）。此外，多变量分析显示，BMI在所有治疗组中均不是PFS或OS的独立因素（任何情况，p>0.05）。至于AE情况，在纳武利尤单抗单药治疗中，高BMI组的发生率明显更高（p = 0.0203），而在其他两种治疗中，发生率相当。
在亚洲人群中，BMI与接受ICI治疗的晚期RCC或UC患者的生存率或缓解率无关。在纳武利尤单抗单药治疗中，高BMI的RCC患者可能更容易发生AE。
