Outcomes Among Patients With or Without Obesity and With Cancer Following Treatment With Immune Checkpoint Blockade
Year: 2022
Type: article
Study design: Observational Study
Abstract: obesity in patients treated with immune checkpoint blockade (ICB) 2,3 and the underlying mechanisms 2 are being examined but the scale and spectrum of benefit across cancer types is unknown.To address this gap in knowledge, we evaluated pretreatment body mass index (BMI) in 1840 patients across 16 cancer types. MethodsThis study was approved by the institutional review board of Memorial Sloan Kettering Cancer Center and followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cohort studies.Patients who received at least 1 dose of ICB treatment from 2014 through 2019 were included.Data were analyzed from January 2014 to December 2021.All patients provided written informed consent for tumor sequencing.BMI was measured within 30 days before treatment.We calculated BMI as weight in kilograms divided by height in meters squared.Normal weight (BMI, 18.5-24.9),overweight (BMI, 25-29.9),and obesity (BMI, Ն30) were defined based on the World Health Organization guidelines.All patient tumors were sequenced using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT).We defined tumor mutational burden (TMB) as the total number of somatic nonsynonymous mutations per megabase.Detailed patient characteristics are described in the eMethods in the Supplement.All statistical tests were performed with R programming language, version 4 (R Foundation for Statistical Computing).Kaplan-Meier plot and Cox proportional hazards regression analyses were performed with the survminer package.P < .05 was considered significant. ResultsOf a total of 1840 patients, the median patient age was 63.84 years (IQR, 55.66-71.16years).Of that total, 1059 patients (57.55%) were male.In pancancer survival analyses, patients with obesity showed better overall survival (OS) after ICB treatment than patients with overweight (hazard ratio [HR], 0.82; 95% CI, 0.70-0.96)or normal weight (HR, 0.67; 95% CI, 0.57-0.78).Patients with overweight showed better OS after ICB treatment than patients with normal weight (HR, 0.81; 95% CI, 0.71-0.93).Patients with obesity showed better progression-free survival (PFS) after ICB treatment than patients with overweight (HR, 0.89; 95% CI, 0.78-1.02)or normal weight (HR, 0.77; 95% CI, 0.68-0.87),and patients with overweight showed better PFS after ICB treatment than patients with normal weight (HR, 0.86; 95% CI, 0.76-0.97)(Figure 1, A and B).Multivariable Cox regression analyses showed having BMI of 30 or higher was associated with better survival than having BMI less than 30 independent of known + Supplemental content
Source: JAMA Network Open
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
Awards: Identifying and targeting neoantigens in aggressive salivary carcinomas, Elucidating genetics of response to immune checkpoint blockade in lung cancer, Towards Precision Immuno-Oncology: Unraveling the Genomic Determinants and Mechanisms Underlying Immunotherapy Efficacy and Resistance, Functionalizing recurrent FAT1 mutations and deletions in oral cancer, Cancer Center Support Grant
OpenAlex ID: W4214620935