Faculty Opinions recommendation of Association of body-mass index and outcomes in patients with metastatic melanoma treated with targeted therapy, immunotherapy, or chemotherapy: a retrospective, multicohort analysis.
Year: 2018
Type: peer-review
Abstract: Background-Obesity has been linked to increased mortality in several cancer types; however, the relationship between obesity and survival in metastatic melanoma is unknown.The aim of this study was to examine the association between BMI, progression-free survival (PFS), and overall survival (OS) in metastatic melanoma.Methods-This study included 6 independent cohorts for a total of 1918 metastatic melanoma patients.These included two targeted therapy cohorts [randomized control trials (RCTs) of dabrafenib and trametinib (n=599) and vemurafenib and cobimetinib (n=240)], two immunotherapy cohorts [RCT of ipilimumab + dacarbazine (DTIC) (n=207) and a retrospective cohort treated with anti-PD-1/PDL-1 (n=331)], and two chemotherapy cohorts [RCT DTIC cohorts (n=320 and n=221)].BMI was classified as normal (BMI 18 to <25; n=694 of 1918, 36.1%)overweight (BMI 25-29.9;n=711, 37.1%) or obese (BMI≥30; n=513, 26.7%).The primary outcomes were the association between BMI, PFS, and OS, stratified by treatment type and sex.These exploratory analyses were based on previously reported intention-to-treat data from the RCTs.The effect of BMI on PFS and OS was assessed by multivariable-adjusted Cox models in independent cohorts.In order to provide a more precise estimate of the association between BMI and outcomes, as well as the interaction between BMI, sex, and therapy type, adjusted hazard ratios were combined in mixed-effects meta-analyses and heterogeneity was explored with metaregression analyses.Findings-In the pooled analysis, obesity, as compared to normal BMI, was associated with improved survival in patients with metastatic melanoma [average adjusted hazard ratio (HR) and 95% CI: 0.77 (0.66-0.90) and 0.74 (0.58-0.95) for PFS and OS, respectively].The survival benefit associated with obesity was restricted to patients treated with targeted therapy [0.72 (0.57-0.91) and 0.60 (0.45-0.79) for PFS and OS, respectively] and immunotherapy [0.75 (0.56-1.00) and 0.64 (0.47-0.86)].No associations were observed with chemotherapy [0.87 (0.65-1.17) and 1.03 McQuade et al.
Authors: Jun J Yang, Heng Xu
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi, Melanoma Research Alliance, Dr. Miriam and Sheldon G. Adelson Medical Research Foundation, American Society of Clinical Oncology, Ariad Pharmaceuticals, Array BioPharma, Les Laboratories Pierre Fabre, Incyte, Castle Biosciences, Cancer Institute NSW, University of Sydney, LEO Pharma, National Institutes of Health, Genentech, EMD Serono, University of Texas MD Anderson Cancer Center, Chugai Pharmaceutical, National Health and Medical Research Council, National Cancer Institute, Moonshot Research and Development Program
Awards: G1229558712, The University of Texas MD Anderson Cancer Center SPORE in Melanoma, G1468253849, G1901027039, G2437083349, Predicting and profiling long-term survival after immune checkpoint inhibition, G2665966410, G293715275, Research Training in Academic Medical Oncology, G3520485882, G3549828030, G4102770861, G4222884455, G4266131079, G4543436975, G6403603385, G6516949535, G6607361216, G6736661663, G7944399959, G9000003249, G9000303076, Cancer Center Support Grant, Cancer Center Support Grant, G95646643, The role of the PI3K pathway in immune resistance
OpenAlex ID: W4244080081