BACKGROUND: Body mass index (BMI) is used to define obesity, but it is an imperfect measure of body composition. In the current study, the authors explored the association between types of fat and survival in patients treated with immunotherapy. METHODS: A retrospective analysis of 90 patients who were treated with immunotherapy on phase 1 clinical trials at the Winship Cancer Institute in Atlanta, Georgia, from 2009 through 2017 was performed. Overall survival (OS) and progression-free survival (PFS) were used to measure clinical outcomes. Baseline BMI and radiographic images at the middle of the third lumbar vertebrae were obtained. Fat densities were calculated and converted to indices (subcutaneous fat index [SFI], intermuscular fat index [IFI], and visceral fat index [VFI]) after dividing by height in meters squared. Risk groups were created using recursive partitioning and the regression trees method for SFI and IFI, which were selected by stepwise variable selection among all fat-related variables. The Cox proportional hazards model and Kaplan-Meier method were used for the association with OS and PFS. RESULTS: The majority of patients (59%) were male and diagnosed with melanoma (33%) or gastrointestinal cancers (22%). The median BMI was 27.4 kg/m2 , the median SFI was 62.78, the median IFI was 4.06, and the median VFI was 40.53. Low-risk patients (those with an SFI ≥73) had a significantly longer OS (hazard ratio, 0.20; 95% CI, 0.09-0.46 [P < .001]) and PFS (hazard ratio, 0.38; 95% CI, 0.20-0.72 [P = .003]) compared with patients at intermediate risk (those with an SFI <73 and IFI <3.4) and poor risk (those with an SFI <73 and IFI ≥3.4). The Uno concordance statistics were found to be higher for fat risk groups than BMI in predicting OS (0.603 vs 0.574; P = .581) and PFS (0.602 vs 0.586; P = .71). CONCLUSIONS: Increased BMI, increased SFI, and decreased IFI may be associated with prolonged survival in patients with cancer who are treated with immunotherapy. Further studies are needed to elucidate the effect of adiposity on the host immune response to immunotherapy.
BACKGROUND: Body mass index (BMI) is used to define obesity, but it is an imperfect measure of body composition. In the current study, the authors explored the association between types of fat and survival in patients treated with immunotherapy. METHODS: A retrospective analysis of 90 patients who were treated with immunotherapy on phase 1 clinical trials at the Winship Cancer Institute in Atlanta, Georgia, from 2009 through 2017 was performed. Overall survival (OS) and progression-free survival (PFS) were used to measure clinical outcomes. Baseline BMI and radiographic images at the middle of the third lumbar vertebrae were obtained. Fat densities were calculated and converted to indices (subcutaneous fat index [SFI], intermuscular fat index [IFI], and visceral fat index [VFI]) after dividing by height in meters squared. Risk groups were created using recursive partitioning and the regression trees method for SFI and IFI, which were selected by stepwise variable selection among all fat-related variables. The Cox proportional hazards model and Kaplan-Meier method were used for the association with OS and PFS. RESULTS: The majority of patients (59%) were male and diagnosed with melanoma (33%) or gastrointestinal cancers (22%). The median BMI was 27.4 kg/m2 , the median SFI was 62.78, the median IFI was 4.06, and the median VFI was 40.53. Low-risk patients (those with an SFI ≥73) had a significantly longer OS (hazard ratio, 0.20; 95% CI, 0.09-0.46 [P < .001]) and PFS (hazard ratio, 0.38; 95% CI, 0.20-0.72 [P = .003]) compared with patients at intermediate risk (those with an SFI <73 and IFI <3.4) and poor risk (those with an SFI <73 and IFI ≥3.4). The Uno concordance statistics were found to be higher for fat risk groups than BMI in predicting OS (0.603 vs 0.574; P = .581) and PFS (0.602 vs 0.586; P = .71). CONCLUSIONS: Increased BMI, increased SFI, and decreased IFI may be associated with prolonged survival in patients with cancer who are treated with immunotherapy. Further studies are needed to elucidate the effect of adiposity on the host immune response to immunotherapy.
Authors: Jacqueline T Brown; Yuan Liu; Julie M Shabto; Dylan J Martini; Deepak Ravindranathan; Emilie Elise Hitron; Greta Anne Russler; Sarah Caulfield; Lauren Beth Yantorni; Shreyas S Joshi; Haydn Kissick; Kenneth Ogan; Wayne B Harris; Bradley C Carthon; Omer Kucuk; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2021-03-18
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Authors: Rachael M Orlandella; Jennifer R Bail; Michael Behring; Karina I Halilova; Roman Johnson; Victoria Williams; Lyse A Norian; Wendy Demark-Wahnefried Journal: Cancer Date: 2020-04-14 Impact factor: 6.860
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Authors: Dylan J Martini; Julie M Shabto; Subir Goyal; Yuan Liu; T Anders Olsen; Sean T Evans; Benjamin L Magod; Deepak Ravindranathan; Jacqueline T Brown; Lauren Yantorni; Greta Anne Russler; Sarah Caulfield; Jamie M Goldman; Bassel Nazha; Shreyas Subhash Joshi; Haydn T Kissick; Kenneth E Ogan; Wayne B Harris; Omer Kucuk; Bradley C Carthon; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2021-08-18
Authors: Alessio Cortellini; Biagio Ricciuti; Marcello Tiseo; Emilio Bria; Giuseppe L Banna; Joachim Gjv Aerts; Fausto Barbieri; Raffaele Giusti; Diego L Cortinovis; Maria R Migliorino; Annamaria Catino; Francesco Passiglia; Mariangela Torniai; Alessandro Morabito; Carlo Genova; Francesca Mazzoni; Vincenzo Di Noia; Diego Signorelli; Alain Gelibter; Mario Alberto Occhipinti; Francesca Rastelli; Rita Chiari; Danilo Rocco; Alessandro Inno; Michele De Tursi; Pietro Di Marino; Giovanni Mansueto; Federica Zoratto; Francesco Grossi; Marco Filetti; Pamela Pizzutilo; Marco Russano; Fabrizio Citarella; Luca Cantini; Giada Targato; Olga Nigro; Miriam G Ferrara; Sebastiano Buti; Simona Scodes; Lorenza Landi; Giorgia Guaitoli; Luigi Della Gravara; Fabrizio Tabbò; Serena Ricciardi; Alessandro De Toma; Alex Friedlaender; Fausto Petrelli; Alfredo Addeo; Giampiero Porzio; Corrado Ficorella Journal: J Immunother Cancer Date: 2020-10 Impact factor: 13.751
Authors: Dylan J Martini; T Anders Olsen; Subir Goyal; Yuan Liu; Sean T Evans; Benjamin Magod; Jacqueline T Brown; Lauren Yantorni; Greta Anne Russler; Sarah Caulfield; Jamie M Goldman; Bassel Nazha; Haydn T Kissick; Wayne B Harris; Omer Kucuk; Bradley C Carthon; Viraj A Master; Mehmet Asim Bilen Journal: Front Oncol Date: 2021-07-09 Impact factor: 6.244