Haizhu Chen1, Daquan Wang2, Qiaofeng Zhong1, Yunxia Tao1, Yu Zhou1, Yuankai Shi3. 1. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Beijing Key Laboratory of Clinical Study On Anticancer Molecular Targeted Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China. 2. Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. 3. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Beijing Key Laboratory of Clinical Study On Anticancer Molecular Targeted Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China. syuankai@cicams.ac.cn.
Abstract
BACKGROUND: This systematic review and meta-analysis aimed to evaluate the association between pretreatment body mass index (BMI) and clinical outcomes in cancer patients treated with immune checkpoint inhibitors (ICIs). METHODS: Systematical searches of PubMed, Embase, and the Cochrane Library databases were carried out. Studies reporting on the association between BMI and outcomes of ICIs were included. The intended outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and immune-related adverse events (irAEs). Quantitative analyses and dose-response meta-analyses were performed under random effect models. RESULTS: Twenty-two eligible studies involving 5686 cancer patients treated with ICIs were identified. Compared to those with lower BMI, patients with higher BMI obtained a significant benefit on OS (HR = 0.698, 95% CI 0.614-0.794, P < 0.001; I2 = 45.9%) and PFS (HR = 0.760, 95% CI 0.672-0.861, P < 0.001; I2 = 37.9%). Most stratified analyses for OS and PFS also showed similar pooled risk estimates. For an increment of every 5 kg/m2 in BMI, the risk for death reduced by approximately 15.6% (HR = 0.844, 95% CI 0.752-0.945, P = 0.003). Moreover, patients with higher BMI had a remarkably better ORR (OR = 0.468, 95% CI 0.263-0.833, P = 0.010; I2 = 73.6%) than that of those with lower BMI. However, no statistically significant differences were found in the incidence of any grade irAEs (P = 0.073) and ≥ 3 grade irAEs (P = 0.105) between higher and lower BMI. CONCLUSION: Higher BMI is significantly associated with improved outcomes in patients treated with ICIs. Further large-scale prospective research is warranted to better illuminate the association between BMI and outcomes from ICIs.
BACKGROUND: This systematic review and meta-analysis aimed to evaluate the association between pretreatment body mass index (BMI) and clinical outcomes in cancerpatients treated with immune checkpoint inhibitors (ICIs). METHODS: Systematical searches of PubMed, Embase, and the Cochrane Library databases were carried out. Studies reporting on the association between BMI and outcomes of ICIs were included. The intended outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and immune-related adverse events (irAEs). Quantitative analyses and dose-response meta-analyses were performed under random effect models. RESULTS: Twenty-two eligible studies involving 5686 cancerpatients treated with ICIs were identified. Compared to those with lower BMI, patients with higher BMI obtained a significant benefit on OS (HR = 0.698, 95% CI 0.614-0.794, P < 0.001; I2 = 45.9%) and PFS (HR = 0.760, 95% CI 0.672-0.861, P < 0.001; I2 = 37.9%). Most stratified analyses for OS and PFS also showed similar pooled risk estimates. For an increment of every 5 kg/m2 in BMI, the risk for death reduced by approximately 15.6% (HR = 0.844, 95% CI 0.752-0.945, P = 0.003). Moreover, patients with higher BMI had a remarkably better ORR (OR = 0.468, 95% CI 0.263-0.833, P = 0.010; I2 = 73.6%) than that of those with lower BMI. However, no statistically significant differences were found in the incidence of any grade irAEs (P = 0.073) and ≥ 3 grade irAEs (P = 0.105) between higher and lower BMI. CONCLUSION: Higher BMI is significantly associated with improved outcomes in patients treated with ICIs. Further large-scale prospective research is warranted to better illuminate the association between BMI and outcomes from ICIs.
Entities:
Keywords:
Body mass index; Cancer patients; Immune checkpoint inhibitors; Meta-analysis; Outcome
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