Yafei You1,2, Chang Jiang1,2, Kunwei Peng1,2, Wenzhuo He1,2, Lei Wang1,2, Yanan Jin1,2, Liangping Xia3,4. 1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Senen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People's Republic of China. 2. Department of The VIP Region, Sun Yat-Senen University Cancer Center, Guangzhou, 510060, Guangdong, People's Republic of China. 3. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Senen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People's Republic of China. xialp@sysucc.org.cn. 4. Department of The VIP Region, Sun Yat-Senen University Cancer Center, Guangzhou, 510060, Guangdong, People's Republic of China. xialp@sysucc.org.cn.
Abstract
OBJECTIVE: High body mass index (BMI) greater than 25 kg/m2 has a complex relationship with cancers. The aim of this systematic review and meta-analysis is to explore controversy over whether BMI is correlated with outcomes including survival and immunotherapy-related adverse events (irAEs) in cancer patients treated with immunotherapy. METHODS: We searched PubMed, Embase, Web of Science, and The Cochrane Library for relevant studies published up to June 2020. Title/abstract screening, full-text review, data extraction, and quality assessment were performed independently. Subgroup analysis was based on sex, treatment lines, the status of programmed death-ligand 1 (PD-L1), and tumor types. Sensitivity analysis was performed by synthesizing studies that adjusted for certain covariates or studies with good quality. Statistical heterogeneity was evaluated by the I2 value. Meta-analysis was performed with hazard ratio (HR) / odds ratio (OR) and 95% confidence intervals (CIs) as the effect measures. RESULTS: Twenty studies were included for survival and irAEs analyses. Patients with high BMI who underwent immunotherapy had longer overall survival (OS) (pooled hazard ratio, pHR = 0.71 [95% CI: 0.59-0.85]) and progression-free survival (PFS) (pHR = 0.76 [95% CI: 0.65-0.88]) than those with low BMI; at the same time, high-BMI patients had increased irAEs (OR = 2.54 [95% CI: 1.12-5.79]). CONCLUSION: In general, high BMI was correlated with improved OS and PFS in patients treated with immunotherapy along with a high risk of irAEs. However, discrepant findings from subgroup analyses urgently call for further analysis.
OBJECTIVE: High body mass index (BMI) greater than 25 kg/m2 has a complex relationship with cancers. The aim of this systematic review and meta-analysis is to explore controversy over whether BMI is correlated with outcomes including survival and immunotherapy-related adverse events (irAEs) in cancerpatients treated with immunotherapy. METHODS: We searched PubMed, Embase, Web of Science, and The Cochrane Library for relevant studies published up to June 2020. Title/abstract screening, full-text review, data extraction, and quality assessment were performed independently. Subgroup analysis was based on sex, treatment lines, the status of programmed death-ligand 1 (PD-L1), and tumor types. Sensitivity analysis was performed by synthesizing studies that adjusted for certain covariates or studies with good quality. Statistical heterogeneity was evaluated by the I2 value. Meta-analysis was performed with hazard ratio (HR) / odds ratio (OR) and 95% confidence intervals (CIs) as the effect measures. RESULTS: Twenty studies were included for survival and irAEs analyses. Patients with high BMI who underwent immunotherapy had longer overall survival (OS) (pooled hazard ratio, pHR = 0.71 [95% CI: 0.59-0.85]) and progression-free survival (PFS) (pHR = 0.76 [95% CI: 0.65-0.88]) than those with low BMI; at the same time, high-BMI patients had increased irAEs (OR = 2.54 [95% CI: 1.12-5.79]). CONCLUSION: In general, high BMI was correlated with improved OS and PFS in patients treated with immunotherapy along with a high risk of irAEs. However, discrepant findings from subgroup analyses urgently call for further analysis.
Authors: Jennifer L McQuade; Carrie R Daniel; Kenneth R Hess; Carmen Mak; Daniel Y Wang; Rajat R Rai; John J Park; Lauren E Haydu; Christine Spencer; Matthew Wongchenko; Stephen Lane; Dung-Yang Lee; Mathilde Kaper; Meredith McKean; Kathryn E Beckermann; Samuel M Rubinstein; Isabelle Rooney; Luna Musib; Nageshwar Budha; Jessie Hsu; Theodore S Nowicki; Alexandre Avila; Tomas Haas; Maneka Puligandla; Sandra Lee; Shenying Fang; Jennifer A Wargo; Jeffrey E Gershenwald; Jeffrey E Lee; Patrick Hwu; Paul B Chapman; Jeffrey A Sosman; Dirk Schadendorf; Jean-Jacques Grob; Keith T Flaherty; Dana Walker; Yibing Yan; Edward McKenna; Jeffrey J Legos; Matteo S Carlino; Antoni Ribas; John M Kirkwood; Georgina V Long; Douglas B Johnson; Alexander M Menzies; Michael A Davies Journal: Lancet Oncol Date: 2018-02-12 Impact factor: 41.316
Authors: Julie Brahmer; Karen L Reckamp; Paul Baas; Lucio Crinò; Wilfried E E Eberhardt; Elena Poddubskaya; Scott Antonia; Adam Pluzanski; Everett E Vokes; Esther Holgado; David Waterhouse; Neal Ready; Justin Gainor; Osvaldo Arén Frontera; Libor Havel; Martin Steins; Marina C Garassino; Joachim G Aerts; Manuel Domine; Luis Paz-Ares; Martin Reck; Christine Baudelet; Christopher T Harbison; Brian Lestini; David R Spigel Journal: N Engl J Med Date: 2015-05-31 Impact factor: 91.245
Authors: Hossein Borghaei; Luis Paz-Ares; Leora Horn; David R Spigel; Martin Steins; Neal E Ready; Laura Q Chow; Everett E Vokes; Enriqueta Felip; Esther Holgado; Fabrice Barlesi; Martin Kohlhäufl; Oscar Arrieta; Marco Angelo Burgio; Jérôme Fayette; Hervé Lena; Elena Poddubskaya; David E Gerber; Scott N Gettinger; Charles M Rudin; Naiyer Rizvi; Lucio Crinò; George R Blumenschein; Scott J Antonia; Cécile Dorange; Christopher T Harbison; Friedrich Graf Finckenstein; Julie R Brahmer Journal: N Engl J Med Date: 2015-09-27 Impact factor: 91.245
Authors: Niloofar Taghizadeh; H Marike Boezen; Jan P Schouten; Carolien P Schröder; E G Elisabeth de Vries; Judith M Vonk Journal: PLoS One Date: 2015-04-16 Impact factor: 3.240
Authors: Alessio Cortellini; Melissa Bersanelli; Sebastiano Buti; Katia Cannita; Daniele Santini; Fabiana Perrone; Raffaele Giusti; Marcello Tiseo; Maria Michiara; Pietro Di Marino; Nicola Tinari; Michele De Tursi; Federica Zoratto; Enzo Veltri; Riccardo Marconcini; Francesco Malorgio; Marco Russano; Cecilia Anesi; Tea Zeppola; Marco Filetti; Paolo Marchetti; Andrea Botticelli; Gian Carlo Antonini Cappellini; Federica De Galitiis; Maria Giuseppa Vitale; Francesca Rastelli; Federica Pergolesi; Rossana Berardi; Silvia Rinaldi; Marianna Tudini; Rosa Rita Silva; Annagrazia Pireddu; Francesco Atzori; Rita Chiari; Biagio Ricciuti; Andrea De Giglio; Daniela Iacono; Alain Gelibter; Mario Alberto Occhipinti; Alessandro Parisi; Giampiero Porzio; Maria Concetta Fargnoli; Paolo Antonio Ascierto; Corrado Ficorella; Clara Natoli Journal: J Immunother Cancer Date: 2019-02-27 Impact factor: 13.751
Authors: Georg Richtig; Christoph Hoeller; Martin Wolf; Ingrid Wolf; Barbara M Rainer; Günter Schulter; Markus Richtig; Martin R Grübler; Anna Gappmayer; Thomas Haidn; Julian Kofler; Rainer Huegel; Bernhard Lange-Asschenfeldt; Martin Pichler; Stefan Pilz; Akos Heinemann; Erika Richtig Journal: PLoS One Date: 2018-10-01 Impact factor: 3.240
Authors: Minouk J Schoemaker; Hazel B Nichols; Lauren B Wright; Mark N Brook; Michael E Jones; Katie M O'Brien; Hans-Olov Adami; Laura Baglietto; Leslie Bernstein; Kimberly A Bertrand; Marie-Christine Boutron-Ruault; Tonje Braaten; Yu Chen; Avonne E Connor; Miren Dorronsoro; Laure Dossus; A Heather Eliassen; Graham G Giles; Susan E Hankinson; Rudolf Kaaks; Timothy J Key; Victoria A Kirsh; Cari M Kitahara; Woon-Puay Koh; Susanna C Larsson; Martha S Linet; Huiyan Ma; Giovanna Masala; Melissa A Merritt; Roger L Milne; Kim Overvad; Kotaro Ozasa; Julie R Palmer; Petra H Peeters; Elio Riboli; Thomas E Rohan; Atsuko Sadakane; Malin Sund; Rulla M Tamimi; Antonia Trichopoulou; Giske Ursin; Lars Vatten; Kala Visvanathan; Elisabete Weiderpass; Walter C Willett; Alicja Wolk; Jian-Min Yuan; Anne Zeleniuch-Jacquotte; Dale P Sandler; Anthony J Swerdlow Journal: JAMA Oncol Date: 2018-11-08 Impact factor: 31.777
Authors: Dongyu Zhang; Neil J Shah; Michael Cook; Matthew Blackburn; Michael T Serzan; Shailesh Advani; Arnold L Potosky; Michael B Atkins; Dejana Braithwaite Journal: Cancers (Basel) Date: 2021-12-03 Impact factor: 6.575