Tressie Herrmann1, Cécile Mione1, Pierre-François Montoriol2, Ioana Molnar3,4,5, Angeline Ginzac6,7,8, Xavier Durando1,3,4,5, Hakim Mahammedi1. 1. Département d'Oncologie Médicale, Centre Jean PERRIN, Clermont-Ferrand, France. 2. Département de Radiologie, Centre Jean PERRIN, Clermont-Ferrand, France. 3. INSERM U1240 IMoST, Université Clermont Auvergne, Clermont-Ferrand, France. 4. Centre d'investigation Clinique UMR 501, Clermont-Ferrand, France. 5. Département de Recherche Clinique et Innovation, Centre Jean PERRIN, Clermont-Ferrand, France. 6. INSERM U1240 IMoST, Université Clermont Auvergne, Clermont-Ferrand, France, angeline.ginzac@clermont.unicancer.fr. 7. Centre d'investigation Clinique UMR 501, Clermont-Ferrand, France, angeline.ginzac@clermont.unicancer.fr. 8. Département de Recherche Clinique et Innovation, Centre Jean PERRIN, Clermont-Ferrand, France, angeline.ginzac@clermont.unicancer.fr.
Abstract
INTRODUCTION: The advent of immune checkpoint inhibitors (ICIs) such as nivolumab has enabled outcomes for metastatic renal cell carcinoma (mRCC) to be improved. However, only around 25% of patients respond to these therapies without being able to formally identify them. Data on relevant predictive markers are still lacking. The obesity paradox has been shown as a relevant prognostic marker in mRCC with better outcomes for obese patients. Nevertheless, the impact of weight variation and the presence of sarcopenia during ICI treatment is not known for now. METHODS: In a retrospective study, weight and its variations were collected at first day of ICI and at 6 weeks of treatment. Scanographic imagery was used to define the skeletal muscle index (SMI) as a reflect of sarcopenia. The impact of these parameters as predictive and prognostic factors for mRCC with nivolumab was evaluated. RESULTS: A higher body mass index (BMI) at baseline was significantly associated with response at the first scan (p = 0.036). Longer overall survival (OS) was observed for patients with a weight gain compared to the group with weight loss (p = 0.00028). Median OS for sarcopenic patients was 17.2 months and 31.6 months for the non-sarcopenic group of patients, but there was no statistical difference. CONCLUSION: This trial showed that a higher BMI and weight gain during nivolumab treatment were good predictive markers for outcomes in mRCC with nivolumab. Sarcopenia and variations in SMI could thus be of interest, but further studies are required.
INTRODUCTION: The advent of immune checkpoint inhibitors (ICIs) such as nivolumab has enabled outcomes for metastatic renal cell carcinoma (mRCC) to be improved. However, only around 25% of patients respond to these therapies without being able to formally identify them. Data on relevant predictive markers are still lacking. The obesity paradox has been shown as a relevant prognostic marker in mRCC with better outcomes for obese patients. Nevertheless, the impact of weight variation and the presence of sarcopenia during ICI treatment is not known for now. METHODS: In a retrospective study, weight and its variations were collected at first day of ICI and at 6 weeks of treatment. Scanographic imagery was used to define the skeletal muscle index (SMI) as a reflect of sarcopenia. The impact of these parameters as predictive and prognostic factors for mRCC with nivolumab was evaluated. RESULTS: A higher body mass index (BMI) at baseline was significantly associated with response at the first scan (p = 0.036). Longer overall survival (OS) was observed for patients with a weight gain compared to the group with weight loss (p = 0.00028). Median OS for sarcopenic patients was 17.2 months and 31.6 months for the non-sarcopenic group of patients, but there was no statistical difference. CONCLUSION: This trial showed that a higher BMI and weight gain during nivolumab treatment were good predictive markers for outcomes in mRCC with nivolumab. Sarcopenia and variations in SMI could thus be of interest, but further studies are required.
Authors: Christoph Minichsdorfer; Andreas Gleiss; Marie-Bernadette Aretin; Manuela Schmidinger; Thorsten Fuereder Journal: Ann Med Date: 2022-12 Impact factor: 5.348