Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort
The response to immunotherapy has been little investigated in overweight and obese cancer patients. We evaluated the relationships between BMI, toxicity, and survival in patients treated by immunotherapy for metastatic cancer. We included metastatic cancer patients treated by immunotherapy between J...
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2021-05-01
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author | Laetitia Collet Lidia Delrieu Amine Bouhamama Hugo Crochet Aurélie Swalduz Alexandre Nerot Timothée Marchal Sylvie Chabaud Pierre Etienne Heudel |
author_facet | Laetitia Collet Lidia Delrieu Amine Bouhamama Hugo Crochet Aurélie Swalduz Alexandre Nerot Timothée Marchal Sylvie Chabaud Pierre Etienne Heudel |
author_sort | Laetitia Collet |
collection | DOAJ |
description | The response to immunotherapy has been little investigated in overweight and obese cancer patients. We evaluated the relationships between BMI, toxicity, and survival in patients treated by immunotherapy for metastatic cancer. We included metastatic cancer patients treated by immunotherapy between January 2017 and June 2020 at the Centre Léon Bérard. In total, 272 patients were included: 64% men and 36% women, with a median age of 61.4 years. BMI ≥ 25 in 34.2% and 50% had non-small cell lung cancer (<i>n</i> = 136). Most received monotherapy, with nivolumab in 41.9% and pembrolizumab in 37.9%. Toxicity, mostly dysthyroiditis, occurred in 41%. Median overall survival (OS), estimated by Kaplan–Meier analysis, was significantly longer for patients with a BMI ≥ 25 than for those with a BMI < 25 (24.8 versus 13.7 months HR = 0.63; 95% CI 0.44–0.92, <i>p</i> = 0.015), and for patients experiencing toxicity than for those without toxicity (NR versus 7.8 months, HR = 0.22; 95% CI 0.15–0.33, <i>p</i> < 0.001). Adjusted OS was associated with toxicity, and the occurrence of toxicity was associated with sex and histological features but not with BMI. Thus, being overweight and experiencing toxicity was associated with longer overall survival in patients treated by immunotherapy. More attention should be paid to body composition in the care of cancer patients. |
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spelling | doaj.art-e5ac65b9c11045e1beaa2a345ff742f22023-11-21T18:17:40ZengMDPI AGCancers2072-66942021-05-01139220010.3390/cancers13092200Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective CohortLaetitia Collet0Lidia Delrieu1Amine Bouhamama2Hugo Crochet3Aurélie Swalduz4Alexandre Nerot5Timothée Marchal6Sylvie Chabaud7Pierre Etienne Heudel8Department of Medical Oncology, Centre Léon Bérard, 69008 Lyon, FranceDepartment of Prevention Cancer Environment, Léon Bérard Cancer Centre, 69008 Lyon, FranceRadiology Department, Centre Léon Bérard, 69008 Lyon, FranceData and Artificial Intelligence Team, Centre Léon Bérard, 69008 Lyon, FranceDepartment of Medical Oncology, Centre Léon Bérard, 69008 Lyon, FranceRadiology Department, Centre Léon Bérard, 69008 Lyon, FranceDepartment of Supportive Care, Institut Curie, 75005 Paris, FranceDepartment of Clinical Research and Innovation, Léon Bérard Cancer Centre, 69008 Lyon, FranceDepartment of Medical Oncology, Centre Léon Bérard, 69008 Lyon, FranceThe response to immunotherapy has been little investigated in overweight and obese cancer patients. We evaluated the relationships between BMI, toxicity, and survival in patients treated by immunotherapy for metastatic cancer. We included metastatic cancer patients treated by immunotherapy between January 2017 and June 2020 at the Centre Léon Bérard. In total, 272 patients were included: 64% men and 36% women, with a median age of 61.4 years. BMI ≥ 25 in 34.2% and 50% had non-small cell lung cancer (<i>n</i> = 136). Most received monotherapy, with nivolumab in 41.9% and pembrolizumab in 37.9%. Toxicity, mostly dysthyroiditis, occurred in 41%. Median overall survival (OS), estimated by Kaplan–Meier analysis, was significantly longer for patients with a BMI ≥ 25 than for those with a BMI < 25 (24.8 versus 13.7 months HR = 0.63; 95% CI 0.44–0.92, <i>p</i> = 0.015), and for patients experiencing toxicity than for those without toxicity (NR versus 7.8 months, HR = 0.22; 95% CI 0.15–0.33, <i>p</i> < 0.001). Adjusted OS was associated with toxicity, and the occurrence of toxicity was associated with sex and histological features but not with BMI. Thus, being overweight and experiencing toxicity was associated with longer overall survival in patients treated by immunotherapy. More attention should be paid to body composition in the care of cancer patients.https://www.mdpi.com/2072-6694/13/9/2200body mass indeximmunotherapysurvivaltoxicityadvanced cancerimmune-related adverse events |
spellingShingle | Laetitia Collet Lidia Delrieu Amine Bouhamama Hugo Crochet Aurélie Swalduz Alexandre Nerot Timothée Marchal Sylvie Chabaud Pierre Etienne Heudel Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort Cancers body mass index immunotherapy survival toxicity advanced cancer immune-related adverse events |
title | Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort |
title_full | Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort |
title_fullStr | Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort |
title_full_unstemmed | Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort |
title_short | Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort |
title_sort | association between body mass index and survival outcome in metastatic cancer patients treated by immunotherapy analysis of a french retrospective cohort |
topic | body mass index immunotherapy survival toxicity advanced cancer immune-related adverse events |
url | https://www.mdpi.com/2072-6694/13/9/2200 |
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