|
1
|
Collet L, Delrieu L, Bouhamama A, Crochet H, Swalduz A, Nerot A, Marchal T, Chabaud S, Heudel PE. Association between Body Mass Index and Survival Outcome in Metastatic Cancer Patients Treated by Immunotherapy: Analysis of a French Retrospective Cohort. Cancers (Basel) 2021; 13:cancers13092200. [PMID: 34063692 PMCID: PMC8124396 DOI: 10.3390/cancers13092200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/18/2022] Open
Abstract
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 (n = 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, p = 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, p < 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.
Collapse
Affiliation(s)
- Laetitia Collet
- Department of Medical Oncology, Centre Léon Bérard, 69008 Lyon, France; (L.C.); (A.S.)
| | - Lidia Delrieu
- Department of Prevention Cancer Environment, Léon Bérard Cancer Centre, 69008 Lyon, France;
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France
| | - Amine Bouhamama
- Radiology Department, Centre Léon Bérard, 69008 Lyon, France; (A.B.); (A.N.)
| | - Hugo Crochet
- Data and Artificial Intelligence Team, Centre Léon Bérard, 69008 Lyon, France;
| | - Aurélie Swalduz
- Department of Medical Oncology, Centre Léon Bérard, 69008 Lyon, France; (L.C.); (A.S.)
| | - Alexandre Nerot
- Radiology Department, Centre Léon Bérard, 69008 Lyon, France; (A.B.); (A.N.)
| | - Timothée Marchal
- Department of Supportive Care, Institut Curie, 75005 Paris, France;
| | - Sylvie Chabaud
- Department of Clinical Research and Innovation, Léon Bérard Cancer Centre, 69008 Lyon, France;
| | - Pierre Etienne Heudel
- Department of Medical Oncology, Centre Léon Bérard, 69008 Lyon, France; (L.C.); (A.S.)
- Correspondence: ; Tel.: +33-0478782958
| |
Collapse
|