scholarly journals Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer

2020 ◽  
Vol 8 (2) ◽  
pp. e001674
Author(s):  
Paul Johannet ◽  
Amelia Sawyers ◽  
Yingzhi Qian ◽  
Samuel Kozloff ◽  
Nicholas Gulati ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Advanced Cancer ◽  
Objective Response ◽  
Prognostic Nutritional Index ◽  
Baseline Body Mass Index ◽  
New York University ◽  
Nutritional Index ◽  
Baseline Bmi

BackgroundRecent research suggests that baseline body mass index (BMI) is associated with response to immunotherapy. In this study, we test the hypothesis that worsening nutritional status prior to the start of immunotherapy, rather than baseline BMI, negatively impacts immunotherapy response.MethodsWe studied 629 patients with advanced cancer who received immune checkpoint blockade at New York University. Patients had melanoma (n=268), lung cancer (n=128) or other primary malignancies (n=233). We tested the association between BMI changes prior to the start of treatment, baseline prognostic nutritional index (PNI), baseline BMI category and multiple clinical end points including best overall response (BOR), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS).ResultsDecreasing pretreatment BMI and low PNI were associated with worse BOR (p=0.04 and p=0.0004), ORR (p=0.01 and p=0.0005), DCR (p=0.01 and p<0.0001), PFS (p=0.02 and p=0.01) and OS (p<0.001 and p<0.001). Baseline BMI category was not significantly associated with any treatment outcomes.ConclusionStandard of care measures of worsening nutritional status more accurately associate with immunotherapy outcomes than static measurements of BMI. Future studies should focus on determining whether optimizing pretreatment nutritional status, a modifiable variable, leads to improvement in immunotherapy response.

scholarly journals Prognostic value of combined preoperative prognostic nutritional index and body mass index in HCC after hepatectomy

HPB ◽  
2017 ◽  
Vol 19 (8) ◽  
pp. 695-705 ◽  
Author(s):  
Fei Ji ◽  
Yao Liang ◽  
Shunjun Fu ◽  
Dubo Chen ◽  
XiuQin Cai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Prognostic Value ◽  
Prognostic Nutritional Index ◽  
Nutritional Index

Effects of Initial Body Mass Index and Weight Change on All-Cause Mortality: A 10-Year Cohort Study in Korea

2018 ◽  
Vol 30 (3) ◽  
pp. 217-226 ◽  
Author(s):  
Susan Park ◽  
Sunmi Pi ◽  
Jinseub Hwang ◽  
Jae-Heon Kang ◽  
Jin-Won Kwon
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Weight Change ◽  
Baseline Body Mass Index ◽  
Healthy Weight ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Baseline Bmi

We evaluated the effects of baseline body mass index (BMI) and its changes over 4 years on all-cause mortality in Korean population. We analyzed 351 735 participants whose BMI was measured in both 2002/2003 and 2006/2007. Mortality was assessed until 2013. Multivariate hazard ratios for all-cause mortality were estimated. Underweight and severe obesity with BMI >30 kg/m2 were significantly associated with higher mortality. Similarly, >5% decrease or >10% increase of BMI for 4 years was associated with the increased risk of death. Comparing the results between baseline BMI and BMI change, the BMI change showed more stable associations with mortality than the baseline BMI in subgroup analysis such as nonsmokers and healthy participants. This study suggests that BMI change could be a useful health indicator along with obesity level by BMI. In addition, maintaining a healthy weight is needed for longevity, but rapid weight change should be carefully monitored.

scholarly journals Impact of baseline body mass index on the efficacy and safety of tofacitinib in patients with psoriatic arthritis

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001486
Author(s):  
Jon T Giles ◽  
Alexis Ogdie ◽  
Juan J Gomez Reino ◽  
Philip Helliwell ◽  
Rebecca Germino ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Psoriatic Arthritis ◽  
Body Mass ◽  
Short Form ◽  
Response Rates ◽  
Baseline Body Mass Index ◽  
Two Phase ◽  
Link Type ◽  
The Impact ◽  
Baseline Bmi

ObjectivesThis post-hoc analysis explored the impact of body mass index (BMI) on tofacitinib efficacy/safety in patients with active psoriatic arthritis (PsA).MethodsData were pooled from two phase 3 studies (NCT01877668; NCT01882439). Analyses included patients randomised to tofacitinib 5/10 mg twio times a day or placebo, stratified by baseline BMI: <25 kg/m2, ≥25–<30 kg/m2, ≥30–<35 kg/m2 or ≥35 kg/m2. Endpoints (month 3): American College of Rheumatology (ACR20/50/70), Health Assessment Questionnaire-Disability Index (HAQ-DI) and Psoriasis Area and Severity Index (PASI) 75 response rates; dactylitis/enthesitis resolution rates; changes from baseline Short Form-36 Health Survey version 2 (SF-36v2) Physical/Mental Component Summary (PCS) scores and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) total score. Safety was also reported.ResultsAnalysis included 710 patients; 43.8% were obese (BMI ≥30 kg/m2). Tofacitinib demonstrated higher efficacy response rates at month 3, compared with placebo, regardless of baseline BMI. Generally, ACR20/50/70 and HAQ-DI response rates, enthesitis resolution rates and changes from baseline in SF-36v2 PCS score and FACIT-F total score (month 3) were reduced in patients with baseline BMI ≥35 kg/m2 versus patients with lower BMIs. Elevated alanine aminotransferase/aspartate aminotransferase levels were reported in patients with baseline BMI ≥35 kg/m2 receiving tofacitinib 5 mg but not 10 mg two times a day.ConclusionTofacitinib demonstrated greater efficacy than placebo in patients with PsA, regardless of baseline BMI. For all treatment arms, reduced efficacy was observed in patients with baseline BMI ≥35 kg/m2. Safety was generally comparable across BMI categories, although the effect of tofacitinib on liver enzymes in patients with baseline BMI ≥35 kg/m2 was inconclusive.

scholarly journals Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial

RMD Open ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e000934 ◽  
Author(s):  
Iain B McInnes ◽  
Gianfranco Ferraccioli ◽  
Maria-Antonietta D'Agostino ◽  
Manuela Le Bars ◽  
Subhashis Banerjee ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Psoriatic Arthritis ◽  
Normal Subgroup ◽  
Treatment Response ◽  
Body Mass ◽  
Health Assessment ◽  
Phase Iii ◽  
Baseline Body Mass Index ◽  
Post Hoc ◽  
Baseline Bmi

ObjectiveThis post hoc analysis of the phase III Active PSoriaTic Arthritis RAndomizEd TriAl (ASTRAEA) evaluated the effect of baseline body mass index (BMI) on subsequent response to subcutaneous (SC) abatacept in patients with psoriatic arthritis (PsA).MethodsIn ASTRAEA, patients with active PsA were randomised (1:1) to receive blinded weekly SC abatacept 125 mg or placebo for 24 weeks. Treatment response at week 24 was assessed by the proportions of patients achieving American College of Rheumatology 20% improvement response, Disease Activity Score in 28 joints (DAS28 (C reactive protein (CRP))) ≤3.6 and <2.6, Health Assessment Questionnaire-Disability Index reduction from baseline ≥0.35 and radiographic non-progression (defined as change from baseline ≤0 in PsA-modified total Sharp/van der Heijde score). Responses were stratified by baseline BMI (underweight/normal, <25 kg/m2; overweight, 25–30 kg/m2; obese, >30 kg/m2) and compared in univariate and multivariate models.ResultsOf 212/213 and 210/211 patients with baseline BMI data in the abatacept and placebo groups, respectively, 15% and 19% were underweight/normal, 36% and 27% were overweight, and 49% and 54% were obese. After adjusting for baseline characteristics, there were no significant differences for any outcome measure at week 24 with abatacept in the overweight or obese versus underweight/normal subgroup. In the placebo group, patients in the obese versus underweight/normal subgroup were significantly less likely to achieve DAS28 (CRP) <2.6 at week 24 (OR 0.26; 95% CI 0.08 to 0.87; p=0.03).ConclusionBMI does not impact clinical or radiographic response to SC abatacept in patients with PsA.Trial registration numberNCT01860976.

Prognostic significance of body mass index and prognostic nutritional index in stage II/III gastric cancer

2020 ◽  
Vol 46 (4) ◽  
pp. 620-625 ◽  
Author(s):  
Su Hyung Park ◽  
Sejin Lee ◽  
Jeong Ho Song ◽  
Seohee Choi ◽  
Minah Cho ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Prognostic Significance ◽  
Prognostic Nutritional Index ◽  
Stage Ii ◽  
Nutritional Index

scholarly journals Prevention of Advanced Cancer by Vitamin D3 Supplementation: Interaction by Body Mass Index Revisited

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1408
Author(s):  
Hermann Brenner ◽  
Sabine Kuznia ◽  
Clarissa Laetsch ◽  
Tobias Niedermaier ◽  
Ben Schöttker
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Cancer Patients ◽  
Body Mass ◽  
Advanced Cancer ◽  
Vitamin D3 ◽  
Normal Weight ◽  
The Body ◽  
Published Data ◽  
Vitamin D3 Supplementation

Meta-analyses of randomized controlled trials (RCTs) have demonstrated a protective effect of vitamin D3 (cholecalciferol) supplementation against cancer mortality. In the VITAL study, a RCT including 25,871 men ≥ 50 years and women ≥ 55 years, protective effects of vitamin D3 supplementation (2000 IU/day over a median of 5.3 years) with respect to incidence of any cancer and of advanced cancer (metastatic cancer or cancer death) were seen for normal-weight participants but not for overweight or obese participants. We aimed to explore potential reasons for this apparent variation of vitamin D effects by body mass index. We conducted complementary analyses of published data from the VITAL study on the association of body weight with cancer outcomes, stratified by vitamin D3 supplementation. Significantly increased risks of any cancer and of advanced cancer were seen among normal-weight participants compared to obese participants in the control group (relative risk (RR), 1.27; 95% confidence interval (CI), 1.07–1.52, and RR, 1.44; 95% CI, 1.04–1.97, respectively). No such patterns were seen in the intervention group. Among those with incident cancer, vitamin D3 supplementation was associated with a significantly reduced risk of advanced cancer (RR, 0.86; 95% CI, 0.74–0.99). The observed patterns point to pre-diagnostic weight loss of cancer patients and preventive effects of vitamin D3 supplementation from cancer progression as plausible explanations for the body mass index (BMI)—intervention interactions. Further research, including RCTs more comprehensively exploring the potential of adjuvant vitamin D therapy for cancer patients, should be pursued with priority.

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