Abstract B050: Validation of body mass index (BMI) as a prognostic factor in patients (pts) treated with immune checkpoint inhibitors (ICI) across multiple cancer types (CT) and the impact of confounding factors (CF)

2019 ◽  
Author(s):  
Analía Azaro ◽  
Alejandra Ivars ◽  
Ignacio Matos ◽  
Omar Saavedra ◽  
Itziar Gardeazabal ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Prognostic Factor ◽  
Body Mass ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Confounding Factors ◽  
Multiple Cancer ◽  
Cancer Types ◽  
The Impact

scholarly journals Association between body mass index, dosing strategy, and efficacy of immune checkpoint inhibitors

2021 ◽  
Vol 9 (6) ◽  
pp. e002349
Author(s):  
Murtaza Ahmed ◽  
Mitchell S von Itzstein ◽  
Thomas Sheffield ◽  
Shaheen Khan ◽  
Farjana Fattah ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Clinical Outcomes ◽  
Body Mass ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Fixed Dose ◽  
Radiographic Response ◽  
Dosing Strategy ◽  
High Bmi

BackgroundIncreased body mass index (BMI) has been associated with improved response to immune checkpoint inhibitors (ICIs) in multiple cancer types. We evaluated associations between BMI, ICI dosing strategy, and clinical outcomes.MethodsWe abstracted clinical data on patients with cancer treated with ICI, including age, sex, cancer type, BMI, ICI type, dosing strategy (weight-based or fixed), radiographic response, overall survival (OS), and progression-free survival (PFS). We compared clinical outcomes between low-BMI and high-BMI populations using Kaplan-Meier curves, Cox regressions, and Pearson product-moment correlation coefficients.ResultsA total of 297 patients were enrolled, of whom 40% were women and 59% were overweight (BMI≥25). Of these, 204 (69%) received fixed and 93 (31%) received weight-based ICI dosing. In the overall cohort, overweight BMI was associated with improved PFS (HR 0.69; 95% CI 0.51 to 0.94; p=0.02) and had a trend toward improved OS (HR 0.77; 95% CI 0.57 to 1.04; p=0.08). For both endpoints, improved outcomes in the overweight population were limited to patients who received weight-based ICI dosing (PFS HR 0.53; p=0.04 for weight-based; vs HR 0.79; p=0.2 for fixed dosing) (OS HR 0.56; p=0.03 for weight-based; vs HR 0.89; p=0.54 for fixed dosing). In multivariable analysis, BMI was not associated with PFS or OS. However, the interaction of BMI≥25 and weight-based dosing had a trend toward association with PFS (HR 0.53; 95% CI 0.26 to 1.10; p=0.09) and was associated with OS (HR 0.50; 95% CI 0.25 to 0.99; p=0.05). Patients with BMI<25 tended to have better outcomes with fixed-dose compared with weight-based ICI, while patients with BMI≥25 tended to have better outcomes with weight-based ICI, although these differences did not achieve statistical significance. There was no association between radiographic response and BMI with fixed-dose ICI (p=0.97), but a near-significant trend with weight-based ICI (p=0.1). In subset analyses, the association between BMI, ICI dosing strategy, and clinical outcomes appeared limited to men.ConclusionsThe clinical benefit of ICI in high-BMI populations appears limited to individuals receiving weight-based ICI dosing. Further research into optimal ICI dosing strategies may be warranted.

scholarly journals Anti-PD-1/Anti-PD-L1 Drugs and Radiation Therapy: Combinations and Optimization Strategies

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4893
Author(s):  
Jihane Boustani ◽  
Benoît Lecoester ◽  
Jérémy Baude ◽  
Charlène Latour ◽  
Olivier Adotevi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Optimal Dose ◽  
Target Volume ◽  
Clinical Responses ◽  
Cancer Types ◽  
The Impact

Immune checkpoint inhibitors have been associated with long-term complete responses leading to improved overall survival in several cancer types. However, these novel immunotherapies are only effective in a small proportion of patients, and therapeutic resistance represents a major limitation in clinical practice. As with chemotherapy, there is substantial evidence that radiation therapy promotes anti-tumor immune responses that can enhance systemic responses to immune checkpoint inhibitors. In this review, we discuss the main preclinical and clinical evidence on strategies that can lead to an enhanced response to PD-1/PD-L1 blockade in combination with radiation therapy. We focused on central issues in optimizing radiation therapy, such as the optimal dose and fractionation for improving the therapeutic ratio, as well as the impact on immune and clinical responses of dose rate, target volume, lymph nodes irradiation, and type of radiation particle. We explored the addition of a third immunomodulatory agent to the combination such as other checkpoint inhibitors, chemotherapy, and treatment targeting the tumor microenvironment components. The strategies described in this review provide a lead for future clinical trials.

scholarly journals Association Between Body Mass Index and Survival Outcomes In Patients Treated With Immune Checkpoint Inhibitors

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Run-Cong Nie ◽  
Guo-Ming Chen ◽  
Yun Wang ◽  
Shu-Qiang Yuan ◽  
Jie Zhou ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Survival Outcomes

scholarly journals Association between Body Mass Index and Immune-Related Adverse Events (irAEs) among Advanced-Stage Cancer Patients Receiving Immune Checkpoint Inhibitors: A Pan-Cancer Analysis

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6109
Author(s):  
Dongyu Zhang ◽  
Neil J. Shah ◽  
Michael Cook ◽  
Matthew Blackburn ◽  
Michael T. Serzan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Adverse Events ◽  
Cancer Patients ◽  
Body Mass ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Multivariable Logistic Regression Model ◽  
Multivariable Logistic Regression

Evidence regarding the association between body mass index (BMI) and immune-related adverse events (irAEs) among cancer patients receiving immune checkpoint inhibitors (ICIs) is limited. Here, we use cross-sectional hospital-based data to explore their relationship. Pre-treatment BMI was treated as an ordinal variable (<25, 25 to ≤30, ≥30 kg/m2). The outcome of interest was irAEs after ICI initiation. A multivariable logistic regression model estimated the adjusted odds ratio (aOR) and 95% confidence interval (CI) of BMI. A total of 684 patients with stage III or IV cancer were included in the study (lung: 269, melanoma: 204, other: 211). The mean age at the first dose of ICI was 64.1 years (SD = 13.5), 394 patients (57.6%) were male, and over one-third (N = 260, 38.0%) were non-White. Overall, 52.9% of patients had BMI ≥ 25 kg/m2 (25 to ≤30: 217, ≥30: 145) and 288 (42.1%) had irAEs after ICI treatment. Patients with higher BMI tended to have a higher rate of irAEs (<25: 35.7%, 25 to ≤30: 47.0%, ≥30: 49.0%). The multivariable logistic regression yielded consistent results (BMI ≥ 30 vs. BMI < 25: aOR = 1.47, 95% CI = 0.96–2.23; 25 ≤ BMI < 30 vs. BMI < 25: aOR = 1.46, 95% CI = 1.02–2.11, p-trend = 0.04). In conclusion, among patients with advanced cancer receiving ICIs, the rate of irAEs appears to be higher among those with higher BMI.

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