Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.

Alessio Cortellini; Biagio Ricciuti; Marcello Tiseo; Emilio Bria; Giuseppe L. Banna; Joachim Gjv Aerts; Fausto Barbieri; Raffaele Giusti; Diego L. Cortinovis; Maria R. Migliorino; Annamaria Catino; Francesco Passiglia; Mariangela Torniai; Alessandro Morabito; Carlo Genova; Francesca Mazzoni; Vincenzo Di Noia; Diego Signorelli; Alain Gelibter; Mario Alberto Occhipinti; Francesca Rastelli; Rita Chiari; Danilo Rocco; Alessandro Inno; Michele De Tursi; Pietro Di Marino; Giovanni Mansueto; Federica Zoratto; Francesco Grossi; Marco Filetti; Pamela Pizzutilo; Marco Russano; Fabrizio Citarella; Luca Cantini; Giada Targato; Olga Nigro; Miriam G. Ferrara; Sebastiano Buti; Simona Scodes; Lorenza Landi; Giorgia Guaitoli; Luigi Della Gravara; Fabrizio Tabbò; Serena Ricciardi; Alessandro De Toma; Alex Friedlaender; Fausto Petrelli; Alfredo Addeo; Giampiero Porzio; Corrado Ficorella

doi:10.1136/jitc-2020-001403

Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.

Alessio Cortellini, Biagio Ricciuti, Marcello Tiseo, Emilio Bria, Giuseppe L. Banna, Joachim Gjv Aerts, Fausto Barbieri, Raffaele Giusti, Diego L. Cortinovis, Maria R. Migliorino, Annamaria Catino, Francesco Passiglia, Mariangela Torniai, Alessandro Morabito, Carlo Genova, Francesca Mazzoni, Vincenzo Di Noia, Diego Signorelli, Alain Gelibter, Mario Alberto OcchipintiFrancesca Rastelli, Rita Chiari, Danilo Rocco, Alessandro Inno, Michele De Tursi, Pietro Di Marino, Giovanni Mansueto, Federica Zoratto, Francesco Grossi, Marco Filetti, Pamela Pizzutilo, Marco Russano, Fabrizio Citarella, Luca Cantini, Giada Targato, Olga Nigro, Miriam G. Ferrara, Sebastiano Buti, Simona Scodes, Lorenza Landi, Giorgia Guaitoli, Luigi Della Gravara, Fabrizio Tabbò, Serena Ricciardi, Alessandro De Toma, Alex Friedlaender, Fausto Petrelli, Alfredo Addeo, Giampiero Porzio, Corrado Ficorella

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Abstract

BACKGROUND: The association between obesity and outcomes in patients receiving programmed death-1/programmed death ligand-1 (PD-L1) checkpoint inhibitors has already been confirmed in pre-treated non-small cell lung cancer (NSCLC) patients, regardless of PD-L1 tumor expression. METHODS: We present the outcomes analysis according to baseline body mass index (BMI) and BMI variation in a large cohort of metastatic NSCLC patients with a PD-L1 expression ≥50%, receiving first line pembrolizumab. We also evaluated a control cohort of metastatic NSCLC patients treated with first line platinum-based chemotherapy. Normal weight was set as control group. RESULTS: 962 patients and 426 patients were included in the pembrolizumab and chemotherapy cohorts, respectively. Obese patients had a significantly higher objective response rate (ORR) (OR=1.61 (95% CI: 1.04-2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37-0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45-0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01-1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49-0.99)), while no significant differences according to baseline BMI were found in the chemotherapy cohort. BMI variation significantly affected ORR, PFS and OS in both the pembrolizumab and the chemotherapy cohorts. CONCLUSIONS: Baseline obesity is associated to significantly improved ORR, PFS and OS in metastatic NSCLC patients with a PD-L1 expression of ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes.

Original language	English
Article number	e001403
Journal	J. Immunother. Cancer
Volume	8
Issue number	2
DOIs	https://doi.org/10.1136/jitc-2020-001403
Publication status	Published - Oct 1 2020

Keywords

immunotherapy

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10.1136/jitc-2020-001403

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Cortellini, A., Ricciuti, B., Tiseo, M., Bria, E., Banna, G. L., Aerts, J. G., Barbieri, F., Giusti, R., Cortinovis, D. L., Migliorino, M. R., Catino, A., Passiglia, F., Torniai, M., Morabito, A., Genova, C., Mazzoni, F., Di Noia, V., Signorelli, D., Gelibter, A., ... Ficorella, C. (2020). Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation. J. Immunother. Cancer, 8(2), [e001403]. https://doi.org/10.1136/jitc-2020-001403

Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation. / Cortellini, Alessio; Ricciuti, Biagio; Tiseo, Marcello; Bria, Emilio; Banna, Giuseppe L.; Aerts, Joachim Gjv; Barbieri, Fausto; Giusti, Raffaele; Cortinovis, Diego L.; Migliorino, Maria R.; Catino, Annamaria; Passiglia, Francesco; Torniai, Mariangela; Morabito, Alessandro ; Genova, Carlo; Mazzoni, Francesca; Di Noia, Vincenzo; Signorelli, Diego; Gelibter, Alain; Occhipinti, Mario Alberto; Rastelli, Francesca; Chiari, Rita; Rocco, Danilo; Inno, Alessandro; De Tursi, Michele; Di Marino, Pietro; Mansueto, Giovanni; Zoratto, Federica; Grossi, Francesco; Filetti, Marco; Pizzutilo, Pamela; Russano, Marco; Citarella, Fabrizio; Cantini, Luca; Targato, Giada; Nigro, Olga; Ferrara, Miriam G.; Buti, Sebastiano; Scodes, Simona; Landi, Lorenza; Guaitoli, Giorgia; Della Gravara, Luigi; Tabbò, Fabrizio; Ricciardi, Serena; De Toma, Alessandro; Friedlaender, Alex; Petrelli, Fausto; Addeo, Alfredo; Porzio, Giampiero; Ficorella, Corrado.

In: J. Immunother. Cancer, Vol. 8, No. 2, e001403, 01.10.2020.

Research output: Contribution to journal › Article › peer-review

Cortellini, A, Ricciuti, B, Tiseo, M, Bria, E, Banna, GL, Aerts, JG, Barbieri, F, Giusti, R, Cortinovis, DL, Migliorino, MR, Catino, A, Passiglia, F, Torniai, M, Morabito, A , Genova, C, Mazzoni, F, Di Noia, V, Signorelli, D, Gelibter, A, Occhipinti, MA, Rastelli, F, Chiari, R, Rocco, D, Inno, A, De Tursi, M, Di Marino, P, Mansueto, G, Zoratto, F, Grossi, F, Filetti, M, Pizzutilo, P, Russano, M, Citarella, F, Cantini, L, Targato, G, Nigro, O, Ferrara, MG, Buti, S, Scodes, S, Landi, L, Guaitoli, G, Della Gravara, L, Tabbò, F, Ricciardi, S, De Toma, A, Friedlaender, A, Petrelli, F, Addeo, A, Porzio, G & Ficorella, C 2020, 'Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.', J. Immunother. Cancer, vol. 8, no. 2, e001403. https://doi.org/10.1136/jitc-2020-001403

Cortellini, Alessio ; Ricciuti, Biagio ; Tiseo, Marcello ; Bria, Emilio ; Banna, Giuseppe L. ; Aerts, Joachim Gjv ; Barbieri, Fausto ; Giusti, Raffaele ; Cortinovis, Diego L. ; Migliorino, Maria R. ; Catino, Annamaria ; Passiglia, Francesco ; Torniai, Mariangela ; Morabito, Alessandro ; Genova, Carlo ; Mazzoni, Francesca ; Di Noia, Vincenzo ; Signorelli, Diego ; Gelibter, Alain ; Occhipinti, Mario Alberto ; Rastelli, Francesca ; Chiari, Rita ; Rocco, Danilo ; Inno, Alessandro ; De Tursi, Michele ; Di Marino, Pietro ; Mansueto, Giovanni ; Zoratto, Federica ; Grossi, Francesco ; Filetti, Marco ; Pizzutilo, Pamela ; Russano, Marco ; Citarella, Fabrizio ; Cantini, Luca ; Targato, Giada ; Nigro, Olga ; Ferrara, Miriam G. ; Buti, Sebastiano ; Scodes, Simona ; Landi, Lorenza ; Guaitoli, Giorgia ; Della Gravara, Luigi ; Tabbò, Fabrizio ; Ricciardi, Serena ; De Toma, Alessandro ; Friedlaender, Alex ; Petrelli, Fausto ; Addeo, Alfredo ; Porzio, Giampiero ; Ficorella, Corrado. / Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation. In: J. Immunother. Cancer. 2020 ; Vol. 8, No. 2.

@article{7d4c483543644e0c8e318c2d08c17cc0,

title = "Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.",

abstract = "BACKGROUND: The association between obesity and outcomes in patients receiving programmed death-1/programmed death ligand-1 (PD-L1) checkpoint inhibitors has already been confirmed in pre-treated non-small cell lung cancer (NSCLC) patients, regardless of PD-L1 tumor expression. METHODS: We present the outcomes analysis according to baseline body mass index (BMI) and BMI variation in a large cohort of metastatic NSCLC patients with a PD-L1 expression ≥50%, receiving first line pembrolizumab. We also evaluated a control cohort of metastatic NSCLC patients treated with first line platinum-based chemotherapy. Normal weight was set as control group. RESULTS: 962 patients and 426 patients were included in the pembrolizumab and chemotherapy cohorts, respectively. Obese patients had a significantly higher objective response rate (ORR) (OR=1.61 (95% CI: 1.04-2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37-0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45-0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01-1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49-0.99)), while no significant differences according to baseline BMI were found in the chemotherapy cohort. BMI variation significantly affected ORR, PFS and OS in both the pembrolizumab and the chemotherapy cohorts. CONCLUSIONS: Baseline obesity is associated to significantly improved ORR, PFS and OS in metastatic NSCLC patients with a PD-L1 expression of ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes.",

keywords = "immunotherapy",

author = "Alessio Cortellini and Biagio Ricciuti and Marcello Tiseo and Emilio Bria and Banna, {Giuseppe L.} and Aerts, {Joachim Gjv} and Fausto Barbieri and Raffaele Giusti and Cortinovis, {Diego L.} and Migliorino, {Maria R.} and Annamaria Catino and Francesco Passiglia and Mariangela Torniai and Alessandro Morabito and Carlo Genova and Francesca Mazzoni and {Di Noia}, Vincenzo and Diego Signorelli and Alain Gelibter and Occhipinti, {Mario Alberto} and Francesca Rastelli and Rita Chiari and Danilo Rocco and Alessandro Inno and {De Tursi}, Michele and {Di Marino}, Pietro and Giovanni Mansueto and Federica Zoratto and Francesco Grossi and Marco Filetti and Pamela Pizzutilo and Marco Russano and Fabrizio Citarella and Luca Cantini and Giada Targato and Olga Nigro and Ferrara, {Miriam G.} and Sebastiano Buti and Simona Scodes and Lorenza Landi and Giorgia Guaitoli and {Della Gravara}, Luigi and Fabrizio Tabb{\`o} and Serena Ricciardi and {De Toma}, Alessandro and Alex Friedlaender and Fausto Petrelli and Alfredo Addeo and Giampiero Porzio and Corrado Ficorella",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine",

year = "2020",

month = oct,

day = "1",

doi = "10.1136/jitc-2020-001403",

language = "English",

volume = "8",

journal = "J. Immunother. Cancer",

issn = "2051-1426",

publisher = "BioMed Central Ltd.",

number = "2",

}

TY - JOUR

T1 - Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.

AU - Cortellini, Alessio

AU - Ricciuti, Biagio

AU - Tiseo, Marcello

AU - Bria, Emilio

AU - Banna, Giuseppe L.

AU - Aerts, Joachim Gjv

AU - Barbieri, Fausto

AU - Giusti, Raffaele

AU - Cortinovis, Diego L.

AU - Migliorino, Maria R.

AU - Catino, Annamaria

AU - Passiglia, Francesco

AU - Torniai, Mariangela

AU - Morabito, Alessandro

AU - Genova, Carlo

AU - Mazzoni, Francesca

AU - Di Noia, Vincenzo

AU - Signorelli, Diego

AU - Gelibter, Alain

AU - Occhipinti, Mario Alberto

AU - Rastelli, Francesca

AU - Chiari, Rita

AU - Rocco, Danilo

AU - Inno, Alessandro

AU - De Tursi, Michele

AU - Di Marino, Pietro

AU - Mansueto, Giovanni

AU - Zoratto, Federica

AU - Grossi, Francesco

AU - Filetti, Marco

AU - Pizzutilo, Pamela

AU - Russano, Marco

AU - Citarella, Fabrizio

AU - Cantini, Luca

AU - Targato, Giada

AU - Nigro, Olga

AU - Ferrara, Miriam G.

AU - Buti, Sebastiano

AU - Scodes, Simona

AU - Landi, Lorenza

AU - Guaitoli, Giorgia

AU - Della Gravara, Luigi

AU - Tabbò, Fabrizio

AU - Ricciardi, Serena

AU - De Toma, Alessandro

AU - Friedlaender, Alex

AU - Petrelli, Fausto

AU - Addeo, Alfredo

AU - Porzio, Giampiero

AU - Ficorella, Corrado

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

PY - 2020/10/1

Y1 - 2020/10/1

N2 - BACKGROUND: The association between obesity and outcomes in patients receiving programmed death-1/programmed death ligand-1 (PD-L1) checkpoint inhibitors has already been confirmed in pre-treated non-small cell lung cancer (NSCLC) patients, regardless of PD-L1 tumor expression. METHODS: We present the outcomes analysis according to baseline body mass index (BMI) and BMI variation in a large cohort of metastatic NSCLC patients with a PD-L1 expression ≥50%, receiving first line pembrolizumab. We also evaluated a control cohort of metastatic NSCLC patients treated with first line platinum-based chemotherapy. Normal weight was set as control group. RESULTS: 962 patients and 426 patients were included in the pembrolizumab and chemotherapy cohorts, respectively. Obese patients had a significantly higher objective response rate (ORR) (OR=1.61 (95% CI: 1.04-2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37-0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45-0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01-1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49-0.99)), while no significant differences according to baseline BMI were found in the chemotherapy cohort. BMI variation significantly affected ORR, PFS and OS in both the pembrolizumab and the chemotherapy cohorts. CONCLUSIONS: Baseline obesity is associated to significantly improved ORR, PFS and OS in metastatic NSCLC patients with a PD-L1 expression of ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes.

AB - BACKGROUND: The association between obesity and outcomes in patients receiving programmed death-1/programmed death ligand-1 (PD-L1) checkpoint inhibitors has already been confirmed in pre-treated non-small cell lung cancer (NSCLC) patients, regardless of PD-L1 tumor expression. METHODS: We present the outcomes analysis according to baseline body mass index (BMI) and BMI variation in a large cohort of metastatic NSCLC patients with a PD-L1 expression ≥50%, receiving first line pembrolizumab. We also evaluated a control cohort of metastatic NSCLC patients treated with first line platinum-based chemotherapy. Normal weight was set as control group. RESULTS: 962 patients and 426 patients were included in the pembrolizumab and chemotherapy cohorts, respectively. Obese patients had a significantly higher objective response rate (ORR) (OR=1.61 (95% CI: 1.04-2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37-0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45-0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01-1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49-0.99)), while no significant differences according to baseline BMI were found in the chemotherapy cohort. BMI variation significantly affected ORR, PFS and OS in both the pembrolizumab and the chemotherapy cohorts. CONCLUSIONS: Baseline obesity is associated to significantly improved ORR, PFS and OS in metastatic NSCLC patients with a PD-L1 expression of ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes.

KW - immunotherapy

U2 - 10.1136/jitc-2020-001403

DO - 10.1136/jitc-2020-001403

M3 - Article

VL - 8

JO - J. Immunother. Cancer

JF - J. Immunother. Cancer

SN - 2051-1426

IS - 2

M1 - e001403

ER -

Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.

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