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

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Article numbere001403
JournalJ. Immunother. Cancer
Volume8
Issue number2
DOIs
Publication statusPublished - Oct 1 2020

Keywords

  • immunotherapy

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