Abstract 5872
Background
A previous study identified an association between high body mass index (BMI) and better overall survival (OS) in mRCC patients treated with vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs) (Albiges et al JCO 2016). We assessed whether the effect of BMI on OS extended beyond VEGF-TKI to immunotherapy (IO) or VEGF/IO combination regimens.
Methods
A retrospective study was done among patients diagnosed with mRCC treated at a single institution from 2009 to 2017. Demographic and clinical variables were collected. BMI was characterized as high (≥25 kg/m2) versus low (<25 kg/m2). The Kaplan-Meier method was used to estimate the difference in OS, segregated by BMI and further by treatment type (e.g., VEGF-TKI, IO or VEGF/IO).
Results
Among 235 patients, median age was 65 years (33-90), 73% were male, and 65% were overweight or obese (BMI ≥ 25 kg/m2). The majority of patients had undergone nephrectomy (86%). The most systemic therapy was VEGF-TKI (58%), followed by IO (17%) and VEGF/IO (25%). In patients treated with VEGF-TKI with low BMI, median OS was 25.0 months (95% CI: 18.7-31.2) versus 36.0 months (95% CI: 25.2-46.7) in patients with high BMI (P = 0.01). A similar result was found for patients treated with VEGF/IO, where median OS was 18.0 months (95% CI:10.0-25.9) for patients with low BMI versus 24.0 months (95% CI: 14.8-33.2) in patients with high BMI (P = 0.01). However, patients treated with IO with low BMI, median OS was 55.0 months (95% CI: 33.7-76.7) versus 22.9 months (95% CI: 17.7-28.1) in patients with high BMI (P = 0.33).
Conclusions
High BMI was associated with improved OS in patients with mRCC treated with VEGF-TKI or VEGF/IO, but the inverse trend was observed among patients receiving IO. In addition to validating previous findings associating VEGF-TKI, BMI and clinical outcome, our data highlight the need to reassess this phenomenon in the context of IO-based regimens.
Clinical trial identification
Legal entity responsible for the study
City of Hope.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.