165P - BMI impact on the prognosis of unresectable HCC patients receiving first-line lenvatinib or atezolizumab plus bevacizumab

Background

Overweight is a negative, long-term, prognostic factor, however, the role of Body Mass Index (BMI) in the short-mid term in advanced tumors is unclear. The present analysis investigates the role of BMI weight classes in a large sample of HCC patients either receiving atezolizumab plus bevacizumab or lenvatinib as first line treatment.

Methods

The cohort included consecutive patients affected by BCLC-C and BCLC-B HCC patients from a multicenter international study group who received atezolizumab plus bevacizumab or lenvatinib as first line therapy. Population was stratified according to the conventional BMI thresholds into under-, over- and normal-weight. The primary objective of the study was to evaluate the prognostic and predictive impact of BMI in patients affected by advanced or intermediate HCC. Survival curves were estimated using the product-limit method of Kaplan-Meier. The role of stratification factors was analyzed with log-rank tests.

Results

1292 consecutive patients with HCC were analyzed. 466 (36%) patients were treated with lenvatinib and 826 (64%) patients were treated with atezolizumab plus bevacizumab. In the atezolizumab plus bevacizumab arm, 510 (62%) patients were normal-weight, 52 (6%) underweight and 264 (32%) overweight. At the univariate analysis for OS, underweight patients had significantly shorter OS compared to the normal-weight, whereas no difference was found between normal-weight versus overweight. Multivariate analysis confirmed that underweight patients had significantly shorter OS compared to normal-weight patients. patients (HR 1.7; 95% CI, 1.0-2.8; p=0.0323). In the lenvatinib arm, 26 patients (5.6%) were categorized as underweight, 256 (54.9%) as normal-weight, and 184 (39.5%) as overweight. At the univariate analysis for OS, no significative difference was found between normal-weight versus underweight and between normal-weight versus overweight, which was confirmed at multivariate analysis.

Conclusions

Our analysis highlighted a prognostic role of BMI in a cohort of patients with advanced HCC who received atezolizumab plus bevacizumab, while no prognostic role for low BMI was apparent in the lenvatinib arm.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.