Abstract 3069
Background
An elevated BMI is associated with improved prognosis in certain solid tumors treated with ICI; however, real-world data and genomic analysis has been lacking. We investigated the effect of BMI on RCC patients treated with PD-1/PD-L1 based ICI and explored potential genomic alterations (GA).
Methods
Using the International Metastatic RCC Database Consortium (IMDC) database, we performed a retrospective analysis on patients treated with ICI alone or in combination with other therapies. The association of BMI with overall survival (OS), time to treatment failure (TTF), and objective response rate (ORR) was evaluated using Cox and logistic regressions respectively, adjusted for IMDC risk groups, histology, line and type of therapy, age, gender, and race. In an exploratory analysis of patients with clear cell RCC and available NGS panel data (275-447 genes), GA frequencies and tumor mutational burden (TMB) were compared by BMI status using Fisher’s exact and Mann-Whitney U tests. Results were considered statistically significant if p < 0.05 or q < 0.10.
Results
Of 1055 eligible patients, 735 had BMI data at start of ICI. Median follow up was 13.5 (<1-78.6) months (mos). Patients were mostly male (76%), had clear cell histology (85%), and were intermediate risk (60%). Overall, 31% received first-line ICI and 31% received combination ICI (19% with VEGF, 12% with CTLA-4/other therapies). At ICI initiation, 274 (37%) patients were considered low BMI (<25 kg/m2) and 461 (63%) considered high BMI (≥25 kg/m2). Patients with high BMI had better OS compared to those with low BMI, with 1-yr OS 79% vs 66% (adjusted HR = 0.75, 0.57-0.97, p = 0.03). ORR (30% vs 21%, adjusted p = 0.06) and TTF (median 7.4 vs 4.9 mos, adjusted p = 0.8) did not statistically differ. In a subset of 319 patients with clear cell RCC and available NGS data, GA and TMB (6.81 vs 6.81 mut/Mb, p = 0.9) were found to be similar between those with high BMI compared to low BMI.
Conclusions
High BMI is associated with improved OS in advanced RCC patients treated with ICI. In an exploratory analysis, there were no differences in genomic alterations on NGS by BMI status. Further correlative work is ongoing.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S.K. Pal: Advisory / Consultancy: Astellas; Advisory / Consultancy: Aveo; Advisory / Consultancy: BMS; Advisory / Consultancy: Eisai; Advisory / Consultancy: Exelixis; Advisory / Consultancy: Genentech; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Myriad; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pfizer; Research grant / Funding (institution): Medivation. A.R. Hansen: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Boehringer Ingelheim; Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy, Research grant / Funding (institution): GSK; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy: Pfizer. F. Donskov: Research grant / Funding (institution): Ipsen; Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Pfizer. T. Yuasa: Advisory / Consultancy: BMS; Advisory / Consultancy: Novartis; Advisory / Consultancy: Ono; Advisory / Consultancy: Pfizer. U. Vaishampayan: Advisory / Consultancy, Research grant / Funding (institution): Astellas; Advisory / Consultancy: Bayer; Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy, Research grant / Funding (institution): Exelixis; Advisory / Consultancy: Genentech; Advisory / Consultancy, Research grant / Funding (institution): Pfizer; Advisory / Consultancy: Sanofi. N.S. Basappa: Advisory / Consultancy: Astellas; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Bayer; Speaker Bureau / Expert testimony: BMS; Advisory / Consultancy: Eisai; Advisory / Consultancy: Ipsen; Advisory / Consultancy: Janssen; Advisory / Consultancy: Merck; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Roche. D.Y.C. Heng: Advisory / Consultancy: Astellas; Advisory / Consultancy, Research grant / Funding (institution): BMS; Research grant / Funding (institution): Exelixis; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy, Research grant / Funding (institution): Pfizer; Advisory / Consultancy: Janssen. T.K. Choueiri: Advisory / Consultancy: Alexion; Advisory / Consultancy: Alligent; Advisory / Consultancy: Analysis Group; Research grant / Funding (institution): Agensys; Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Bayer; Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy, Research grant / Funding (institution): Cerulean; Advisory / Consultancy, Research grant / Funding (institution): Corvus; Advisory / Consultancy, Research grant / Funding (institution): Eisai; Advisory / Consultancy, Research grant / Funding (institution): Exelixis; Advisory / Consultancy, Research grant / Funding (institution): Foundation Medicine; Advisory / Consultancy, Research grant / Funding (institution): GSK; Advisory / Consultancy, Research grant / Funding (institution): Ipsen; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy, Research grant / Funding (institution): Peloton; Advisory / Consultancy, Research grant / Funding (institution): Pfizer; Advisory / Consultancy, Research grant / Funding (institution): Prometheus; Advisory / Consultancy, Research grant / Funding (institution): Roche/Genentech. All other authors have declared no conflicts of interest.
Resources from the same session
2344 - Lung Cancer in Europe: strengthening policy responses to address unmet needs
Presenter: Mary Bussell
Session: Poster Display session 3
Resources:
Abstract
1359 - Curative treatment timelines for breast, colorectal, lung and prostate cancer: Implications for medical leave coverage
Presenter: Selina Wong
Session: Poster Display session 3
Resources:
Abstract
4433 - Acute Diagnostic Oncology Clinic: A Unique Primary Care-Oncology Service
Presenter: Abhijit Gill
Session: Poster Display session 3
Resources:
Abstract
3506 - THE NEW MUTATIONAL MODEL IN ONCOLOGY. What changes in welfare, clinical practice, research, and regulatory procedures
Presenter: Nicola Normanno
Session: Poster Display session 3
Resources:
Abstract
3350 - Selection of a set of quality indicators (QI) for oncological clinical pathway
Presenter: Aude Fourcade
Session: Poster Display session 3
Resources:
Abstract
4400 - Sustainable drug prices at market launch: policy proposals and their empirical evidence
Presenter: Nora Fanzen
Session: Poster Display session 3
Resources:
Abstract
4118 - Impact of financial considerations on French physicians’ prescription choices for advanced non-small cell lung cancer (NSCLC)
Presenter: Nathalie Olympios
Session: Poster Display session 3
Resources:
Abstract
1340 - The direct medical cost of breast cancer in a Belgian hospital
Presenter: Hannan Lemhouer
Session: Poster Display session 3
Resources:
Abstract
1863 - Does the healthcare system approaches cancer patients for using private services during diagnostic process?
Presenter: Karolina Osowiecka
Session: Poster Display session 3
Resources:
Abstract
2637 - Measuring financial toxicity of cancer in the Italian health care system: initial results of the patient reported outcome for Fighting Financial Toxicity of cancer project (proFFiT).
Presenter: Silvia Riva
Session: Poster Display session 3
Resources:
Abstract