Abstract 2548
Background
Immunotherapy is a new and effective form of therapy in several types of cancer, although molecular predictors of response are limited. Recently, we have described that immune-related adverse-events (irAEs) are significantly associated with immunotherapy efficacy, and it has been suggested that body mass index (BMI) might be a favourable factor. We have studied whether excess weight influences the efficacy outcomes of immunotherapy and whether it is associated with immune-related adverse events. We have also evaluated the combined effect of overweight and irAEs.
Methods
We calculated BMI in patients treated with single-agent anti-PD-1 antibodies for advanced cancer. Efficacy of anti-PD-1 treatment was evaluated with both objective response (OR) rate, and progression-free survival (PFS), and toxicity with irAEs. We established the association between overweight and OR, PFS and irAEs.
Results
One hundred and thirty-two patients were included in the study. Primary malignancies were lung cancer (n = 93), melanoma (n = 12), head and neck carcinoma (n = 9), renal carcinoma (n = 6), urothelial carcinoma (n = 4), Hodgkin’s lymphoma (n = 3), and other cancers (n = 5). Median BMI was 24.9 kg/m2, and 64 patients (48.4%) were excess weight (BMI≥25 kg/m2). An OR was achieved in 50 patients (38.0%), and median PFS was 6 months. IrAEs occurred in 44 patients (33.3%). OR was significantly higher in excess weight patients that in patients with BMI <25 kg/m2 (51.6% vs 25.0%) (Odds Ratio 3.45, CI 95% 1.58-7.55, p = 0.0009). PFS was also significantly improved in excess weight patients (7.25 months vs 4 months, HR 1.72, CI 95% 1.12–2.64, p = 0.01). IrAEs were not more frequent in excess weight patients (54.5% vs 43.2%, p = 0.21). When BMI and irAES were combined, we observed a clear prognostic trend in OR rate (87.5% in overweight patients with irAEs, in contrast with 6.2% in patients with normal BMI) (OR 161.0, CI 95% 1.58-7.55 p < 0.00001), and PFS (14 months vs 3 months) (HR 5.89, p < 0.0001).
Conclusions
Excess weight patients with advanced cancer that receive single-agent anti-PD-1 antibody therapy exhibit a significantly improved clinical outcome compared with patients with normal BMI. This association was especially marked when BMI and irAEs were considered combined.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Instituto Investigacion Sanitaria Princesa.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5383 - A pilot trial to investigate the impact of a personalised self-management lifestyle programme using mobile technology on the health and wellbeing of cancer survivors
Presenter: Mary Grace Kelly
Session: Poster Display session 3
Resources:
Abstract
5084 - The BRIGHTLIGHT national survey of the impact of specialist teenage and young adult cancer care on caregivers’ information and support needs
Presenter: Rachel Taylor
Session: Poster Display session 3
Resources:
Abstract
4328 - Life beyond cancer: Occupational health care service support in returning work experienced by cancer survivals
Presenter: Minna Nurmi
Session: Poster Display session 3
Resources:
Abstract
3337 - Investigating the factors related to primary caregivers' burden in oncology patients in Greece
Presenter: Ourania Govina
Session: Poster Display session 3
Resources:
Abstract
3387 - Factors Influencing the Level of Emotional Support from Nurses Perceived by Patients Undergoing Haematopoietic Stem Cell Transplantation in Protective Isolation
Presenter: Michela Piredda
Session: Poster Display session 3
Resources:
Abstract
935 - Progressive Muscle Relaxation and Guided Imagery Techniques and the Way of Coping of Parents of Children with Malignancies: A randomized controlled trial
Presenter: Tsitsi Theologia
Session: Poster Display session 3
Resources:
Abstract
3457 - Pharmacist and Nurse Led Melanoma Immunotherapy Clinic
Presenter: Dharmisha Chauhan
Session: Poster Display session 3
Resources:
Abstract
5160 - Measuring the impact of the Irish Cancer Society's Cancer Information Services
Presenter: Aileen McHale
Session: Poster Display session 3
Resources:
Abstract
4297 - It's Great to Talk
Presenter: Noreen Andersen
Session: Poster Display session 3
Resources:
Abstract
4444 - Impact of Burn-Out Syndrome in Oncology personnel and its improvement through specific interventions
Presenter: Inmaculada Ortega
Session: Poster Display session 3
Resources:
Abstract