Abstract 975P
Background
Anti-PD-1/PD-L1 agents have revolutionized the treatment of advanced cancer. However, many patients still do not benefit from these treatments. We sought to evaluate the impact of body mass index on the efficacy of anti-PD-1/PD-L1 drugs.
Methods
Retrospective data was collected from patients with advanced NSCLC (non-small cell lung cancer), genitourinary cancers, or malignant melanoma who received immune checkpoint inhibitor (ICI) treatment with anti-PD-1 or anti-PD-L1. Parameters evaluated included stage, ECOG Performance Status (PS) at initiation of ICI, development of immune related adverse events (irAE), and body mass index (BMI). Univariate and multivariate analyses were performed to assess the association between these parameters and overall survival (OS). The latter was calculated since the first administration of ICI.
Results
One hundred fourteen patients were included in this study. The most frequent tumor origin was lung (70.2%), followed by genitourinary (22.8%) and melanoma (7%). 84.4% of the patients received treatment with an anti-PD-1 agent, whereas 15.5% received treatment with an anti-PD-L1 agent. Patients with a BMI greater than 25 kg/m2 represented 49.2% of the cases. According to BMI classification, patients with underweight, normal-weight, and equal to or greater than overweight, had a median OS of 3.73 months (m), 15.76m, and 19.60m respectively (global p value of <0.001). Statistical analysis revealed that for every unit of increase in BMI, risk of death was reduced by 6%. PS, stage, and BMI remained independently associated with outcome in the multivariate analysis (Table). Table: 975P
Multivariate analysis for overall survival
| Variables | HR (95% CI) | p-value |
| ECOG PS 2 | 6.63 (2.56 – 17.21) | <0.001 |
| Advanced stage at baseline | 1.85 (1 - 3.41) | <0.049 |
| Overweight and obesity (BMI >25) | 0.21 (0.07 – 0.59) | 0.003 |
Conclusions
Our results suggest that low BMI is associated with worse outcome in patients with advanced cancer treated with ICIs. Upfront nutritional assessment and measures might improve the results of treatments with ICI.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
E. Arriola: Other, Institutional, Invited Speaker: BMS; Other, Institutional, Invited Speaker: AstraZeneca; Other, Institutional, Invited Speaker: Roche; Other, Institutional, Invited Speaker: MSD; Other, Institutional, Invited Speaker: Pfizer; Other, Institutional, Invited Speaker: Lilly; Other, Institutional, Invited Speaker: Boehriger Ingelheim. All other authors have declared no conflicts of interest.