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Poster session 18

1754P - Association between body mass index (BMI) and anti-PD1/L1 immune checkpoint inhibitor (ICI) outcomes in patients with metastatic urothelial carcinoma (mUC)


10 Sep 2022


Poster session 18


Tumour Site

Genitourinary Cancers


Soumaya Labidi


Annals of Oncology (2022) 33 (suppl_7): S785-S807. 10.1016/annonc/annonc1080


S. Labidi1, N. meti2, R. barua3, J.J. Riromar4, A.R. Hansen5, D.M. Jiang5, N. Fallah-Rad5, S. Sridhar5, C. Ferrario1, R. Pezo6, S. Cheng6, A. Sacher5, A. Rose1

Author affiliations

  • 1 Segal Cancer Center, Jewish General Hospital, H3T 1E2 - Montreal/CA
  • 2 Medical Oncology, St Mary's Hospital, H3T 1M5 - Montreal/CA
  • 3 Medical Oncology, Michael Garron Hospital, M4C3E7 - Toronto/CA
  • 4 National Oncology Center, Royal hospital, H9GQ+J74 - Muscat/OM
  • 5 Division Of Medical Oncology, UHN - University Health Network - Princess Margaret Cancer Center, M5G 2M9 - Toronto/CA
  • 6 Medical Oncology, Sunnybrook Health Sciences Centre - Odette Cancer Centre, M4N 3M5 - Toronto/CA

Abstract 1754P


Anti-PD1/L1 ICIs are indicated for mUC, however, only a minority of patients (pts) will derive therapeutic benefit. Strong predictive and prognostic factors are lacking. Obesity causes a low grade chronic inflammatory state and has been associated with increased ICI responsiveness in some cancer types. We investigated whether elevated BMI was associated with ICI outcomes in mUC.


We performed a multi-center retrospective cohort study including 121 pts with mUC who received anti-PD1/L1 ICI for metastatic disease between 2016-2021 at 3 Canadian cancer centres. Clinical characteristics, including demographics, BMI, neutrophil to lymphocyte ratio (NLR), objective response, and survival were abstracted from chart review. ICI treatment response was determined by investigator assessment of clinical and radiologic parameters. Fisher’s exact test was used to assess differences in response rates between groups. Log rank and Cox regression models were used to assess overall survival (OS).


Ninety (74%) were male, and 74 (61%) received ICI as a 2nd or later line therapy for metastatic disease. Twenty-three pts had a BMI ≥ 30, 43 had a 25 ≤ BMI < 30 and 55 had a BMI < 25. A BMI ≥ 25 was significantly correlated to a higher response rate to ICI (45.4% vs 16.3%, p=0.02). After a median follow-up of 14.5 months, pts with BMI ≥ 30 experienced significant longer median OS 24.8 months vs 14.4 months for 25 ≤ BMI < 30 and 8.5 months for BMI < 25 (p=0.012). In multivariate analysis, BMI ≥ 30 was an independent prognosis factor for OS as detailed in the table. Table: 1754P

OS Univariable Multivariable
HR 95%CI p-value HR 95%CI p-value
BMI ≥ 30 vs < 30 0.63 0.45-0.88 0.002 0.40 0.17-0.96 0.040
Male vs Female 0.95 0.58-1.57 0.867
ECOG ≥ 2 vs 0-1 1.68 0.86-3.29 0.125 2.21 1.02-4.78 0.042
ICI Line ≥ 2 vs 1 2.39 1.43-3.97 0.001 1.80 1.31-2.48 0.000
NLR ≥ 4 vs < 4 2.46 1.53-3.94 0.000 2.66 1.58-4.49 0.000
Bone metastasis Yes vs No 2.38 1.52-3.73 0.000 1.98 1.17-3.35 0.010
Lung metastasis Yes vs No 1.88 1.21-2.93 0.005
Liver metastasis Yes vs No 1.92 1.20-3.09 0.006
Age ≥ 60 vs < 60 1.88 0.65-5.45 0.235


Our data identified BMI, as a novel potential biomarker that is strongly and independently associated with ICI response and survival in mUC. External validation of these data in a larger study and investigations into the mechanisms behind these findings are warranted.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


University of Toronto, Division of Medical Oncology Strategic Planning Grant.


D.M. Jiang: Financial Interests, Personal, Invited Speaker: Janssen Oncology, Ipsen, Bayer, EMD Serono Canada, Amgen; Financial Interests, Personal, Advisory Board: EMD Serono Pfizer. C. Ferrario: Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer, Merck, Knights Therapeutics; Financial Interests, Institutional, Invited Speaker: Astellas, AstraZeneca, Lilly, Merck, Novartis, Roche-Genetech, Sanofi, Seattle Genetics, Sermonix, Zymeworks; Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Institutional, Funding: Bayer; Non-Financial Interests, Advisory Role: AstraZeneca, Knights Therapeutics, Merck. R. Pezo: Financial Interests, Personal and Institutional, Advisory Board, Research Funding: Merck, Lilly, Pfizer, AstraZeneca, Daiichi Sankyo, Novartis; Financial Interests, Personal, Advisory Board: BMS, EMD Serono, Myriad, Exact Sciences; Financial Interests, Institutional, Research Grant: Ambrx Biopharma, Taiho Pharma, Zymeworks. S. Cheng: Financial Interests, Personal, Advisory Board: Merck, AstraZeneca. A. Sacher: Financial Interests, Institutional, Invited Speaker: Genentech-Roche, BMS, AstraZeneca, Amgen, Iovance, CRISPR Therapeutics, Merck, Pfizer, GSK, Spectrum, Lilly. A. Rose: Other, Personal, Other, spouse: Merck. All other authors have declared no conflicts of interest.

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