Abstract 51P
Background
Immune checkpoint inhibitors (ICI) have revolutionized the management of advanced non-small cell lung cancer (NSCLC). Emerging evidence suggests a potential link between elevated body mass index (BMI) and improved ICI efficacy, though findings remain inconsistent.
Methods
A retrospective study was conducted at a multi-center registry, including stage IV NSCLC patients treated with first-line ICI therapies, either pembrolizumab or ipilimumab-nivolumab, administered as monotherapy or in combination with chemotherapy, between January 2018 and December 2023. Patients were categorized by BMI according to WHO classification. Overall survival (OS) and progression-free survival (PFS) were analysed using Kaplan-Meier survival analysis and Cox proportional hazards regression.
Results
Among 346 patients, 12.72% underweight, 45.38% normal weight, 29.19% overweight, and 12.72% obese. Overweight and obese patients were more likely to receive pembrolizumab (p=0.039) and less likely to receive chemotherapy (p=0.012). No significant differences in median overall survival (OS, log-rank: p=0.155) or progression-free survival (PFS, log-rank: p=0.370) were observed across BMI categories. However, differences in OS and PFS emerged upon further analysis of PD-L1 levels (p=0.002; p=0.003, respectively), additional chemotherapy (p=0.010; p=0.067, respectively), type of ICI therapy (p < 0.001 for both), and histologic diagnosis (p=0.024; p=0.010, respectively).
Conclusions
BMI was not an independent predictor of survival outcomes in advanced NSCLC treated with ICI. Incorporating BMI with other patient-specific factors into personalized immunotherapy strategies highlights the importance of tailored approaches to improve patient care and clinical outcomes.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.