Effect of excess weight and immune-related adverse events on the efficacy of cancer immunotherapy with anti-PD-1 antibodies

Immunotherapy is an effective treatment in advanced cancer, although predictors of response are limited. We studied whether excess weight influences the efficacy outcomes of immunotherapy. We have also evaluated the combined prognostic effect of excess weight and immune-related adverse events (irAEs...

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Bibliographic Details
Authors: Rogado, Jacobo, Romero-Laorden, Nuria, Sanchez-Torres, José Miguel, Ramos-Levi, Ana María, Pacheco-Barcia, Vilma, Ballesteros, Ana Isabel, Arranz, Reyes, Lorenzo, Alicia, Gullon, Pedro, Garrido, Ana, Serra López-Matencio, José María, Donnay, Olga, Adrados, Magdalena, Costas, Pablo, Aspa Marco, Francisco Javier, Alfranca González, Arantzazu, Mondejar, Rebeca, Colomer Bosch, Ramón
Format: article
Publication Date:2020
Country:España
Institution:Universidad Autónoma de Madrid
Repository:Biblos-e Archivo. Repositorio Institucional de la UAM
Language:English
OAI Identifier:oai:repositorio.uam.es:10486/693319
Online Access:http://hdl.handle.net/10486/693319
https://dx.doi.org/10.1080/2162402X.2020.1751548
Access Level:Open access
Keyword:Advanced cancer
Anti-PD-1
Excess weight
Immune-related adverse-events
Immunotherapy
Nivolumab
Obesity
Overweight
Pembrolizumab
Predictive Factor
Medicina
Description
Summary:Immunotherapy is an effective treatment in advanced cancer, although predictors of response are limited. We studied whether excess weight influences the efficacy outcomes of immunotherapy. We have also evaluated the combined prognostic effect of excess weight and immune-related adverse events (irAEs). Efficacy of anti-PD-1 treatment was evaluated with both objective radiological response (ORR) rate and progression-free survival (PFS), and toxicity with irAEs. We studied the association between excess weight and ORR, PFS or irAEs. 132 patients diagnosed with advanced cancer were included. Median body mass index (BMI) was 24.9 kg/m2. 64 patients had normal weight (BMI<25 kg/m2), and 64 patients had excess weight (BMI≥25 kg/m2). Four patients had underweight and were excluded from further analysis. ORR was achieved in 50 patients (38.0%), median PFS was 6 months. 44 patients developed irAEs (33.3%). ORR was higher in excess weight patients than in patients with normal weight (51.6% vs 25.0%; OR 3.45, p = .0009). PFS was improved in patients with excess weight (7.25 months vs 4 months, HR 1.72, p = .01). The incidence of IrAEs was not different in patients with excess weight (54.5% vs 43.2%, p = .21). When high BMI and irAEs were combined, we observed a marked prognostic trend in ORR rate (87.5% vs 6.2%; OR 161.0, p < .00001), and in PFS (14 months vs 3 months; HR 5.89, p < .0001). Excess weight patients with advanced cancer that receive single-agent anti-PD-1 antibody therapy exhibit a significantly improved clinical outcome compared with normal BMI patients. This association was especially marked when BMI and irAEs were considered combined.

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