Nonlinear association between body mass index and overall survival in advanced NSCLC patients treated with immune checkpoint blockade

• Published in: Cancer Immunology, Immunotherapy Immunotherapy, 2023-05, Vol.72 (5), p.1225-1232
• Main Authors: Jain, Aditya, Zhang, Shijia, Shanley, Ryan M., Fujioka, Naomi, Kratzke, Robert A., Patel, Manish R., Kulkarni, Amit A.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Aged; Body Mass Index; Cancer Research; Carcinoma, Non-Small-Cell Lung - pathology; Female; Humans; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - therapeutic use; Immunology; Lung cancer; Lung Neoplasms - pathology; Medicine; Medicine & Public Health; Metastases; Non-small cell lung carcinoma; Oncology; Retrospective Studies; Small cell lung carcinoma; Survival analysis
• ISSN: 0340-7004; 1432-0851
• DOI: 10.1007/s00262-022-03320-3

Background We investigated the association of body mass index (BMI) modeled as a continuous variable with survival outcomes in advanced non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICI). Methods We performed a single-institution retrospective analysis of consecutively diagnosed locally advanced or metastatic NSCLC patients treated with single-agent ICI in the first line or recurrent setting. The primary outcome was overall survival (OS). Secondary outcomes were progression-free survival (PFS) and objective response rate (ORR). BMI was modeled using a four-knot restricted cubic spline. Multiple Cox regression was used for survival analysis. Results Two hundred patients were included (female 54%; never smoker 12%). Adenocarcinoma was the most common histology (61%). Median age was 67 years, median BMI was 25.9 kg/m 2 , and 65% of patients had Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–1. On multivariable analysis, only BMI and ECOG PS were independently associated with OS ( p