29 research outputs found
Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression >= 50%: a multicenter study with external validation
Background The association between obesity and
outcomes in patients receiving programmed death-1/
programmed death ligand-1 (PD-L1) checkpoint inhibitors
has already been confirmed in pre-treated non-small cell
lung cancer (NSCLC) patients, regardless of PD-L1 tumor
expression.
Methods We present the outcomes analysis according
to baseline body mass index (BMI) and BMI variation in a
large cohort of metastatic NSCLC patients with a PD-L1
expression â„50%, receiving first line pembrolizumab.
We also evaluated a control cohort of metastatic
NSCLC patients treated with first line platinum-based
chemotherapy. Normal weight was set as control group.
Results 962 patients and 426 patients were included
in the pembrolizumab and chemotherapy cohorts,
respectively. Obese patients had a significantly higher
objective response rate (ORR) (OR=1.61 (95% CI: 1.04â
2.50)) in the pembrolizumab cohort, while overweight
patients had a significantly lower ORR (OR=0.59 (95%
CI: 0.37â0.92)) within the chemotherapy cohort. Obese
patients had a significantly longer progression-free
survival (PFS) (HR=0.61 (95% CI: 0.45â0.82)) in the
pembrolizumab cohort. Conversely, they had a significantly
shorter PFS in the chemotherapy cohort (HR=1.27 (95%
CI: 1.01â1.60)). Obese patients had a significantly longer
overall survival (OS) within the pembrolizumab cohort
(HR=0.70 (95% CI: 0.49â0.99)), while no significant
differences according to baseline BMI were found in the
chemotherapy cohort. BMI variation significantly affected
ORR, PFS and OS in both the pembrolizumab and the
chemotherapy cohorts.
Conclusions Baseline obesity is associated to
significantly improved ORR, PFS and OS in metastatic
NSCLC patients with a PD-L1 expression of â„50%,
receiving first line pembrolizumab, but not among
patients treated with chemotherapy. BMI variation is also
significantly related to clinical outcomes