Obesity has been associated with improved response to immunotherapy in cancer patients. We investigated the role of body mass index (BMI) in patients from the ARON-1 study (NCT05287464) treated by dual immuno-oncology agents (IO+IO) or a combination of immuno-oncology drug and a tyrosine kinase inhibitors (TKI) as first-line therapy for metastatic renal cell carcinoma (mRCC).
Medical records of patients with documented mRCC treated by immuno-oncology combinations were reviewed at 47 institutions from 16 countries. Patients were assessed for overall survival (OS), progression-free survival (OS), and overall clinical benefit (OCB), defined as the sum of the rate of partial/complete responses and stable disease. Univariate and multivariate analyses were used to explore the association of variables of interest with survival.
A total of 675 patients were included; BMI was >25 kg/m2 in 345 patients (51%) and was associated with improved OS (55.7 vs. 28.4 months, P < .001). The OCB of patients with BMI >25 kg/m2 versus those with BMI ≤25 kg/m2 was significantly higher only in patients with nonclear cell histology (81% vs. 65%, P = .011), and patients with liver metastases (76% vs. 58%, P = .007), Neutrophil to lymphocyte ratio >4 (77% vs 62%, P = .022) or treated by nivolumab plus ipilimumab (77% vs. 64%, P = .044). In the BMI ≤25 kg/m2 subgroup, significant differences were found between patients with NLR >4 versus ≤4 (62% vs. 82%, P = .002) and patients treated by IO+IO versus IO+TKIs combinations (64% vs. 83%, P = .002).
Our study suggests that the prognostic significance and the association of BMI with treatment outcome varies across clinico-pathological mRCC subgroups.
Clinical genitourinary cancer. 2023 Mar 20 [Epub ahead of print]
Matteo Santoni, Francesco Massari, Zin W Myint, Roberto Iacovelli, Martin Pichler, Umberto Basso, Jindrich Kopecky, Jakub Kucharz, Sebastiano Buti, Alessia Salfi, Thomas Büttner, Ugo De Giorgi, Ravindran Kanesvaran, Ondřej Fiala, Enrique Grande, Paolo Andrea Zucali, Giuseppe Fornarini, Maria T Bourlon, Sarah Scagliarini, Javier Molina-Cerrillo, Gaetano Aurilio, Marc R Matrana, Renate Pichler, Carlo Cattrini, Tomas Büchler, Emmanuel Seront, Fabio Calabrò, Alvaro Pinto, Rossana Berardi, Anca Zgura, Giulia Mammone, Jawaher Ansari, Francesco Atzori, Rita Chiari, Roubini Zakopoulou, Orazio Caffo, Giuseppe Procopio, Maria Bassanelli, Ilaria Zampiva, Carlo Messina, Zsófia Küronya, Alessandra Mosca, Dipen Bhuva, Nuno Vau, Lorena Incorvaia, Sara Elena Rebuzzi, Giandomenico Roviello, Ignacio Ortego Zabalza, Alessandro Rizzo, Veronica Mollica, Ilaria Catalini, Fernando Sabino M Monteiro, Rodolfo Montironi, Nicola Battelli, Mimma Rizzo, Camillo Porta
Oncology Unit, Macerata Hospital, Macerata, Italy., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia. Electronic address: ., Markey Cancer Center, University of Kentucky, Lexington, KY., Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria., Oncology 3 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy., Department of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic., Department of Uro-oncology, Maria Sklodowska-Curie National Research Institute of Oncology Warsaw, Warsaw, Poland., Medical Oncology Unit, University Hospital of Parma - Department of Medicine and Surgery, University of Parma, Parma, Italy., Oncology Unit 2, University Hospital of Pisa, Pisa, Italy., Department of Urology, University Hospital Bonn (UKB), Bonn, Germany., Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy., Division of Medical Oncology, National Cancer Centre Singapore, Singapore., Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic., Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain., Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Oncology, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy., IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., UOC di Oncologia, Azienda Ospedaliera di Rilievo Nazionale Cardarelli di Napoli, Naples, Italy., Department of Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain., Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy., Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA., Department of Urology, Medical University of Innsbruck, Innsbruck, Austria., Department of Medical Oncology, "Maggiore della Carità" University Hospital, Novara, Italy., Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic., Department of Medical Oncology, Centre Hospitalier de Jolimont, Belgium., Department of Oncology, San Camillo Forlanini Hospital, Rome, Italy., Medical Oncology Department, La Paz University Hospital, Madrid, Spain., Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti delle Marche, Ancona, Italy., Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Department of Radiological, Oncological and Anatomo-Pathological Science, "Sapienza" University of Rome, Rome, Italy., Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates., Unità di Oncologia Medica, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy., UOC Oncologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Italy., 2nd Propaedeutic Dept of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece., Medical Oncology Unit, Santa Chiara Hospital, Trento, Italy., Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Oncologia Medica, Ospedale Maggiore di Cremona, Italy., Medical Oncology 1-IRCCS Regina Elena National Cancer Institute, Rome, Italy., Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy., Oncology Unit, A.R.N.A.S. 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Istituto Tumori "Giovanni Paolo II", Bari, Italy., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia., Latin American Cooperative Oncology Group - LACOG; Oncology and Hematology Department, Hospital Santa Lucia, Brasília, Federal District, Brazil., Molecular Medicine and Cell Therapy Foundation, Polytechnic University of the Marche Region, Ancona, Italy., Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy., Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy; Chair of Oncology, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.