Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer
Background Recent research suggests that baseline body mass index (BMI) is associated with response to immunotherapy. In this study, we test the hypothesis that worsening nutritional status prior to the start of immunotherapy, rather than baseline BMI, negatively impacts immunotherapy response.Metho...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/8/2/e001674.full |
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| _version_ | 1846172567680843776 |
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| author | Iman Osman Yingzhi Qian Douglas Donnelly Judy Zhong Amelia Sawyers Paul Johannet Samuel Kozloff Nicholas Gulati |
| author_facet | Iman Osman Yingzhi Qian Douglas Donnelly Judy Zhong Amelia Sawyers Paul Johannet Samuel Kozloff Nicholas Gulati |
| author_sort | Iman Osman |
| collection | DOAJ |
| description | Background Recent research suggests that baseline body mass index (BMI) is associated with response to immunotherapy. In this study, we test the hypothesis that worsening nutritional status prior to the start of immunotherapy, rather than baseline BMI, negatively impacts immunotherapy response.Methods We studied 629 patients with advanced cancer who received immune checkpoint blockade at New York University. Patients had melanoma (n=268), lung cancer (n=128) or other primary malignancies (n=233). We tested the association between BMI changes prior to the start of treatment, baseline prognostic nutritional index (PNI), baseline BMI category and multiple clinical end points including best overall response (BOR), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS).Results Decreasing pretreatment BMI and low PNI were associated with worse BOR (p=0.04 and p=0.0004), ORR (p=0.01 and p=0.0005), DCR (p=0.01 and p<0.0001), PFS (p=0.02 and p=0.01) and OS (p<0.001 and p<0.001). Baseline BMI category was not significantly associated with any treatment outcomes.Conclusion Standard of care measures of worsening nutritional status more accurately associate with immunotherapy outcomes than static measurements of BMI. Future studies should focus on determining whether optimizing pretreatment nutritional status, a modifiable variable, leads to improvement in immunotherapy response. |
| format | Article |
| id | doaj-art-0956b51e101241dda4478ae71809a011 |
| institution | Kabale University |
| issn | 2051-1426 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-0956b51e101241dda4478ae71809a0112024-11-09T22:25:08ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-001674Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancerIman Osman0Yingzhi Qian1Douglas Donnelly2Judy Zhong3Amelia Sawyers4Paul Johannet5Samuel Kozloff6Nicholas Gulati7Interdisciplinary Melanoma Program, NYU Langone Health Perlmutter Cancer Center, New York, New York, USAPopulation Health, New York University School of Medicine, New York City, New York, USADermatology, New York University School of Medicine, New York City, New York, USAPopulation Health, New York University School of Medicine, New York City, New York, USADermatology, New York University School of Medicine, New York City, New York, USAMedicine, New York University School of Medicine, New York City, New York, USAMedicine, New York University School of Medicine, New York City, New York, USADermatology, New York University School of Medicine, New York City, New York, USABackground Recent research suggests that baseline body mass index (BMI) is associated with response to immunotherapy. In this study, we test the hypothesis that worsening nutritional status prior to the start of immunotherapy, rather than baseline BMI, negatively impacts immunotherapy response.Methods We studied 629 patients with advanced cancer who received immune checkpoint blockade at New York University. Patients had melanoma (n=268), lung cancer (n=128) or other primary malignancies (n=233). We tested the association between BMI changes prior to the start of treatment, baseline prognostic nutritional index (PNI), baseline BMI category and multiple clinical end points including best overall response (BOR), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS).Results Decreasing pretreatment BMI and low PNI were associated with worse BOR (p=0.04 and p=0.0004), ORR (p=0.01 and p=0.0005), DCR (p=0.01 and p<0.0001), PFS (p=0.02 and p=0.01) and OS (p<0.001 and p<0.001). Baseline BMI category was not significantly associated with any treatment outcomes.Conclusion Standard of care measures of worsening nutritional status more accurately associate with immunotherapy outcomes than static measurements of BMI. Future studies should focus on determining whether optimizing pretreatment nutritional status, a modifiable variable, leads to improvement in immunotherapy response.https://jitc.bmj.com/content/8/2/e001674.full |
| spellingShingle | Iman Osman Yingzhi Qian Douglas Donnelly Judy Zhong Amelia Sawyers Paul Johannet Samuel Kozloff Nicholas Gulati Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer Journal for ImmunoTherapy of Cancer |
| title | Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer |
| title_full | Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer |
| title_fullStr | Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer |
| title_full_unstemmed | Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer |
| title_short | Baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer |
| title_sort | baseline prognostic nutritional index and changes in pretreatment body mass index associate with immunotherapy response in patients with advanced cancer |
| url | https://jitc.bmj.com/content/8/2/e001674.full |
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