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...
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BMJ Publishing Group
2020-10-01
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| Series: | Journal for ImmunoTherapy of Cancer |
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| author | Danilo Rocco Alex Friedlaender Alfredo Addeo Diego Signorelli Alessio Cortellini Sebastiano Buti Raffaele Giusti Marcello Tiseo Pietro Di Marino Michele De Tursi Federica Zoratto Marco Russano Marco Filetti Francesca Rastelli Rita Chiari Biagio Ricciuti Alain Gelibter Mario Alberto Occhipinti Giampiero Porzio Corrado Ficorella Emilio Bria Alessandro Morabito Giuseppe L Banna Joachim GJV Aerts Fausto Barbieri Diego L Cortinovis Maria R Migliorino Annamaria Catino Francesco Passiglia Mariangela Torniai Carlo Genova Francesca Mazzoni Vincenzo Di Noia Alessandro Inno Giovanni Mansueto Francesco Grossi Pamela Pizzutilo Fabrizio Citarella Luca Cantini Giada Targato Olga Nigro Miriam G Ferrara Simona Scodes Lorenza Landi Giorgia Guaitoli Luigi Della Gravara Fabrizio Tabbò Serena Ricciardi Alessandro De Toma Fausto Petrelli |
| author_facet | Danilo Rocco Alex Friedlaender Alfredo Addeo Diego Signorelli Alessio Cortellini Sebastiano Buti Raffaele Giusti Marcello Tiseo Pietro Di Marino Michele De Tursi Federica Zoratto Marco Russano Marco Filetti Francesca Rastelli Rita Chiari Biagio Ricciuti Alain Gelibter Mario Alberto Occhipinti Giampiero Porzio Corrado Ficorella Emilio Bria Alessandro Morabito Giuseppe L Banna Joachim GJV Aerts Fausto Barbieri Diego L Cortinovis Maria R Migliorino Annamaria Catino Francesco Passiglia Mariangela Torniai Carlo Genova Francesca Mazzoni Vincenzo Di Noia Alessandro Inno Giovanni Mansueto Francesco Grossi Pamela Pizzutilo Fabrizio Citarella Luca Cantini Giada Targato Olga Nigro Miriam G Ferrara Simona Scodes Lorenza Landi Giorgia Guaitoli Luigi Della Gravara Fabrizio Tabbò Serena Ricciardi Alessandro De Toma Fausto Petrelli |
| author_sort | Danilo Rocco |
| collection | DOAJ |
| description | 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 ≥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: 1.04–2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37–0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45–0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01–1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49–0.99)), 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 ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes. |
| format | Article |
| id | doaj-art-8d9243d9c0474d25a434c32eef0f0d36 |
| 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-8d9243d9c0474d25a434c32eef0f0d362024-11-10T21:40:08ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-001403Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validationDanilo Rocco0Alex Friedlaender1Alfredo Addeo2Diego Signorelli3Alessio Cortellini4Sebastiano Buti5Raffaele Giusti6Marcello Tiseo7Pietro Di Marino8Michele De Tursi9Federica Zoratto10Marco Russano11Marco Filetti12Francesca Rastelli13Rita Chiari14Biagio Ricciuti15Alain Gelibter16Mario Alberto Occhipinti17Giampiero Porzio18Corrado Ficorella19Emilio Bria20Alessandro Morabito21Giuseppe L Banna22Joachim GJV Aerts23Fausto Barbieri24Diego L Cortinovis25Maria R Migliorino26Annamaria Catino27Francesco Passiglia28Mariangela Torniai29Carlo Genova30Francesca Mazzoni31Vincenzo Di Noia32Alessandro Inno33Giovanni Mansueto34Francesco Grossi35Pamela Pizzutilo36Fabrizio Citarella37Luca Cantini38Giada Targato39Olga Nigro40Miriam G Ferrara41Simona Scodes42Lorenza Landi43Giorgia Guaitoli44Luigi Della Gravara45Fabrizio Tabbò46Serena Ricciardi47Alessandro De Toma48Fausto Petrelli49Pneumo-Oncology Unit, Ospedali dei Colli Monaldi Cotugno CTO, Napoli, ItalyMedical Oncology, University Hospital of Geneva, Geneva, SwitzerlandMedical Oncology, University Hospital of Geneva, Geneva, SwitzerlandMedical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, ItalyDepartment of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, ItalyMedicine and Surgery Department, University of Parma, Parma, ItalyMedical Oncology Unit, Sant`Andrea Hospital, Roma, ItalyDepartment of Medicine and Surgery, University of Parma, Parma, ItalyClinical Oncology Unit, SS Annunziata Hospital, Chieti, Italy28 Department of Medical, Oral and Biotechnological Sciences, University G. D`Annunzio Chieti-Pescara, Chieti, CH, ItalyMedical Oncology, Ospedale Santa Maria Goretti, Latina, ItalyMedical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, ItalyDepartment of Clinical and Molecular Medicine, Oncology Unit, Sant’Andrea Hospital, Sapienza University of Rome, Roma, ItalyMedical Department, ASUR Area Vasta 4, Fermo, ItalyMedical Oncology, Ospedali riuniti Padova Sud Madre Teresa Di Calcutta, Monselice, Padova, ItalyLowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA2Sapienza Università di Roma, Oncologia Medica B, Rome, Italy23 Medical Oncology Unit B, Policlinico Umberto I, Sapienza University of Rome, Roma, Lazio, ItalyMedical Oncology, San Salvatore Hospital, L`Aquila, ItalyDepartment of Biotechnological and Applied Clinical Sciences, St Salvatore Hospital, University of L`Aquila, L`Aquila, ItalyFacolta di Medicina e Chirurgia, Universita Cattolica del Sacro Cuore, Roma, Lazio, ItalyDepartment of Thoracic Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, ItalyCandiolo Cancer Institute, FPO-IRCCS, Candiolo, ItalyDepartment of Pulmonary Disease, Erasmus Medical Center, Rotterdam, NetherlandsDipartimento di Oncologia ed Ematologia, AOU Policlinico di Modena, Modena, ItalyMedical Oncology, Azienda Ospedaliera San Gerardo, Monza, ItalyMedical Oncology, San Camillo Forlanini Hospital, Roma, ItalyMedical Thoracic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, ItalyDepartment of Oncology, San Luigi Gonzaga University Hospital, Orbassano, ItalyOncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, ItalyLung Cancer Unit, IRCCS Ospedal Policlinico San Martino, Genova, ItalyMedical Oncology Unit, University Hospital Careggi, Firenze, Italy21 Oncologia Medica e Terapia Biomolecolare, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Foggia, Foggia, Puglia, ItalyOncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, ItalyMedical Oncology, Azienda Sanitaria Locale Frosinone, Frosinone, ItalyMedical Oncology Department, Fondazione IRCCS Ca` Granda Ospedale Maggiore Policlinico, Milan, Italy15 Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Tumori Giovanni Paolo II, Bari, Puglia, ItalyMedical Oncology, Campus Bio-Medico University, Roma, ItalyDepartment of Pulmonary Disease, Erasmus Medical Center, Rotterdam, Netherlands34 Department of Oncology, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, ItalyComprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy36 Department of Oncology and Hematology, AUSL della Romagna, Ravenna, Emilia-Romagna, ItalyDepartment of Oncology and Hematology, AUSL della Romagna, Ravenna, ItalyMedical Oncology Unit, Universita degli Studi di Modena e Reggio Emilia, Modena, ItalyPneumo-Oncology Unit, Ospedali dei Colli Monaldi Cotugno CTO, Napoli, Italy2Thoracic oncology unit, San Luigi Hospital, University of Turin, Torino, Piemonte, ItalyPneumo-Oncology Unit, San Camillo Forlanini Hospital, Roma, ItalyMedical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy38 Oncology Unit, ASST Bergamo Ovest, Treviglio, Lombardia, ItalyBackground 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 ≥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: 1.04–2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37–0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45–0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01–1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49–0.99)), 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 ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes.https://jitc.bmj.com/content/8/2/e001403.full |
| spellingShingle | Danilo Rocco Alex Friedlaender Alfredo Addeo Diego Signorelli Alessio Cortellini Sebastiano Buti Raffaele Giusti Marcello Tiseo Pietro Di Marino Michele De Tursi Federica Zoratto Marco Russano Marco Filetti Francesca Rastelli Rita Chiari Biagio Ricciuti Alain Gelibter Mario Alberto Occhipinti Giampiero Porzio Corrado Ficorella Emilio Bria Alessandro Morabito Giuseppe L Banna Joachim GJV Aerts Fausto Barbieri Diego L Cortinovis Maria R Migliorino Annamaria Catino Francesco Passiglia Mariangela Torniai Carlo Genova Francesca Mazzoni Vincenzo Di Noia Alessandro Inno Giovanni Mansueto Francesco Grossi Pamela Pizzutilo Fabrizio Citarella Luca Cantini Giada Targato Olga Nigro Miriam G Ferrara Simona Scodes Lorenza Landi Giorgia Guaitoli Luigi Della Gravara Fabrizio Tabbò Serena Ricciardi Alessandro De Toma Fausto Petrelli Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation Journal for ImmunoTherapy of Cancer |
| title | Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation |
| title_full | Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation |
| title_fullStr | Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation |
| title_full_unstemmed | Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation |
| title_short | Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation |
| title_sort | baseline bmi and bmi variation during first line pembrolizumab in nsclc patients with a pd l1 expression ≥ 50 a multicenter study with external validation |
| url | https://jitc.bmj.com/content/8/2/e001403.full |
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