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The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients
Despite major improvements in combatting metastatic melanoma since the advent of immunotherapy, the overall survival for patients with advanced disease remains low. Recently, there is a growing number of reports supporting an “obesity paradox,” in which patients who are overweight or mildly obese ma...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700794/ https://www.ncbi.nlm.nih.gov/pubmed/31426863 http://dx.doi.org/10.1186/s40425-019-0699-5 |
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author | Donnelly, Douglas Bajaj, Shirin Yu, Jaehong Hsu, Miles Balar, Arjun Pavlick, Anna Weber, Jeffrey Osman, Iman Zhong, Judy |
author_facet | Donnelly, Douglas Bajaj, Shirin Yu, Jaehong Hsu, Miles Balar, Arjun Pavlick, Anna Weber, Jeffrey Osman, Iman Zhong, Judy |
author_sort | Donnelly, Douglas |
collection | PubMed |
description | Despite major improvements in combatting metastatic melanoma since the advent of immunotherapy, the overall survival for patients with advanced disease remains low. Recently, there is a growing number of reports supporting an “obesity paradox,” in which patients who are overweight or mildly obese may exhibit a survival benefit in patients who received immune checkpoint inhibitors. We studied the relationship between body mass index and progression-free survival and overall survival in a cohort of 423 metastatic melanoma patients receiving immunotherapy, enrolled and prospectively followed up in the NYU Interdisciplinary Melanoma Cooperative Group database. We analyzed this association stratified by first vs. second or greater-line of treatment and treatment type adjusting for age, gender, stage, lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, number of metastatic sites, and body mass index classification changes. In our cohort, the patients who were overweight or obese did not have different progression-free survival than patients with normal body mass index. Stratifying this cohort by first vs. non-first line immunotherapy revealed a moderate but insignificant association between being overweight or obese and better progression-free survival in patients who received first line. Conversely, an association with worse progression-free survival was observed in patients who received non-first line immune checkpoint inhibitors. Specifically, overweight and obese patients receiving combination immunotherapy had a statistically significant survival benefit, whereas patients receiving the other treatment types showed heterogeneous trends. We caution the scientific community to consider several important points prior to drawing conclusions that could potentially influence patient care, including preclinical data associating obesity with aggressive tumor biology, the lack of congruence amongst several investigations, and the limited reproduced comprehensiveness of these studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40425-019-0699-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6700794 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67007942019-08-26 The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients Donnelly, Douglas Bajaj, Shirin Yu, Jaehong Hsu, Miles Balar, Arjun Pavlick, Anna Weber, Jeffrey Osman, Iman Zhong, Judy J Immunother Cancer Short Report Despite major improvements in combatting metastatic melanoma since the advent of immunotherapy, the overall survival for patients with advanced disease remains low. Recently, there is a growing number of reports supporting an “obesity paradox,” in which patients who are overweight or mildly obese may exhibit a survival benefit in patients who received immune checkpoint inhibitors. We studied the relationship between body mass index and progression-free survival and overall survival in a cohort of 423 metastatic melanoma patients receiving immunotherapy, enrolled and prospectively followed up in the NYU Interdisciplinary Melanoma Cooperative Group database. We analyzed this association stratified by first vs. second or greater-line of treatment and treatment type adjusting for age, gender, stage, lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, number of metastatic sites, and body mass index classification changes. In our cohort, the patients who were overweight or obese did not have different progression-free survival than patients with normal body mass index. Stratifying this cohort by first vs. non-first line immunotherapy revealed a moderate but insignificant association between being overweight or obese and better progression-free survival in patients who received first line. Conversely, an association with worse progression-free survival was observed in patients who received non-first line immune checkpoint inhibitors. Specifically, overweight and obese patients receiving combination immunotherapy had a statistically significant survival benefit, whereas patients receiving the other treatment types showed heterogeneous trends. We caution the scientific community to consider several important points prior to drawing conclusions that could potentially influence patient care, including preclinical data associating obesity with aggressive tumor biology, the lack of congruence amongst several investigations, and the limited reproduced comprehensiveness of these studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40425-019-0699-5) contains supplementary material, which is available to authorized users. BioMed Central 2019-08-19 /pmc/articles/PMC6700794/ /pubmed/31426863 http://dx.doi.org/10.1186/s40425-019-0699-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Short Report Donnelly, Douglas Bajaj, Shirin Yu, Jaehong Hsu, Miles Balar, Arjun Pavlick, Anna Weber, Jeffrey Osman, Iman Zhong, Judy The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
title | The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
title_full | The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
title_fullStr | The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
title_full_unstemmed | The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
title_short | The complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
title_sort | complex relationship between body mass index and response to immune checkpoint inhibition in metastatic melanoma patients |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700794/ https://www.ncbi.nlm.nih.gov/pubmed/31426863 http://dx.doi.org/10.1186/s40425-019-0699-5 |
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