BMI and age do not influence survival/irAEs in patients treated with immune checkpoint inhibitors

A recent study by Corentin et al. showed that body mass index (BMI) and age do not influence the survival rate in patients with non-small-cell lung cancer (NSCLC) who are being treated with immune checkpoint inhibitors. There is also no effect of these two factors on the incidence of immune-related adverse events (irAEs).

Although it is widely acknowledged that age and BMI are important factors in cancer patients who are treated with chemotherapy, the same is not quite clear with regard to treatment with immune checkpoint inhibitors. A pooled analysis of age by Marur et al. in 2018 demonstrated that the age of the patient did not have any impact on the clinical response to checkpoint inhibitors [1]. With regard to BMI, it was shown earlier that obese patients (BMI >35) who suffered from melanoma or renal cell carcinoma had better outcomes [2-4].

Thus, Corentin et al. aimed to investigate the role of age and BMI in NSCLC patients who were eligible for treatment with immune checkpoint inhibitors. This was done in a retrospective analysis which included 381 advanced NSCLC patients from 3 centres in France and Canada who received treatment with immune checkpoint inhibitors. These 3 cohorts (n=381) were of similar median age (±65 years). Median BMI was around 24.5, with little over half of patients being overweight. The majority of patients had ≥2 lines of treatment. Multivariate analysis using multiple Cox regression showed that both overall survival and progression-free survival were not impacted by either age or BMI. The incidence of all grade irAEs in patients aged <70 years (n=191) and those aged ≥70 (n=92) was 49% and 47%, respectively. When stratified to BMI, all grade irAEs occurred in 46% of patients with BMI <25 (n=158) vs 51% in those with BMI ≥25 (n=125). All observed irAEs are displayed in the Table [5]. Thus, in spite of what has been reported before, age and BMI are not associated with efficacy outcomes in NSCLC patients who are treated with immune checkpoint inhibitors [5].

Table. The incidence of irAEs in NSCLC patients treated with immune checkpoint inhibitors, stratified by age/BMI [5]

1. Marur S, et al. Semin Oncol. 2018;45(4):220-225.
2. Fang S, et al. J Invest Dermatol. 2017;137(8):1792-1795.
3. Albiges L, et al. J Clin Oncol. 2016;34(30):3655-36633.
4. Bagheri M, et al. Int J Obes. 2016;40(12):1817-1822.
5. Corentin R, et al. P1.04-01. WCLC 2019.

Posted on 8 November 20195 March 2021