Cancer Management and Research (Aug 2024)

Prognostic Role of Pre-Treatment Body Composition Parameters in Patients Undergoing First-Line Immunotherapy for Metastatic Renal Cell Carcinoma

  • Lee S,
  • Kim JH,
  • Song W,
  • Sung HH,
  • Jeon HG,
  • Jeong BC,
  • Seo SI,
  • Jeon SS,
  • Park SH,
  • Lee JH,
  • Yu J,
  • Kang M

Journal volume & issue
Vol. Volume 16
pp. 1091 – 1101

Abstract

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Sangmin Lee,1 Jae-Hun Kim,2 Wan Song,1 Hyun Hwan Sung,1 Hwang Gyun Jeon,1 Byong Chang Jeong,1 Seong Il Seo,1 Seong Soo Jeon,1 Se Hoon Park,3 Ji Hyun Lee,2 Jiwoong Yu,1,* Minyong Kang1,4,5,* 1Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 2Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 3Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 4Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea; 5Samsung Genome Institute, Samsung Medical Center, Seoul, Korea*These authors contributed equally to this workCorrespondence: Minyong Kang; Jiwoong Yu, Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea, Tel +82-2-3410-1138 ; +82-2-3410-3559, Fax +82-2-3410-6992 ; +82-2-3410-6990, Email [email protected]; [email protected]: We investigated the relationship between body mass index (BMI), radiological body composition, and survival outcomes in patients with metastatic renal cell carcinoma (mRCC) underwent first-line immune checkpoint inhibitor (ICI)-based therapy.Methods: Analyzing data from 102 patients treated between November 2019 and March 2023, pre-treatment computed tomography (CT) scans assessed fat and muscle areas. BMI and body composition indices were examined, including skeletal muscle index, subcutaneous fat index (SFI), visceral fat index, and total fat index. Kaplan–Meier curves and Log rank tests compared progression-free survival (PFS) and overall survival (OS), while multivariable Cox proportional regression analysis was performed to identify the variables significantly associated with survival outcomes.Results: 54 patients (52.9%) experienced disease progression, and 26 (25.5%) died during a median follow-up of 17.4 months. High SFI was significantly associated with improved OS (p = 0.018) but not PFS (p = 0.090). Multivariable analysis confirmed the positive impact of high SFI on OS (adjusted HR: 0.37, p = 0.029) and suggested a trend towards improved PFS (adjusted HR: 0.61, p = 0.088). Notably, in the ipilimumab + nivolumab subgroup, high SFI significantly correlated with both PFS and OS (p = 0.047 and p = 0.012, respectively).Conclusion: High SFI predicts favorable OS in patients with mRCC receiving first-line ICI-based therapy, especially patients treated with ipilimumab + nivolumab displayed a significant association between high SFI and favorable PFS and OS.Keywords: immunotherapy, renal cell carcinoma, body composition, prognosis

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