Journal for ImmunoTherapy of Cancer (Oct 2020)
Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation
- 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
Affiliations
- Danilo Rocco
- Pneumo-Oncology Unit, Ospedali dei Colli Monaldi Cotugno CTO, Napoli, Italy
- Alex Friedlaender
- Medical Oncology, University Hospital of Geneva, Geneva, Switzerland
- Alfredo Addeo
- Medical Oncology, University Hospital of Geneva, Geneva, Switzerland
- Diego Signorelli
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Alessio Cortellini
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Sebastiano Buti
- Medicine and Surgery Department, University of Parma, Parma, Italy
- Raffaele Giusti
- Medical Oncology Unit, Sant`Andrea Hospital, Roma, Italy
- Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Pietro Di Marino
- Clinical Oncology Unit, SS Annunziata Hospital, Chieti, Italy
- Michele De Tursi
- 28 Department of Medical, Oral and Biotechnological Sciences, University G. D`Annunzio Chieti-Pescara, Chieti, CH, Italy
- Federica Zoratto
- Medical Oncology, Ospedale Santa Maria Goretti, Latina, Italy
- Marco Russano
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Marco Filetti
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’Andrea Hospital, Sapienza University of Rome, Roma, Italy
- Francesca Rastelli
- Medical Department, ASUR Area Vasta 4, Fermo, Italy
- Rita Chiari
- Medical Oncology, Ospedali riuniti Padova Sud Madre Teresa Di Calcutta, Monselice, Padova, Italy
- Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Alain Gelibter
- 2Sapienza Università di Roma, Oncologia Medica B, Rome, Italy
- Mario Alberto Occhipinti
- 23 Medical Oncology Unit B, Policlinico Umberto I, Sapienza University of Rome, Roma, Lazio, Italy
- Giampiero Porzio
- Medical Oncology, San Salvatore Hospital, L`Aquila, Italy
- Corrado Ficorella
- Department of Biotechnological and Applied Clinical Sciences, St Salvatore Hospital, University of L`Aquila, L`Aquila, Italy
- Emilio Bria
- Facolta di Medicina e Chirurgia, Universita Cattolica del Sacro Cuore, Roma, Lazio, Italy
- Alessandro Morabito
- Department of Thoracic Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
- Giuseppe L Banna
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Joachim GJV Aerts
- Department of Pulmonary Disease, Erasmus Medical Center, Rotterdam, Netherlands
- Fausto Barbieri
- Dipartimento di Oncologia ed Ematologia, AOU Policlinico di Modena, Modena, Italy
- Diego L Cortinovis
- Medical Oncology, Azienda Ospedaliera San Gerardo, Monza, Italy
- Maria R Migliorino
- Medical Oncology, San Camillo Forlanini Hospital, Roma, Italy
- Annamaria Catino
- Medical Thoracic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
- Francesco Passiglia
- Department of Oncology, San Luigi Gonzaga University Hospital, Orbassano, Italy
- Mariangela Torniai
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Italy
- Carlo Genova
- Lung Cancer Unit, IRCCS Ospedal Policlinico San Martino, Genova, Italy
- Francesca Mazzoni
- Medical Oncology Unit, University Hospital Careggi, Firenze, Italy
- Vincenzo Di Noia
- 21 Oncologia Medica e Terapia Biomolecolare, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Foggia, Foggia, Puglia, Italy
- Alessandro Inno
- Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy
- Giovanni Mansueto
- Medical Oncology, Azienda Sanitaria Locale Frosinone, Frosinone, Italy
- Francesco Grossi
- Medical Oncology Department, Fondazione IRCCS Ca` Granda Ospedale Maggiore Policlinico, Milan, Italy
- Pamela Pizzutilo
- 15 Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Tumori Giovanni Paolo II, Bari, Puglia, Italy
- Fabrizio Citarella
- Medical Oncology, Campus Bio-Medico University, Roma, Italy
- Luca Cantini
- Department of Pulmonary Disease, Erasmus Medical Center, Rotterdam, Netherlands
- Giada Targato
- 34 Department of Oncology, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia, Italy
- Olga Nigro
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Miriam G Ferrara
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Simona Scodes
- 36 Department of Oncology and Hematology, AUSL della Romagna, Ravenna, Emilia-Romagna, Italy
- Lorenza Landi
- Department of Oncology and Hematology, AUSL della Romagna, Ravenna, Italy
- Giorgia Guaitoli
- Medical Oncology Unit, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
- Luigi Della Gravara
- Pneumo-Oncology Unit, Ospedali dei Colli Monaldi Cotugno CTO, Napoli, Italy
- Fabrizio Tabbò
- 2Thoracic oncology unit, San Luigi Hospital, University of Turin, Torino, Piemonte, Italy
- Serena Ricciardi
- Pneumo-Oncology Unit, San Camillo Forlanini Hospital, Roma, Italy
- Alessandro De Toma
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
- Fausto Petrelli
- 38 Oncology Unit, ASST Bergamo Ovest, Treviglio, Lombardia, Italy
- DOI
- https://doi.org/10.1136/jitc-2020-001403
- Journal volume & issue
-
Vol. 8,
no. 2
Abstract
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.
