Efficacy of immunotherapy in obese patients with cancer

Abstract

Obesity is a condition of excessive fat tissue and high body mass index (BMI ≥30), which is increasing worldwide. Excess body weight is associated with poorer results in cancer treatments; however, recent studies emphasized that elevated BMI was associated with improved outcomes in cases treated by immune checkpoint inhibitor (ICI) therapies, which is called the obesity paradox. In this review, we discuss the correlation between obesity and cancer immunotherapy, especially ICIs, the underlying mechanisms, and the outcomes in different types of cancers. In addition, we describe the occurrence of immune-related adverse events and the effect of gender in obese patients during immunotherapy using all relevant studies with available full texts.

Keywords:

• Obesity
• BMI
• immunotherapy
• immune-related adverse events
• immune checkpoint inhibitor

Acknowledgments

The authors wish to appreciate Professor Teunis B. H. Geijtenbeek (Department of Experimental Immunology, Amsterdam institute for infection and immunity, Amsterdam UMC, University of Amsterdam) for his advice and guidance. The authors acknowledge the support prepared by Iran University of Medical Sciences, Tehran, Iran.

Ethical statement

Not applicable since no study was performed on cells, animals, and human.

Author contributions

Y Mojibi: study design, data collection, and writing the manuscript; F Seif: revised the manuscript for important intellectual content, N Mojibi: editing the manuscript; A Aghamajidi: figure design; HA Torang: editing the manuscript, M Mohsenzadagan: analysis of results and manuscript review. All authors read and approved the final manuscript.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this article.