No Association Between BMI and Immunotoxicity or Clinical Outcomes for Immune Checkpoint Inhibitors

Abstract

Background: The impact of BMI on immune checkpoint inhibitor toxicity and efficacy has not been clearly characterized. Methods: The authors conducted a retrospective single-center study of patients with advanced unresectable/metastatic cancer initiated on immune checkpoint inhibitors. Results: Of the 409 patients included in the study, 115 (28%) had a BMI ≥30. There was no difference in the development of immune-related adverse events, treatment response or overall survival with respect to BMI <30 versus ≥30 for the whole study population or the melanoma subgroup. Conclusion: Patients with BMI in the obese range (≥30) were not at increased risk of immunotoxicity. Furthermore, BMI was not correlated with treatment response or overall survival in patients receiving immune checkpoint inhibitors.

Plain language summary

Several previous studies have suggested that obesity may be correlated with improved efficacy of immunotherapy and raised the concern that obesity may be associated with increased immunotoxicity; however, other studies have not replicated these findings. The authors evaluated the records from one center of 409 patients with advanced cancer on immune checkpoint inhibitors. There was no difference with respect to adverse events, treatment response or survival between obese and nonobese patients.

Keywords::

• BMI
• immune checkpoint inhibitors
• immune-related adverse events
• immunotherapy
• obesity

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/imt-2021-250

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by C Yeung, A Kartolo and W Hopman. The first draft of the manuscript was written by C Yeung, and all authors commented on subsequent versions of the manuscript. All authors read and approved the final version of the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The study was approved by the university research ethics board. All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Given the retrospective chart review study design, formal patient consent is not required.