Impact of BMI on Survival Outcomes of Immunotherapy in Solid Tumors: A Systematic Review.
Alice IndiniErika RijavecMichele GhidiniGianluca TomaselloMonica CattaneoFrancesca BarbinClaudia BareggiBarbara GalassiDonatella GambiniFrancesco GrossiPublished in: International journal of molecular sciences (2021)
Growing research has focused on obesity as a prognostic factor during therapy with immune-checkpoint inhibitors (ICIs). The role of body-mass index (BMI) in predicting response and toxicity to ICIs is not clear, as studies have shown inconsistent results and significant interpretation biases. We performed a systematic review to evaluate the relationship between BMI and survival outcomes during ICIs, with a side focus on the incidence of immune-related adverse events (irAEs). A total of 17 studies were included in this systematic review. Altogether, the current evidence does not support a clearly positive association of BMI with survival outcomes. Regarding toxicities, available studies confirm a superimposable rate of irAEs among obese and normal weight patients. Intrinsic limitations of the analyzed studies include the retrospective nature, the heterogeneity of patients' cohorts, and differences in BMI categorization for obese patients across different studies. These factors might explain the heterogeneity of available results, and the subsequent absence of a well-established role of baseline BMI on the efficacy of ICIs among cancer patients. Further prospective studies are needed, in order to clarify the role of obesity in cancer patients treated with immunotherapy.
Keyphrases
- body mass index
- weight gain
- prognostic factors
- case control
- weight loss
- obese patients
- systematic review
- metabolic syndrome
- end stage renal disease
- bariatric surgery
- newly diagnosed
- ejection fraction
- type diabetes
- insulin resistance
- physical activity
- roux en y gastric bypass
- adipose tissue
- oxidative stress
- mesenchymal stem cells
- cross sectional
- risk factors
- patient reported outcomes
- bone marrow
- drug induced
- smoking cessation
- patient reported