Correlation between body mass index and efficacy of anti-PD-1 inhibitor in patients with non-small cell lung cancer.

Abstract

High body mass index (BMI) has been reported to be associated with the efficacy of immune checkpoint inhibitors in patients with advanced non-small cell lung cancer (NSCLC), but the association between BMI and efficacy of anti-PD-1 inhibitors remains controversial. The present study investigated this association in patients with advanced NSCLC. We retrospectively reviewed patients with advanced NSCLC who received PD-1 inhibitors at the National Cancer Center Hospital between January 2016 and December 2018. The efficacy of PD-1 inhibitors (progression-free survival [PFS], overall survival [OS], and response rate) was compared between overweight (BMI ≥25kg/m2) and non-overweight (BMI <25kg/m2) groups. Cohort 1 included patients with high PD-L1 expression who were treated with pembrolizumab as first-line therapy; Cohort 2 included patients treated with nivolumab/pembrolizumab as second- or later-line treatment. A total of 324 patients were included in this study and the median BMI (IQR) was 21.4 (19.5-23.6) kg/m2. Of the 324 patients, 279 (86.1%) and 45 (13.9%) were in the non-overweight and overweight groups, respectively. No significant differences in objective response rate (ORR), PFS, or OS were found between overweight and non-overweight patients overall (n=324; overweight vs. non-overweight: ORR, 28.9% vs. 31.9%, respectively [p=0.68]; PFS, 7.6 vs. 5.8 months, respectively [p=0.43]; and OS, 17.6 vs. 15.3 months, respectively [p=0.90]), or between overweight and non-overweight patients in Cohorts 1 and 2. No significant differences in the efficacy of PD-1 inhibitors were observed between overweight and non-overweight patients.