{"title":"Impact of body mass index on the efficacy of immune combination therapy in metastatic renal cell carcinoma: a multicenter study in Japan.","authors":"Toshiki Anami, Takanobu Motoshima, Yuto Matsushita, Takahiro Kojima, Shimpei Yamashita, Hisanori Taniguchi, Keisuke Monji, Ryo Ishiyama, Yoshihide Kawasaki, Takuma Kato, Shuichi Tatarano, Kimihiko Masui, Eijiro Nakamura, Tomoyuki Kaneko, Makito Miyake, Hiroshi Kitamura, Hideaki Miyake, Tomomi Kamba","doi":"10.1007/s10147-025-02823-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is a major urologic malignancy worldwide, with obesity recognized as a known risk factor. Interestingly, a higher body mass index (BMI) has been associated with improved outcomes in immunotherapy, a phenomenon termed the \"obesity paradox.\" This study investigates the influence of BMI on the effectiveness of immune combination therapies in Japanese patients with metastatic RCC.</p><p><strong>Methods: </strong>A retrospective study was conducted on 243 Japanese patients with metastatic RCC who received immune combination therapies between 2018 and 2022. Patients were stratified into two groups: non-overweight/obesity (BMI < 25 kg/m<sup>2</sup>) and overweight/obesity (BMI ≥ 25 kg/m<sup>2</sup>). Survival outcomes, including progression-free survival (PFS) and overall survival (OS), were compared between the groups.</p><p><strong>Results: </strong>There was no significant difference in PFS between the groups. However, the overweight/obesity group showed a trend toward longer OS, particularly in patients receiving IO-IO regimens (P = 0.011). In contrast, although no statistically significant difference was observed in the IO-TKI regimen, there was a trend toward prolonged OS in the non-overweight/obesity group. No significant differences in immune-related adverse events were observed between the groups.</p><p><strong>Conclusion: </strong>Higher BMI may be associated with better outcomes in immune combination therapy, especially with IO-IO regimens. These findings suggest that BMI could be a useful factor in optimizing RCC treatment. Further research with larger cohorts is needed to confirm these results and understand the mechanisms behind the \"obesity paradox.\"</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2079-2086"},"PeriodicalIF":2.8000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474707/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02823-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/20 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
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Abstract
Background: Renal cell carcinoma (RCC) is a major urologic malignancy worldwide, with obesity recognized as a known risk factor. Interestingly, a higher body mass index (BMI) has been associated with improved outcomes in immunotherapy, a phenomenon termed the "obesity paradox." This study investigates the influence of BMI on the effectiveness of immune combination therapies in Japanese patients with metastatic RCC.
Methods: A retrospective study was conducted on 243 Japanese patients with metastatic RCC who received immune combination therapies between 2018 and 2022. Patients were stratified into two groups: non-overweight/obesity (BMI < 25 kg/m2) and overweight/obesity (BMI ≥ 25 kg/m2). Survival outcomes, including progression-free survival (PFS) and overall survival (OS), were compared between the groups.
Results: There was no significant difference in PFS between the groups. However, the overweight/obesity group showed a trend toward longer OS, particularly in patients receiving IO-IO regimens (P = 0.011). In contrast, although no statistically significant difference was observed in the IO-TKI regimen, there was a trend toward prolonged OS in the non-overweight/obesity group. No significant differences in immune-related adverse events were observed between the groups.
Conclusion: Higher BMI may be associated with better outcomes in immune combination therapy, especially with IO-IO regimens. These findings suggest that BMI could be a useful factor in optimizing RCC treatment. Further research with larger cohorts is needed to confirm these results and understand the mechanisms behind the "obesity paradox."
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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