Eric V. Mastrolonardo MD, Pablo Llerena BS, Emma De Ravin MD, Kathryn Nunes BA, Praneet C. Kaki BS, Kelly M. Bridgham MD, Dev R. Amin MD, Daniel J. Campbell MD, Ramez Philips MD, Scott H. Koeneman PhD, David M. Cognetti MD, Adam J. Luginbuhl MD, Nicole L. Simone MD, Jennifer M. Johnson MD, Joseph M. Curry MD
{"title":"在不同类型的实体肿瘤中，免疫检查点抑制后BMI升高可改善生存率","authors":"Eric V. Mastrolonardo MD, Pablo Llerena BS, Emma De Ravin MD, Kathryn Nunes BA, Praneet C. Kaki BS, Kelly M. Bridgham MD, Dev R. Amin MD, Daniel J. Campbell MD, Ramez Philips MD, Scott H. Koeneman PhD, David M. Cognetti MD, Adam J. Luginbuhl MD, Nicole L. Simone MD, Jennifer M. Johnson MD, Joseph M. Curry MD","doi":"10.1002/cncr.35799","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction/Background</h3>\n \n <p>Obesity is a well-known risk factor for various cancers, yet emerging research demonstrates its association with improved survival outcomes in cancer treatment, labeled as “the obesity paradox.” Studies investigating the clinical benefits of obesity across various cancer types after immune checkpoint inhibition (ICI) are limited.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Data were queried from the TriNetX database to identify patients with solid tumor malignancies of various organ systems (pulmonary/intrathoracic, cutaneous, head and neck, gastrointestinal, breast, genitourinary) who received ICI between 2012 and 2024. Propensity score matching was used to match cohorts for demographics, medical comorbidities, and oncologic staging. Primary outcome was overall survival (OS) up to 5 years and compared between obese body mass index (BMI; >30) and normal BMI (20–24.9) cohorts.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>After propensity score matching, there were a total of 18,434 patients, with 9217 patients in the obese BMI cohort and 9217 patients in the normal BMI cohort for all solid tumor malignancies. In the overall pan-cancer analysis, obese BMI was associated with significantly improved OS up to 5 years compared to the normal BMI cohort (hazard ratio [HR], 0.69 [0.66–0.72]). Subgroup analysis likewise demonstrated that obese BMI was associated with significantly improved OS up to 5 years for respiratory/intrathoracic (HR, 0.77 [0.72–0.83]), cutaneous (HR, 0.62 [0.63–0.78]), head and neck (HR, 0.67 [0.58–0.78]), gastrointestinal (HR, 0.67 [0.58–0.78]), breast (HR, 0.66 [0.55–0.79]), and genitourinary (HR, 0.57 [0.34–0.93]) malignancies (though not renal cell carcinoma specifically.)</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Obesity was associated with improved 5-year OS after treatment with ICI across various solid tumor malignancies in this electronic health record–based big data study. Further investigation is warranted to understand the mechanism of this association.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 6","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35799","citationCount":"0","resultStr":"{\"title\":\"Improved survival with elevated BMI following immune checkpoint inhibition across various solid tumor cancer types\",\"authors\":\"Eric V. Mastrolonardo MD, Pablo Llerena BS, Emma De Ravin MD, Kathryn Nunes BA, Praneet C. Kaki BS, Kelly M. Bridgham MD, Dev R. Amin MD, Daniel J. Campbell MD, Ramez Philips MD, Scott H. Koeneman PhD, David M. Cognetti MD, Adam J. Luginbuhl MD, Nicole L. Simone MD, Jennifer M. Johnson MD, Joseph M. Curry MD\",\"doi\":\"10.1002/cncr.35799\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction/Background</h3>\\n \\n <p>Obesity is a well-known risk factor for various cancers, yet emerging research demonstrates its association with improved survival outcomes in cancer treatment, labeled as “the obesity paradox.” Studies investigating the clinical benefits of obesity across various cancer types after immune checkpoint inhibition (ICI) are limited.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Data were queried from the TriNetX database to identify patients with solid tumor malignancies of various organ systems (pulmonary/intrathoracic, cutaneous, head and neck, gastrointestinal, breast, genitourinary) who received ICI between 2012 and 2024. Propensity score matching was used to match cohorts for demographics, medical comorbidities, and oncologic staging. Primary outcome was overall survival (OS) up to 5 years and compared between obese body mass index (BMI; >30) and normal BMI (20–24.9) cohorts.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>After propensity score matching, there were a total of 18,434 patients, with 9217 patients in the obese BMI cohort and 9217 patients in the normal BMI cohort for all solid tumor malignancies. In the overall pan-cancer analysis, obese BMI was associated with significantly improved OS up to 5 years compared to the normal BMI cohort (hazard ratio [HR], 0.69 [0.66–0.72]). Subgroup analysis likewise demonstrated that obese BMI was associated with significantly improved OS up to 5 years for respiratory/intrathoracic (HR, 0.77 [0.72–0.83]), cutaneous (HR, 0.62 [0.63–0.78]), head and neck (HR, 0.67 [0.58–0.78]), gastrointestinal (HR, 0.67 [0.58–0.78]), breast (HR, 0.66 [0.55–0.79]), and genitourinary (HR, 0.57 [0.34–0.93]) malignancies (though not renal cell carcinoma specifically.)</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Obesity was associated with improved 5-year OS after treatment with ICI across various solid tumor malignancies in this electronic health record–based big data study. Further investigation is warranted to understand the mechanism of this association.</p>\\n </section>\\n </div>\",\"PeriodicalId\":138,\"journal\":{\"name\":\"Cancer\",\"volume\":\"131 6\",\"pages\":\"\"},\"PeriodicalIF\":5.1000,\"publicationDate\":\"2025-03-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35799\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cncr.35799\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cncr.35799","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Improved survival with elevated BMI following immune checkpoint inhibition across various solid tumor cancer types
Introduction/Background
Obesity is a well-known risk factor for various cancers, yet emerging research demonstrates its association with improved survival outcomes in cancer treatment, labeled as “the obesity paradox.” Studies investigating the clinical benefits of obesity across various cancer types after immune checkpoint inhibition (ICI) are limited.
Methods
Data were queried from the TriNetX database to identify patients with solid tumor malignancies of various organ systems (pulmonary/intrathoracic, cutaneous, head and neck, gastrointestinal, breast, genitourinary) who received ICI between 2012 and 2024. Propensity score matching was used to match cohorts for demographics, medical comorbidities, and oncologic staging. Primary outcome was overall survival (OS) up to 5 years and compared between obese body mass index (BMI; >30) and normal BMI (20–24.9) cohorts.
Results
After propensity score matching, there were a total of 18,434 patients, with 9217 patients in the obese BMI cohort and 9217 patients in the normal BMI cohort for all solid tumor malignancies. In the overall pan-cancer analysis, obese BMI was associated with significantly improved OS up to 5 years compared to the normal BMI cohort (hazard ratio [HR], 0.69 [0.66–0.72]). Subgroup analysis likewise demonstrated that obese BMI was associated with significantly improved OS up to 5 years for respiratory/intrathoracic (HR, 0.77 [0.72–0.83]), cutaneous (HR, 0.62 [0.63–0.78]), head and neck (HR, 0.67 [0.58–0.78]), gastrointestinal (HR, 0.67 [0.58–0.78]), breast (HR, 0.66 [0.55–0.79]), and genitourinary (HR, 0.57 [0.34–0.93]) malignancies (though not renal cell carcinoma specifically.)
Conclusions
Obesity was associated with improved 5-year OS after treatment with ICI across various solid tumor malignancies in this electronic health record–based big data study. Further investigation is warranted to understand the mechanism of this association.
期刊介绍：
The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society.
CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
