Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Effect of body mass index and age on survival in patients with advanced lung cancer treated with anti-PD-1 immune checkpoint inhibitors.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20676)
Author(s): Corentin Richard, Arielle Elkrief, Julie Malo, Lena Cvetkovic, Marie Florescu, Normand Blais, Mustapha Tehfe, Andréanne Gagné, Michèle Orain, Catherine Labbe, Philippe Joubert, François Ghiringhelli, Bertrand Routy; Research Platform in Biological Oncology, Center GF Leclerc, Dijon, France; McGill University Health Centre, Montréal, QC, Canada; CRCHUM, Montreal, QC, Canada; Universite de Montreal, Montréal, QC, Canada; Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada; Quebec Heart and Lung Institute Research Center, Quebec, QC, Canada; Department of Pathology and Research Center, CHUQ, L'Hôtel-Dieu de Québec, Quebec, QC, Canada; Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medical Oncology, Center GF Leclerc, Dijon, France, Dijon, France; Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
Background: Age and body mass index (BMI) are important factors in patients treated with chemotherapy. However, in the era of immune checkpoint inhibitors (ICI), the importance of these baseline characteristics is unclear. For example, pooled analysis of age did not influence the clinical response to ICI, whereas patients with BMI > 35 had better outcomes in melanoma and renal cell carcinoma. More data are needed to clarify the role of these two characteristics in non-small cell lung cancer (NSCLC) patients amenable ICI. Methods: We conducted a retrospective analysis of patients treated with anti-PD1 ICI for advanced NSCLC at the Dijon Cancer Center (n = 177), University of Montreal University Hospital (n = 106) and Quebec Heart and Lung Institute (n = 98). BMI and age were considered as continuous or categorical variables. Patients’ baseline characteristics were compared using the Chi-squared test. Survival curves were estimated by the Kaplan-Meier method and compared with the Log-rank test in a univariate analysis. Multivariate cox regression model was used to determine hazard ratios and 95% confidence intervals for progression-free survival (PFS) and overall survival (OS) between the groups, adjusting for other clinicopathologic features. Results: Among 381 patients included, the median BMI was 24.5 (range 16.2-43.4) and 32.7% and 13.6% were classified as overweight or obese respectively. The median age was 66 (range 37-89) and 29% were older than 70 years-of-age. Considering BMI and age as continuous or categorical variables, they were not associated with PFS or OS, with the exception of BMI in the Dijon cohort (continuous: HR = 0.95, 95%CI[0.91-0.99]; < 25 vs > 25: HR = 0.68, 95%CI[0.47-0.99]). Subgroup analysis and multivariate cox regression did not reveal significant interaction of these two factors with outcomes. There was no difference in toxicity between the groups. ECOG performance status was the only significant factor in the three cohorts. Conclusions: Unlike previously described in the era of chemotherapy, obesity and age were not associated with outcomes in NSCLC patients treated with ICI.