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.
Impact of cholesterolemia and body mass index on outcome of metastatic non small cell lung cancer treated with immunotherapy.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20691)
Author(s): Giulia Galli, Paola Corsetto, Roberto Ferrara, Arsela Prelaj, Claudia Proto, Diego Signorelli, Nicoletta Zilembo, Alessandro De Toma, Filippo Pagani, Giovanni Randon, Monica Ganzinelli, Antonio Sica, Filippo G. De Braud, Marina Chiara Garassino, Giuseppe Lo Russo; Division of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; University of Milan, Milan, Italy; Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Humanitas Clinical and Research Center, Milan, Italy; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
Background: Immunotherapy (IO) is effective against metastatic Non Small Cell Lung Cancer (mNSCLC). Nonetheless, a minority of patients (pts) gains a benefit from IO and predictive variables of response are scarcely understood. Previous retrospective studies have showed a superior outcome for obese pts and preclinical data suggest a role of lipid profile. We aimed at investigating these topics in a cohort of pts with mNSCLC. Methods: We retrospectively collected data about all consecutive pts with mNSCLC treated with IO at our Institution between 12/2017 and 12/2018. Body Mass Index (BMI) was calculated as weight/height2; pts were classified as overweight if having a BMI≥25 kg/m2. Basal Cholesterolemia (BC) was dosed between one month (mo) before and one mo after the beginning of IO, with a cut-off for normality of 200 mg/dL. Survival was estimated with Kaplan-Meier method. Cox model was used for multivariate analyses. Results: We identified 55 pts. Thirty-three had a normal baseline BMI, the remaining were overweighted. Median BC was 171.5 mg/dL (range 15-313); 14 pts had hypercholesterolemia. No correlation was evident between BMI and BC (p .1772). Neither BMI nor BC were associated to first and best response to IO. Median Progression Free Survival (PFS) was 3.75 mos; median Overall Survival (OS) was 6.78 mos. Hypercholesterolemia was related to longer PFS (9.44 vs 3.71 mos, p .0484), confirmed at multivariate analysis (p.0392). Both hypercholesterolemia and BMI≥25 kg/m2 were associated to longer OS (15.56 vs 5.13 mos, p.0411, and 16.67 vs 4.97 mos, p.0222, respectively), but only BMI retained significance at multivariate analysis (p .0279). Conclusions: Hypercholesterolemia shows a positive impact on outcome of mNSCLC treated with IO. The independence of this correlation from BMI suggests the existence of a true different metabolic pathways. Moreover, overweight patients have a longer OS than those with normal BMI. This result confirms previous data on obese patients, extending the range of BMI values that are linked to a better prognosis. In conclusion, the role of metabolism and body composition in defining the benefit from IO in mNSCLC is likely multifaceted, warranting further investigation.