Baseline BMI and BMI variation during first line pembrolizumab in NSCLC patients with a PD-L1 expression ≥ 50%: a multicenter study with external validation.

Autor:	Cortellini A; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy alessiocortellini@gmail.com.; Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy., Ricciuti B; Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.; Medical Oncology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy., Tiseo M; Medical Oncology, University Hospital of Parma, Parma, Emilia-Romagna, Italy.; Department of Medicine and Surgery, University of Parma, Parma, Italy., Bria E; Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Romae, Lazio, Italy.; Comprehensive Cancer Center, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy., Banna GL; Oncology Department, Queen Alexandra University Hospital, Portsmouth Hospitals NHS Trust, Portsmuth, UK., Aerts JG; Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands., Barbieri F; Department of Oncology and Hematology, University Hospital Modena, Modena, Emilia-Romagna, Italy., Giusti R; Medical Oncology Unit, Sant'Andrea Hospital, Roma, Lazio, Italy., Cortinovis DL; Medical Oncology, Azienda Ospedaliera San Gerardo, Monza, Lombardia, Italy., Migliorino MR; Pneumo-Oncology Unit, San Camillo Forlanini Hospital, Roma, Lazio, Italy., Catino A; Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Tumori 'Giovanni Paolo II', Bari, Puglia, Italy., Passiglia F; Department of Oncology, University of Turin, San Luigi Gonzaga University Hospital, Orbassano, Italy., Torniai M; Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Marche, Italy., Morabito A; Thoracic Medical Oncology, Istituto Nazionale Tumori 'Fondazione G Pascale' IRCCS, Napoli, Campania, Italy., Genova C; Lung Cancer Unit, IRCCS Ospedale Policlinnico San Martino, Genova, Liguria, Italy., Mazzoni F; Medical Oncology, University Hospital Careggi, Firenze, Toscana, Italy., Di Noia V; Oncologia Medica e Terapia Biomolecolare, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Foggia, Foggia, Puglia, Italy., Signorelli D; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy., Gelibter A; Medical Oncology Unit B, Policlinico Umberto I, Sapienza University of Rome, Roma, Lazio, Italy., Occhipinti MA; Medical Oncology Unit B, Policlinico Umberto I, Sapienza University of Rome, Roma, Lazio, Italy., Rastelli F; Medical Oncology, ASUR District Area 4 Fermo, Ascoli Piceno, Italy., Chiari R; Medical Oncology, Ospedali Riuniti Padova Sud 'Madre Teresa di Calcutta', Monselice, Veneto, Italy., Rocco D; Pneumo-Oncology Unit, Ospedali dei Colli Monaldi Cotugno CTO, Napoli, Campania, Italy., Inno A; Oncology Unit, IRCCS Ospedale Sacro Cuore don Calabria, Negrar, Veneto, Italy., De Tursi M; Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, CH, Italy., Di Marino P; Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy., Mansueto G; Medical Oncology, F. Spaziani Hospital, Frosinone, Lazio, Italy., Zoratto F; Medical Oncology, Ospedale Santa Maria Goretti, Latina, Lazio, Italy., Grossi F; Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano, Lombardia, Italy., Filetti M; Medical Oncology Unit, Sant'Andrea Hospital, Roma, Lazio, Italy., Pizzutilo P; Thoracic Oncology Unit, Clinical Cancer Center IRCCS Istituto Tumori 'Giovanni Paolo II', Bari, Puglia, Italy., Russano M; Medical Oncology, Campus Bio-Medico University, Rome, Italy., Citarella F; Medical Oncology, Campus Bio-Medico University, Rome, Italy., Cantini L; Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands.; Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Marche, Italy., Targato G; Department of Oncology, University Hospital Santa Maria della Misericordia, Udine, Friuli-Venezia Giulia, Italy., Nigro O; Medical Oncology, ASST-Sette Laghi, Varese, Lombardia, Italy., Ferrara MG; Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Romae, Lazio, Italy.; Comprehensive Cancer Center, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy., Buti S; Medical Oncology, University Hospital of Parma, Parma, Emilia-Romagna, Italy., Scodes S; Department of Oncology and Hematology, AUSL della Romagna, Ravenna, Emilia-Romagna, Italy., Landi L; Department of Oncology and Hematology, AUSL della Romagna, Ravenna, Emilia-Romagna, Italy., Guaitoli G; Department of Oncology and Hematology, University Hospital Modena, Modena, Emilia-Romagna, Italy., Della Gravara L; Pneumo-Oncology Unit, Ospedali dei Colli Monaldi Cotugno CTO, Napoli, Campania, Italy., Tabbò F; Department of Oncology, University of Turin, San Luigi Gonzaga University Hospital, Orbassano, Italy., Ricciardi S; Pneumo-Oncology Unit, San Camillo Forlanini Hospital, Roma, Lazio, Italy., De Toma A; Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy., Friedlaender A; Oncology Department, University Hospital of Geneva, Geneve, Genève, Switzerland., Petrelli F; Oncology Unit, ASST Bergamo Ovest, Treviglio, Lombardia, Italy., Addeo A; Oncology Department, University Hospital of Geneva, Geneve, Genève, Switzerland., Porzio G; Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy., Ficorella C; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.; Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy.
Jazyk:	angličtina
Zdroj:	Journal for immunotherapy of cancer [J Immunother Cancer] 2020 Oct; Vol. 8 (2).
DOI:	10.1136/jitc-2020-001403
Abstrakt:	Background: The association between obesity and outcomes in patients receiving programmed death-1/programmed death ligand-1 (PD-L1) checkpoint inhibitors has already been confirmed in pre-treated non-small cell lung cancer (NSCLC) patients, regardless of PD-L1 tumor expression. Methods: We present the outcomes analysis according to baseline body mass index (BMI) and BMI variation in a large cohort of metastatic NSCLC patients with a PD-L1 expression ≥50%, receiving first line pembrolizumab. We also evaluated a control cohort of metastatic NSCLC patients treated with first line platinum-based chemotherapy. Normal weight was set as control group. Results: 962 patients and 426 patients were included in the pembrolizumab and chemotherapy cohorts, respectively. Obese patients had a significantly higher objective response rate (ORR) (OR=1.61 (95% CI: 1.04-2.50)) in the pembrolizumab cohort, while overweight patients had a significantly lower ORR (OR=0.59 (95% CI: 0.37-0.92)) within the chemotherapy cohort. Obese patients had a significantly longer progression-free survival (PFS) (HR=0.61 (95% CI: 0.45-0.82)) in the pembrolizumab cohort. Conversely, they had a significantly shorter PFS in the chemotherapy cohort (HR=1.27 (95% CI: 1.01-1.60)). Obese patients had a significantly longer overall survival (OS) within the pembrolizumab cohort (HR=0.70 (95% CI: 0.49-0.99)), while no significant differences according to baseline BMI were found in the chemotherapy cohort. BMI variation significantly affected ORR, PFS and OS in both the pembrolizumab and the chemotherapy cohorts. Conclusions: Baseline obesity is associated to significantly improved ORR, PFS and OS in metastatic NSCLC patients with a PD-L1 expression of ≥50%, receiving first line pembrolizumab, but not among patients treated with chemotherapy. BMI variation is also significantly related to clinical outcomes. Competing Interests: Competing interests: AC received speaker fees and grant consultancies by Astrazeneca, MSD, BMS, Roche, Novartis and Astellas. JA reports receiving commercial research grants from Amphera and Roche, holds ownership interest (including patents) in Amphera BV, and is a consultant/advisory board member for Amphera, Boehringer Ingelheim, Bristol-Myers Squibb, Eli-Lilly, MSD and Roche. EB received speakers’ and travels’ fee from MSD, Astra-Zeneca, Celgene, Pfizer, Helsinn, Eli-Lilly, BMS, Novartis and Roche. EB received consultant’s fee from Roche, Pfizer. EB received institutional research grants from Astra-Zeneca, Roche. MT received speaker fees and grant consultancies by Astrazeneca, Pfizer, Eli-Lilly, BMS, Novartis, Roche, MSD, Boehringer Ingelheim, Otsuka, Takeda and Pierre Fabre. AM received speaker fees by Astra, Roche, BMS, MSD, Boehringer, Pfizer, Takeda. FM received grant consultancies by MSD and Takeda. RG received speaker fees and grant consultancies by Astrazeneca and Roche. FP received grant consultancies by MSD and Astrazeneca. AF received grant consultancies by Roche, Pfizer, Astellas and BMS. AA received grant consultancies by Takeda, MSD, BMJ, Astrazeneca, Roche and Pfizer. RC received speaker fees by BMS, MSD, Takeda, Pfizer, Roche and Astrazeneca. CG received speaker fees/grant consultancies by Astrazeneca, BMS, Boehringer-Ingelheim, Roche and MSD. MR received honoraria for scientific events by Roche, Astrazeneca, Bristol-Myers Squibb, Merck Sharp & Dohme and Boehringer Ingelheim. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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