Abstract
Background
. Obesity has been associated with improved response to immunotherapy in cancer patients.
We investigated the role of Body Mass Index (BMI) in patients from the ARON-1 study
(NCT05287464) treated by dual immuno-oncology agents (IO+IO) or a combination of immuno-oncology
drug and a Tyrosine Kinase Inhibitors (TKI) as first-line therapy for metastatic Renal
Cell Carcinoma (mRCC).
Patients and Methods
. Medical records of patients with documented mRCC treated by immuno-oncology combinations
were reviewed at 47 institutions from 16 countries. Patients were assessed for overall
survival (OS), Progression-Free Survival (OS), and Overall Clinical Benefit (OCB),
defined as the sum of the rate of partial/complete responses and stable disease. Univariate
and multivariate analyses were used to explore the association of variables of interest
with survival.
Results
. A total of 675 patients were included; BMI was >25 kg/m2 in 345 patients (51%) and was associated with improved OS (55.7 vs 28.4 months, p<0.001). The OCB of patients with BMI >25 kg/m2 vs those with BMI ≤25 kg/m2 was significantly higher only in patients with non-clear cell histology (81% vs 65%,
p=0.011), and patients with liver metastases (76% vs 58%, p=0.007), Neutrophil to Lymphocyte Ratio >4 (77% vs 62%, p=0.022) or treated by nivolumab plus ipilimumab (77% vs 64%, p=0.044). In the BMI ≤25 kg/m2 subgroup, significant differences were found between patients with NLR >4 vs ≤4 (62%
vs 82%, p=0.002) and patients treated by IO+IO vs IO+TKIs combinations (64% vs 83%, p=0.002).
Conclusions
: Our study suggests that the prognostic significance and the association of BMI with
treatment outcome varies across clinico-pathological mRCC subgroups.
Clinical Practice Points
: Obesity is a well-known risk factor for the development of Renal Cell Carcinoma
(RCC), one of the most frequent malignant urogenital tumors. The development of immunotherapy
(IO)-based combinations for the treatment of metastatic RCC (mRCC) has led to a marked
improvement of patients’ outcomes and quality of life. The ARON-1 study (NCT05287464)
was designed to globally analyze real-world treatment outcomes of mRCC patients receiving
first-line immune-based combinations. In this sub-analysis, we investigated the role
of Body Mass Index (BMI) in patients treated by immuno-oncology combinations stratified
by clinico-pathological features. According to our results, the prognostic significance
and the association of BMI with treatment outcome may vary across clinico-pathological
mRCC subgroups.
Keywords
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Article info
Publication history
Accepted:
March 14,
2023
Received in revised form:
March 14,
2023
Received:
December 2,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
