@article {Cortellini57, author = {Alessio Cortellini and Melissa Bersanelli and Sebastiano Buti and Katia Cannita and Daniele Santini and Fabiana Perrone and Raffaele Giusti and Marcello Tiseo and Maria Michiara and Pietro Di Marino and Nicola Tinari and Michele De Tursi and Federica Zoratto and Enzo Veltri and Riccardo Marconcini and Francesco Malorgio and Marco Russano and Cecilia Anesi and Tea Zeppola and Marco Filetti and Paolo Marchetti and Andrea Botticelli and Gian Carlo Antonini Cappellini and Federica De Galitiis and Maria Giuseppa Vitale and Francesca Rastelli and Federica Pergolesi and Rossana Berardi and Silvia Rinaldi and Marianna Tudini and Rosa Rita Silva and Annagrazia Pireddu and Francesco Atzori and Rita Chiari and Biagio Ricciuti and Andrea De Giglio and Daniela Iacono and Alain Gelibter and Mario Alberto Occhipinti and Alessandro Parisi and Giampiero Porzio and Maria Concetta Fargnoli and Paolo Antonio Ascierto and Corrado Ficorella and Clara Natoli}, title = {A multicenter study of body mass index in cancer patients treated with anti-PD-1/PD-L1 immune checkpoint inhibitors: when overweight becomes favorable}, volume = {7}, number = {1}, elocation-id = {57}, year = {2019}, doi = {10.1186/s40425-019-0527-y}, publisher = {BMJ Specialist Journals}, abstract = {Background Recent evidence suggested a potential correlation between overweight and the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients.Patients and methods We conducted a retrospective study of advanced cancer patients consecutively treated with anti-PD-1/PD-L1 inhibitors, in order to compare clinical outcomes according to baseline BMI levels as primary analysis. Based on their BMI, patients were categorized into overweight/obese (>= 25) and non-overweight (\< 25). A gender analysis was also performed, using the same binomial cut-off. Further subgroup analyses were performed categorizing patients into underweight, normal weight, overweight and obese.Results Between September 2013 and May 2018, 976 patients were evaluated. The median age was 68 years, male/female ratio was 663/313. Primary tumors were: NSCLC (65.1\%), melanoma (18.7\%), renal cell carcinoma (13.8\%) and others (2.4\%). ECOG-PS was >=2 in 145 patients (14.9\%). PD-1/PD-L1 inhibitors were administered as first-line treatment in 26.6\% of cases. Median BMI was 24.9: 492 patients (50.6\%) were non-overweight, 480 patients (50.4\%) were overweight/obese. 25.2\% of non-overweight patients experienced irAEs of any grade, while 55.6\% of overweight/obese patients (p \< 0.0001). ORR was significantly higher in overweight/obese patients compared to non-overweight (p \< 0.0001). Median follow-up was 17.2 months. Median TTF, PFS and OS were significantly longer for overweight/obese patients in univariate (p \< 0.0001, for all the survival intervals) and multivariate models (p = 0.0009, p \< 0.0001 and p \< 0.0001 respectively). The significance was confirmed in both sex, except for PFS in male patients (p = 0.0668).Conclusions Overweight could be considered a tumorigenic immune-dysfunction that could be effectively reversed by ICIs. BMI could be a useful predictive tool in clinical practice and a stratification factor in prospective clinical trials with ICIs.}, URL = {https://jitc.bmj.com/content/7/1/57}, eprint = {https://jitc.bmj.com/content/7/1/57.full.pdf}, journal = {Journal for ImmunoTherapy of Cancer} }