PT  - JOURNAL ARTICLE
AU  - Alessio Cortellini
AU  - Melissa Bersanelli
AU  - Sebastiano Buti
AU  - Katia Cannita
AU  - Daniele Santini
AU  - Fabiana Perrone
AU  - Raffaele Giusti
AU  - Marcello Tiseo
AU  - Maria Michiara
AU  - Pietro Di Marino
AU  - Nicola Tinari
AU  - Michele De Tursi
AU  - Federica Zoratto
AU  - Enzo Veltri
AU  - Riccardo Marconcini
AU  - Francesco Malorgio
AU  - Marco Russano
AU  - Cecilia Anesi
AU  - Tea Zeppola
AU  - Marco Filetti
AU  - Paolo Marchetti
AU  - Andrea Botticelli
AU  - Gian Carlo Antonini Cappellini
AU  - Federica De Galitiis
AU  - Maria Giuseppa Vitale
AU  - Francesca Rastelli
AU  - Federica Pergolesi
AU  - Rossana Berardi
AU  - Silvia Rinaldi
AU  - Marianna Tudini
AU  - Rosa Rita Silva
AU  - Annagrazia Pireddu
AU  - Francesco Atzori
AU  - Rita Chiari
AU  - Biagio Ricciuti
AU  - Andrea De Giglio
AU  - Daniela Iacono
AU  - Alain Gelibter
AU  - Mario Alberto Occhipinti
AU  - Alessandro Parisi
AU  - Giampiero Porzio
AU  - Maria Concetta Fargnoli
AU  - Paolo Antonio Ascierto
AU  - Corrado Ficorella
AU  - Clara Natoli
TI  - A multicenter study of body mass index in cancer patients treated with anti-PD-1/PD-L1 immune checkpoint inhibitors: when overweight becomes favorable
AID  - 10.1186/s40425-019-0527-y
DP  - 2019 Dec 01
TA  - Journal for ImmunoTherapy of Cancer
PG  - 57
VI  - 7
IP  - 1
4099  - http://jitc.bmj.com/content/7/1/57.short
4100  - http://jitc.bmj.com/content/7/1/57.full
SO  - J Immunother Cancer2019 Dec 01; 7
AB  - 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.