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The predictive value of body mass index on prognosis and adverse events of cancers treated with immunotherapy: a systematic review and meta-analysis

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A Correction to this article was published on 20 March 2021

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Abstract

Objective

High body mass index (BMI) greater than 25 kg/m2 has a complex relationship with cancers. The aim of this systematic review and meta-analysis is to explore controversy over whether BMI is correlated with outcomes including survival and immunotherapy-related adverse events (irAEs) in cancer patients treated with immunotherapy.

Methods

We searched PubMed, Embase, Web of Science, and The Cochrane Library for relevant studies published up to June 2020. Title/abstract screening, full-text review, data extraction, and quality assessment were performed independently. Subgroup analysis was based on sex, treatment lines, the status of programmed death-ligand 1 (PD-L1), and tumor types. Sensitivity analysis was performed by synthesizing studies that adjusted for certain covariates or studies with good quality. Statistical heterogeneity was evaluated by the I2 value. Meta-analysis was performed with hazard ratio (HR) / odds ratio (OR) and 95% confidence intervals (CIs) as the effect measures.

Results

Twenty studies were included for survival and irAEs analyses. Patients with high BMI who underwent immunotherapy had longer overall survival (OS) (pooled hazard ratio, pHR = 0.71 [95% CI: 0.59–0.85]) and progression-free survival (PFS) (pHR = 0.76 [95% CI: 0.65–0.88]) than those with low BMI; at the same time, high-BMI patients had increased irAEs (OR = 2.54 [95% CI: 1.12–5.79]).

Conclusion

In general, high BMI was correlated with improved OS and PFS in patients treated with immunotherapy along with a high risk of irAEs. However, discrepant findings from subgroup analyses urgently call for further analysis.

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Author notes

  1. Yafei You and Chang Jiang contributed equally to this work.

Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Senen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, People’s Republic of China

    Yafei You, Chang Jiang, Kunwei Peng, Wenzhuo He, Lei Wang, Yanan Jin & Liangping Xia

  2. Department of The VIP Region, Sun Yat-Senen University Cancer Center, Guangzhou, 510060, Guangdong, People’s Republic of China

    Yafei You, Chang Jiang, Kunwei Peng, Wenzhuo He, Lei Wang, Yanan Jin & Liangping Xia

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  6. Yanan Jin
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  7. Liangping Xia
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Contributions

X.L.P and Y.Y.F designed the study. Y.Y.F, J.C, and P.K.W designed the statistical plan. Y.Y.F performed the key analyses. Y.Y.F, J.C, and P.K.W generated and collected the data. H.W.Z, W.L, and J.Y.N assisted in data interpretation. Y.Y.F wrote the manuscript. X.L.P revised the manuscript.

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Correspondence to Liangping Xia.

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As this study was based on published data, no ethics approval was sought for the study.

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You, Y., Jiang, C., Peng, K. et al. The predictive value of body mass index on prognosis and adverse events of cancers treated with immunotherapy: a systematic review and meta-analysis. Cancer Immunol Immunother 70, 2323–2335 (2021). https://doi.org/10.1007/s00262-021-02858-y

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  • DOI: https://doi.org/10.1007/s00262-021-02858-y

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