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Excess weight and anti-PD-1 immune checkpoint inhibitor’s outcomes in non-small cell lung cancer

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Abstract

Purpose

Immune checkpoint inhibitors are one of the most effective treatments available in advanced non-small cell lung cancer. However, at present, there are no clinical or analytical biomarkers that define which patients benefit with certainty from these treatments. In our study, we evaluated whether excess weight could be a good predictive biomarker of benefit from these drugs.

Methods

We studied a population of 79 patients, divided into a study group with 39 patients diagnosed with non-small cell lung cancer treated with immunotherapy and 40 patients in a control group, diagnosed with different advanced cancers, treated with non-immunotherapy treatment. We analyzed according to the presence of excess weight or not, the treatment’s outcome in the study group and in the control group (objective response, and progression-free and overall survival).

Results

In our study, we detected a better response rate to immunotherapy in patients with excess weight (62.50 vs 26.08%, OR 4.72, p = 0.02), and a better median progression-free survival (14.19 vs 5.03 months, HR 0.50, p = 0.058) and median overall survival (33.84 months vs 20.76 months, HR 0.43, p = 0.01) in the study group. These findings were specific to the immunotherapy group since in the control group, with patients who did not receive immune checkpoint inhibitors, these findings were not found.

Conclusion

Our study suggests that patients with excess weight who receive anti-PD-1 immune checkpoint inhibitors diagnosed with non-small cell lung cancer have a better outcome. This effect is specific to patients receiving immunotherapy.

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Funding

Projects PIE15/00068, PI17/01865 and PI20/01458 (Instituto de Salud Carlos III) awarded to RC; Projects FIS PI19/01491 and CIBER Cardiovascular (Fondo de Investigación Sanitaria del Instituto de Salud Carlos III with co-funding from the Fondo Europeo de Desarrollo Regional FEDER) awarded to AA; CNIO Bioinformatics Unit is supported by the Instituto de Salud Carlos III (ISCIII); Project RETOS RTI2018-097596-B-I00 (AEI/10.13039/501100011033 MCI/FEDER, UE); Projects PI17/00801 and PI21/01111 grants from Instituto de Salud Carlos III and JR17/00007 awarded to NRL, and Project Molecular analysis of the Exhaled Breath Condensate in the management of solitary pulmonary nodule (ideas semilla AECC 2019), from Asociación Española Contra el Cáncer (AECC) awarded to JA.

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Authors and Affiliations

  1. Medical Oncology Department, Hospital Universitario Infanta Leonor, Gran via del este 80, 28031, Madrid, Spain

    Jacobo Rogado

  2. Instituto de Investigación Sanitaria del Hospital Universitario la Princesa, Madrid, Spain

    Jacobo Rogado, José Miguel Sánchez-Torres, Nuria Romero-Laorden, Rebeca Mondejar, Olga Donnay, Anabel Ballesteros, Vilma Pacheco-Barcia, Javier Aspa, Arantzazu Alfranca & Ramon Colomer

  3. Bioinformatics Unit, Spanish National Cancer Research Centre, Madrid, Spain

    Fernando Pozo, Kevin Troulé & Fátima Al-Shahrour

  4. Medical Oncology Department, Hospital Universitario la Princesa, Madrid, Spain

    José Miguel Sánchez-Torres, Nuria Romero-Laorden, Rebeca Mondejar, Olga Donnay, Anabel Ballesteros & Ramon Colomer

  5. Department of Medicine and Chair of Personalized Precision Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Rebeca Mondejar & Ramon Colomer

  6. Medical Oncology Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain

    Vilma Pacheco-Barcia

  7. Neumology Department, Hospital Universitario la Princesa, Madrid, Spain

    Javier Aspa

  8. Immunology Department. Hospital, Universitario la Princesa, Madrid, Spain

    Arantzazu Alfranca

Authors
  1. Jacobo Rogado
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  2. Fernando Pozo
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  3. Kevin Troulé
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  4. José Miguel Sánchez-Torres
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  10. Javier Aspa
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  11. Fátima Al-Shahrour
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Contributions

J.R. contributed to the conception and design of the study, data acquisition, interpretation of the data and writing of the manuscript. F.P. and K.T. contributed to the statistical analysis and interpretation of the data. J.M.S.T., N.R.L., R.M., O.D., A.B., V.P.B. and J.A. contributed to the data acquisition. F.A-S. contributed to the statistical analysis and interpretation of the data. A.A. contributed to the data acquisition, interpretation of the data and writing of the manuscript. R.C. contributed to the conception and design of the study, interpretation of the data and writing of the manuscript. All authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Jacobo Rogado.

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Conflict of interest

Jacobo Rogado reports personal fees from Roche, AstraZeneca, Merck, Ferrer, Persan Farma, Fresenius Kabi, travel expenses from MSD, BMS, Roche, AstraZeneca and advisor consultancies from Fresenius Kabi. Nuria Romero reports advisory consultancies from Ipsen, Janssen, Clovis, AstraZeneca and research funding from Janssen, MSD and Pfizer. Ramon Colomer reports research funding from Roche, Janssen, BMS, and MSD. All the declared conflict of interests are outside the submitted work. All the other authors have no conflicts to declare.

Ethical approval

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of the Hospital Universitario La Princesa on 22 December 2016 under the code 2918.

Informed consent

Informed consent was obtained from all patients involved in the study.

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Rogado, J., Pozo, F., Troulé, K. et al. Excess weight and anti-PD-1 immune checkpoint inhibitor’s outcomes in non-small cell lung cancer. Clin Transl Oncol 24, 2241–2249 (2022). https://doi.org/10.1007/s12094-022-02887-8

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