Overweight as a Favorable Clinical Biomarker for Checkpoint Inhibitor Therapy Response in Recurrent Gynecologic Cancer Patients
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Descriptive Characteristics
3.2. Predictive Value of a Pretherapeutic BMI for CPI Therapy
3.3. Prognostic Value of a Pretherapeutic BMI on Patient Survival during CPI Therapy
3.4. Subgroup Analysis Excluding Vaginal Cancer Patients
3.5. Immune-Related Adverse Events (irAEs)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | All Patients | BMI < 25 | BMI ≥ 25 | p-Value |
---|---|---|---|---|
number of patients | 36 | 20 | 16 | 0.679 * |
age at CPI induction (years) | 56.5 (45.8–65.8) | 54.5 (40.8–62.8) | 58.5 (52.0–68.3) | 0.679 * |
CPI courses administered | 8 (5–15) | 5 (5–10) | 10 (7–23) | 0.042 * |
primary | 0.578 † | |||
endometrium | 9 (25.0%) | 4 (20.0%) | 5 (31.3%) | |
cervix | 21 (58.3%) | 12 (60.0%) | 9 (56.3%) | |
vulva | 4 (11.1%) | 2 (10.0%) | 2 (12.5%) | |
vagina | 2 (5.6%) | 2 (10.0%) | 0 (0%) | |
body mass index (BMI) | 24.7 (20.5–27.6) | 21.4 (18.8–24.3) | 27.7 (26.3–32.9) | <0.001 * |
combined positive score (CPS) | 30.0 (5.0–72.5) | 35.0 (7.5–84.0) | 30.0 (3.5–72.5) | 0.639 * |
charlson comorbidity index | 7 (6–8) | 7 (6–8) | 7 (7–8) | 0.406 * |
neutrophile-to-platelet ratio | 5.1 (3.6–10.0) | 4.9 (3.8–9.4) | 9.1 (2.8–11.1) | 0.868 * |
CT-derived subcutaneous fat volume (mL) | 711.8 (334.8–1202.3) | 476.7 (223.0–721.7) | 1242.9 (904.6–1534.1) | <0.001 * |
CT-based visceral fat volume (mL) | 327.1 (160.1–557.2) | 226.3 (99.5–388.7) | 532.4 (285.2–755.4) | <0.001 * |
overall response rate (ORR) | 36.1% (13/36) | 5.0% (1/20) | 75.0% (12/16) | <0.001 * |
disease control rate (DCR) | 58.3% (21/36) | 40.0% (8/20) | 81.3% (13/16) | 0.023 * |
progression-free survival (PFS, months) | 6.5 (3.0–13.8) | 4.0 (2.0–10.8) | 9.0 (4.0–20.5) | 0.102 * |
overall survival (OS, months) | 9.5 (4.3–18.8) | 7.0 (4.3–15.8) | 13.5 (4.5–22.0) | 0.499 * |
a. Parameters | Overall Response after CPI Therapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
combined positive score | 0.608 | 0.99 (0.97–1.02) | - | - |
body mass index (5 kg/m2 increment) | 0.002 | 10.93 (2.39–49.82) | 0.020 | 64.09 (1.90–2160.48) |
neutrophile-to-lymphocyte ratio | 0.572 | 0.95 (0.81–1.13) | 0.681 | 0.94 (0.68–1.28) |
age-adjusted charlson comorbidity index | 0.373 | 1.19 (0.81–1.74) | 0.418 | 0.71 (0.31–1.62) |
subcutaneous fat volume (100 mL increment) | 0.023 | 1.20 (1.03–1.41) | 0.186 | 0.712 (0.44–1.17) |
visceral fat volume (100 mL increment) | 0.108 | 1.26 (0.95–1.66) | - | - |
b. Parameters | Disease Control after CPI Therapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
combined positive score | 0.163 | 0.98 (0.96–1.01) | ||
body mass index (5 kg/m2 increment) | 0.048 | 2.19 (0.99–4.83) | 0.026 | 10.07 (1.33–76.51) |
neutrophile-to-lymphocyte ratio | 0.144 | 0.89 (0.76–1.04) | 0.199 | 0.87 (0.51–1.40) |
age-adjusted charlson comorbidity index | 0.968 | 0.972 (0.241–3.93) | 0.506 | 0.84 (0.51–1.40) |
subcutaneous fat volume (100 mL increment) | 0.745 | 1.02 (0.89–1.17) | 0.063 | 0.720 (0.51–1.02) |
visceral fat volume (100 mL increment) | 0.474 | 1.10 (0.84–1.44) | - | - |
a. Parameters | PFS after CPI Therapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
combined positive score | 0.746 | 1.00 (0.99–1.01) | - | - |
body mass index (5 kg/m2 increment) | 0.038 | 1.54 (1.03–2.34) | 0.002 | 3.73 (1.63–8.50) |
neutrophile-to-lymphocyte ratio | 0.767 | 1.01 (0.95–1.08) | 0.789 | 0.99 (0.93–1.06) |
age-adjusted charlson comorbidity index | 0.675 | 1.04 (0.85–1.28) | 0.419 | 1.11 (0.87–1.41) |
subcutaneous fat volume (100 mL increment) | 0.992 | 1.00 (0.92–1.08) | 0.007 | 1.23 (1.06–1.43) |
visceral fat volume (100 mL increment) | 0.487 | 0.95 (0.82–1.10) | - | - |
b. Parameters | OS after CPI Therapy | |||
Univariate Analysis | Multivariable Analysis | |||
p-Value | OR (95% CI) | p-Value | OR (95% CI) | |
combined positive score | 0.220 | 1.01 (0.991.–1.03) | - | - |
body mass index (5 kg/m2 increment) | 0.028 | 1.87 (1.07–3.29) | 0.010 | 7.44 (1.62–34.16) |
neutrophile-to-lymphocyte ratio | 0.397 | 1.04 (0.95–1.15) | 0.478 | 1.04 (0.94–1.14) |
age-adjusted charlson comorbidity index | 0.959 | 0.99 (0.73–1.36) | 0.694 | 1.07 (0.75–1.53) |
subcutaneous fat volume (100 mL increment) | 0.620 | 0.973 (0.873–1.08) | 0.035 | 1.36 (1.02–1.81) |
visceral fat volume (100 mL increment) | 0.201 | 0.868 (0.70–1.08) | - | - |
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Bartl, T.; Onoprienko, A.; Hofstetter, G.; Müllauer, L.; Poetsch, N.; Fuereder, T.; Kofler, P.; Polterauer, S.; Grimm, C. Overweight as a Favorable Clinical Biomarker for Checkpoint Inhibitor Therapy Response in Recurrent Gynecologic Cancer Patients. Biomolecules 2021, 11, 1700. https://doi.org/10.3390/biom11111700
Bartl T, Onoprienko A, Hofstetter G, Müllauer L, Poetsch N, Fuereder T, Kofler P, Polterauer S, Grimm C. Overweight as a Favorable Clinical Biomarker for Checkpoint Inhibitor Therapy Response in Recurrent Gynecologic Cancer Patients. Biomolecules. 2021; 11(11):1700. https://doi.org/10.3390/biom11111700
Chicago/Turabian StyleBartl, Thomas, Arina Onoprienko, Gerda Hofstetter, Leonhard Müllauer, Nina Poetsch, Thorsten Fuereder, Paul Kofler, Stephan Polterauer, and Christoph Grimm. 2021. "Overweight as a Favorable Clinical Biomarker for Checkpoint Inhibitor Therapy Response in Recurrent Gynecologic Cancer Patients" Biomolecules 11, no. 11: 1700. https://doi.org/10.3390/biom11111700