Clinico-Pathological Features Influencing the Prognostic Role of Body Mass Index in Patients With Advanced Renal Cell Carcinoma Treated by Immuno-Oncology Combinations (ARON-1)

Santoni, Matteo;Massari, Francesco;Myint, Zin W.;Iacovelli, Roberto;Porta, Camillo;et.al.
(2023) Clinical Genitourinary Cancer — Vol. 21, n° 5, p. e309-e319 (2023)

Files

Santoni%2BClin%2BGenitourin%2BCancer%2C%2B2023.pdf
  • Open Access
  • Adobe PDF
  • 2.38 MB
Download

Details

Authors
  • Santoni, Matteo
    Author
  • Massari, Francesco
    Author
  • Myint, Zin W.
    Author
  • Iacovelli, Roberto
    Author
  • Seront, EmmanuelUCLouvain
    Author
  • Porta, Camillo
    Author
Show more
Abstract
Obesity is a well-known risk factor for the development of renal cell carcinoma (RCC), one of the most frequent malignant urogenital tumors. The development of immunotherapy (IO)-based combinations for the treatment of metastatic RCC (mRCC) has led to a marked improvement of patients’ outcomes and quality of life. The ARON- 1 study (NCT05287464) was designed to globally analyze real-world treatment outcomes of mRCC patients receiving first-line immune-based combinations. In this sub-analysis, we investigated the role of body mass index (BMI) in patients treated by immuno-oncology combinations stratified by clinico-pathological features. According to our results, the prognostic significance and the association of BMI with treatment outcome may vary across clinico-pathological mRCC subgroups. Background: Obesity has been associated with improved response to immunotherapy in cancer patients. We investi- gated the role of body mass index (BMI) in patients from the ARON-1 study (NCT05287464) treated by dual immuno- oncology agents (IO+IO) or a combination of immuno-oncology drug and a tyrosine kinase inhibitors (TKI) as first- line therapy for metastatic renal cell carcinoma (mRCC). Patients and Methods: Medical records of patients with documented mRCC treated by immuno-oncology combinations were reviewed at 47 institutions from 16 countries. Patients were assessed for overall survival (OS), progression-free survival (OS), and overall clinical benefit (OCB), defined as the sum of the rate of partial/complete responses and stable disease. Univariate and multivariate analyses were used to explore the association of variables of interest with survival. Results: A total of 675 patients were included; BMI was >25 kg/m2 in 345 patients (51%) and was associated with improved OS (55.7 vs. 28.4 months, P < .001). The OCB of patients with BMI >25 kg/m2 versus those with BMI ≤25 kg/m2 was significantly higher only in patients with nonclear cell histology (81% vs. 65%, P= .011), and patients with liver metastases (76% vs. 58%, P= .007), Neutrophil to lymphocyte ratio >4 (77% vs 62%, P= .022) or treated by nivolumab plus ipilimumab (77% vs. 64%, P= .044). In the BMI ≤25 kg/m2 subgroup, significant differences were found between patients with NLR >4 versus ≤4 (62% vs. 82%, P= .002) and patients treated by IO+IO versus IO+TKIs combinations (64% vs. 83%, P= .002). Conclusion: Our study suggests that the prognostic significance and the association of BMI with treatment outcome varies across clinico-pathological mRCC subgroups.
Affiliations
  • Macerata Hospital, Macerata, ItalyOncology Unit
  • Centre Hospitalier de Jolimont, BelgiumDepartment of Medical Oncology
  • A.O.U. Consorziale Policlinico di Bari, Bari, ItalyDivision of Medical Oncology
  • University of Bari “Aldo Moro”, Bari, ItalyChair of Oncology, Interdisciplinary Department of Medicine

Citations

  • APA
  • Chicago
  • FWB

Santoni, M., Massari, F., Myint, Z. W., Iacovelli, R., Pichler, M., Basso, U., Kopecky, J., Kucharz, J., Buti, S., Salfi, A., Buttner, T., De Giorgi, U., Kanesvaran, R., Fiala, O., Grande, E., Zucali, P. A., Fornarini, G., Bourlon, M. T., Scagliarini, S., et al. (2023). Clinico-Pathological Features Influencing the Prognostic Role of Body Mass Index in Patients With Advanced Renal Cell Carcinoma Treated by Immuno-Oncology Combinations (ARON-1). Clinical Genitourinary Cancer, 21(5), e309-e319. https://doi.org/10.1016/j.clgc.2023.03.006 (Original work published 2023)