Expected and paradoxical effects of obesity on cancer treatment response

Gallo, Marco; Adinolfi, Valerio; Barucca, Viola; Prinzi, Natalie; Renzelli, Valerio; Barrea, Luigi; Giacinto, Paola Di; Ruggeri, Rosaria Maddalena; Sesti, Franz; Arvat, Emanuela; Baldelli, Roberto; Colao, Annamaria; Isidori, Andrea M.; Lenzi, Andrea; Baldell, Roberto; Albertelli, Megan A.; Attala, D.; Bianchi, Alessia; Sarno, Antonella Di; Feola, Tiziana; Mazziotti, Gherardo; Nervo, Alice; Pozza, Carlotta; Puliani, Giulia; Razzore, Paola; Ramponi, Sara; Ricciardi, Serena; Rizzà, Laura; Rota, Federica; Sbardella, Emilia; Zatelli, Maria Chiara

doi:10.1007/s11154-020-09597-y

Cited by 20 publications

(20 citation statements)

References 174 publications

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“…The patients with obesity may have better outcome in treating with ICI, in which the impact of body adiposity might be related to the irAEs development. 32 A nutritional status has a pleiotropic effect on an individual patient background, both synergically acting in producing cancer treatment outcomes. Because of such complex interactions, a clear cause-effect relationship between BMI and cancer treatment survival seems to be difficult to carry out, we avoid to simply compare the body weight in this study.…”

Section: Discussionmentioning

confidence: 99%

Pre-Existing Diabetes Limits Survival Rate After Immune Checkpoint Inhibitor Treatment for Advanced Lung Cancer: A Retrospective Study in Japan

Hisanaga¹,

Uchino²,

Kakisu³

et al. 2021

DMSO

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Background Although immune checkpoint inhibitors (ICIs) are promising in the treatment of advanced cancer, their use is associated with immune-related adverse events (irAEs) that affect endocrine organ systems. Although development of irAEs was associated with improved cancer-specific survival, the risk of irAEs is unclear. We investigated the association of pre-ICI comorbidities—including diabetes—with irAEs, overall survival (OS), and progression-free survival (PFS) in advanced lung cancer. Methods Patients with lung cancer who were treated with ICIs during the period from September 1, 2015 through July 31, 2018 were retrospectively enrolled. All data were collected from the NEPTUNE database of university patients. Hazard ratios were estimated by using Cox regression weighted for propensity scores. Odds ratios were calculated by logistic regression and adjusted for unbalanced variables. The Kaplan–Meier method was used to compare OS, and the generalized Wilcoxon test was used to compare median survival. Results Among the 88 patients identified, 22 (25.0%) had diabetes (DM) before ICI treatment and 57 (75.0%) did not (non-DM); irAEs developed in 12.2% of patients with DM and in 9.1% of patients in non-DM (p=0.87). Diabetes status was not associated with irAE risk in relation to baseline characteristics (age, sex, TNM staging, thyroid and renal function) or in propensity score–matched analysis (age, TNM staging). During a mean follow-up of 30 months, OS and cancer-specific PFS were significantly higher in patients who developed irAEs (Kaplan–Meier estimates, p=0·04 and 0·03, respectively). In propensity score–matched analysis, diabetes was significantly associated with lower OS (multivariate hazard ratio, 0·36; 95% CI, 0·13–0·98) unrelated to irAEs. Irrespective of irAEs, PFS was also lower among patients with DM than among non-DM patients (Kaplan–Meier estimate, p=0·04). Conclusion Pre-existing diabetes was associated with higher mortality in advanced lung cancer, regardless of irAE development during treatment with ICI.

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Section: Discussionmentioning

confidence: 99%

Pre-Existing Diabetes Limits Survival Rate After Immune Checkpoint Inhibitor Treatment for Advanced Lung Cancer: A Retrospective Study in Japan

Hisanaga¹,

Uchino²,

Kakisu³

et al. 2021

DMSO

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“…Although obesity is a risk factor for many diseases, 29,30 with respect to tumors, cardiovascular disease, and the entire life course, the impact of obesity on health cannot be generalized. [31][32][33] In this study, large WC, as an indicator of abdominal obesity, had a significant positive relationship with registration and language scores. For personal use only.…”

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confidence: 86%

Relationship Between Metabolic Syndrome and Cognitive Function: A Population-Based Study of Middle-Aged and Elderly Adults in Rural China

Zhan¹,

Wang²,

Liu³

et al. 2021

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Introduction To explore the relationship between metabolic syndrome (MetS) and cognitive impairment in a low-income and low-education population. Methods All residents aged ≥45 years in a low-income population in Tianjin, China, were eligible to participate in this study. The Mini-Mental State Examination (MMSE) scale was used to conduct a preliminary screening and assessment of the participants’ cognitive statuses. The MMSE components are orientation, registration, attention and calculation, recall, and language. Results In this population, the prevalences of MetS and cognitive impairment were 54.1% and 44.5%, respectively. In the overall population, the registration score was 0.105 points lower in the elevated triglycerides (TG) group than in the normal TG group (β, −0.105; 95% confidence interval [CI]: −0.201, −0.010; P=0.030). In men, high TG was associated with registration scores that were 0.152 points lower than those in the normal TG group (95% CI: −0.281, −0.022; P=0.022), while larger WC and lower HDL-C had positive effects on cognitive scores (all P<0.05). However, in women, there were no significant differences between cognitive scores and MetS or its components. Conclusion In this population, first, TG had a great impact on cognition, even greater than the impact of MetS on cognition. Second, the impact of MetS components on cognition was more obvious in men, and not all of the effects were negative. Therefore, the effect of MetS on cognition may need to be analyzed separately for different populations, and it may be that the effect of a single component is greater than the overall effect. When formulating prevention strategies for cognitive impairments, population differences must also be taken into consideration.

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“…Although obesity is considered an important risk factor for developing various types of cancer, the presence of obesity seems to be a paradoxical protective factor that can improve response to treatment and, consequently, survival in patients with several chronic diseases, but there are conflicting and controversial results [ 127 ]. A possible explanation for this paradox could be the diagnosis of obesity based on the determination of BMI (in kg/m 2 ), as this indicator does not accurately differentiate each tissue individually, such as lean mass and fat mass [ 128 , 129 ].…”

Section: Epidemiological and Clinical Evidence Of The Association Between Sarcopenic Obesity And Cancermentioning

confidence: 99%

The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications

Silveira

Filho

Spexoto

et al. 2021

IJMS

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Obesity is globally a serious public health concern and is associated with a high risk of cardiovascular disease (CVD) and various types of cancers. It is important to evaluate various types of obesity, such as visceral and sarcopenic obesity. The evidence on the associated risk of CVD, cancer and sarcopenic obesity, including pathophysiological aspects, occurrence, clinical implications and survival, needs further investigation. Sarcopenic obesity is a relatively new term. It is a clinical condition that primarily affects older adults. There are several endocrine-hormonal, metabolic and lifestyle aspects involved in the occurrence of sarcopenic obesity that affect pathophysiological aspects that, in turn, contribute to CVD and neoplasms. However, there is no available evidence on the role of sarcopenic obesity in the occurrence of CVD and cancer and its pathophysiological interplay. Therefore, this review aims to describe the pathophysiological aspects and the clinical and epidemiological evidence on the role of sarcopenic obesity related to the occurrence and mortality risk of various types of cancer and cardiovascular disease. This literature review highlights the need for further research on sarcopenic obesity to demonstrate the interrelation of these various associations.

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Expected and paradoxical effects of obesity on cancer treatment response

Cited by 20 publications

References 174 publications

Pre-Existing Diabetes Limits Survival Rate After Immune Checkpoint Inhibitor Treatment for Advanced Lung Cancer: A Retrospective Study in Japan

Pre-Existing Diabetes Limits Survival Rate After Immune Checkpoint Inhibitor Treatment for Advanced Lung Cancer: A Retrospective Study in Japan

Relationship Between Metabolic Syndrome and Cognitive Function: A Population-Based Study of Middle-Aged and Elderly Adults in Rural China

The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications

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