Sub-cutaneous Fat Mass measured on multislice computed tomography of pretreatment PET/CT is a prognostic factor of stage IV non-small cell lung cancer treated by nivolumab

Popinat, G.; Cousse, Stéphanie; Goldfarb, Lucas; Becker, Stéphanie; Gardin, Isabelle; Salaün, Mathieu; Thureau, S.; Véra, Pierre; Guisier, Florian; Decazes, Pierre

doi:10.1080/2162402x.2019.1580128

Cited by 40 publications

(54 citation statements)

References 35 publications

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“…The remaining 26 studies were subsequently reviewed and screened according to our inclusion and exclusion criteria. Finally, 18 studies were included in our systematic review ( Figure 2 ) [ 18 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. The included studies were published between 2018 and 2020, and were retrospective studies, either single or multicenter; one study was a pooled analysis of patients treated with immunotherapy in the context of phase 2 and 3 trials.…”

Section: Resultsmentioning

confidence: 99%

“…It should be noted, however, that the cutoff for overweight category in this study was BMI ≥19.1 kg/m 2 [ 28 ]. Then, two smaller single-center reports found no association of BMI with oncological outcomes, but showed that pre-treatment weight loss (HR 1.19, p = 0.16) [ 27 ] and low subcutaneous fat mass (SCFM) (HR 0.75, p = 0.006) [ 26 ] were predictors for poor survival outcomes in NSCLC patients treated with nivolumab.…”

Section: Resultsmentioning

confidence: 99%

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Impact of BMI on Survival Outcomes of Immunotherapy in Solid Tumors: A Systematic Review

Indini

Rijavec

Ghidini

et al. 2021

IJMS

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Growing research has focused on obesity as a prognostic factor during therapy with immune-checkpoint inhibitors (ICIs). The role of body-mass index (BMI) in predicting response and toxicity to ICIs is not clear, as studies have shown inconsistent results and significant interpretation biases. We performed a systematic review to evaluate the relationship between BMI and survival outcomes during ICIs, with a side focus on the incidence of immune-related adverse events (irAEs). A total of 17 studies were included in this systematic review. Altogether, the current evidence does not support a clearly positive association of BMI with survival outcomes. Regarding toxicities, available studies confirm a superimposable rate of irAEs among obese and normal weight patients. Intrinsic limitations of the analyzed studies include the retrospective nature, the heterogeneity of patients’ cohorts, and differences in BMI categorization for obese patients across different studies. These factors might explain the heterogeneity of available results, and the subsequent absence of a well-established role of baseline BMI on the efficacy of ICIs among cancer patients. Further prospective studies are needed, in order to clarify the role of obesity in cancer patients treated with immunotherapy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Impact of BMI on Survival Outcomes of Immunotherapy in Solid Tumors: A Systematic Review

Indini

Rijavec

Ghidini

et al. 2021

IJMS

View full text Add to dashboard Cite

show abstract

“…The remaining 27 studies were subsequently reviewed and screened according to our inclusion and exclusion criteria. Finally, 13 studies [13][14][15][16][17][23][24][25][26][27][28][29][30] were included in our meta-analysis ( Fig. 1).…”

Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

“…Moreover, some preclinical data also revealed that obesity increases amount of aged T cell with higher PD-1 expression and dysregulated immune function, which could make cancer cells more sensitive to ICIs therapy [15]. Although several researches have investigated the association between the BMI and ICIs efficacy, heterogeneous conclusions were revealed in these studies [16,17]. Therefore, a high-grade meta-analysis was required to evaluate the relationship between patients BMI and ICIs efficacy.…”

Section: Introductionmentioning

confidence: 99%

Association between body mass index and survival outcomes for cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Wu²,

Wang

et al. 2020

J Transl Med

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Background: Immune checkpoint inhibitors (ICIs) have been increasingly applied in the treatment of several kinds of malignancies. Some clinical demographic characteristics were reported to be associated with the ICIs efficacy. The purpose of our current meta-analysis was to clearly evaluated the relationship between BMI and ICIs efficacy for cancer patients receiving immunotherapy. Methods: A systematic search of Pubmed, EMBASE and conference proceedings was performed to investigate the influence of BMI on ICIs efficacy. Pooled analysis for overall survival (OS), progression-free survival (PFS) and immunerelated adverse effects (IRAEs) were analyzed in current study. Results: A total of 13 eligible studies comprising 5279 cancer patients treated with ICIs were included in the analysis. The pooled analysis showed there is positive association between high BMI and improved OS and PFS among patients with ICIs treatment (OS: HR = 0.62, 95% CI 0.55-0.71, P < 0.0001; I 2 = 26.3%, P = 0.202); PFS: HR = 0.71, 95% CI 0.61-0.83, P < 0.0001; I 2 = 0%, P = 0.591). There is no significant difference between the incidence of all grade IRAEs between obese, overweight patients and normal patients (Overweight vs Normal: pooled RR = 1.28, 95% CI 0.76-2.18, P = 0.356; Obese vs Normal: pooled RR = 1.36, 95% CI 0.85-2.17, P = 0.207). Conclusion: An improved OS and PFS were observed in patients with high BMI after receiving ICIs treatment compared with patients of low BMI. No significant association between BMI and incidence of IRAEs was found in cancer patients after ICIs treatment.

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“…Another indirect predictive factor is the determination of body composition parameters on the anatomical CT associated with the PET. Therefore, in a study including 55 patients with NSCLC treated by nivolumab, whole-body subcutaneous fat mass measured automatically on the CT of the PET was a significant prognostic factor with a better prognosis for fatty patients (HR = 0.75, p = 0.006 in multivariate analysis) [27,28], possibly because adipocytes in the human obese subcutaneous fat mass release several pro-inflammatory cytokines and chemokines, which contribute to the establishment and maintenance of local and systemic inflammation [29].…”

Section: F-fdg Pet/ctmentioning

confidence: 99%

Immunotherapy by Immune Checkpoint Inhibitors and Nuclear Medicine Imaging: Current and Future Applications

Decazes

Bohn

2020

Cancers

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Immunotherapy by using immune checkpoint inhibitors is a revolutionary development in oncology. Medical imaging is also impacted by this new therapy, particularly nuclear medicine imaging (also called radionuclide imaging), which uses radioactive tracers to visualize metabolic functions. Our aim was to review the current applications of nuclear medicine imaging in immunotherapy, along with their limitations, and the perspectives offered by this imaging modality. Method: Articles describing the use of radionuclide imaging in immunotherapy were researched using PubMed by April 2019 and analyzed. Results: More than 5000 articles were analyzed, and nearly 100 of them were retained. Radionuclide imaging, notably 18F-FDG PET/CT, already has a major role in many cancers for pre-therapeutic and therapeutic evaluation, diagnoses of adverse effects, called immune-related adverse events (IrAE), and end-of-treatment evaluations. However, these current applications can be hindered by immunotherapy, notably due to atypical response patterns such as pseudoprogression, which is defined as an increase in the size of lesions, or the visualization of new lesions, followed by a response, and hyperprogression, which is an accelerated tumor growth rate after starting treatment. To overcome these difficulties, new opportunities are offered, particularly therapeutic evaluation criteria adapted to immunotherapy and immuno-PET allowing us to predict responses to immunotherapy. Moreover, some new technological solutions are also promising, such as radiomic analyses and body composition on associated anatomical images. However, more research has to be done, notably for the diagnosis of hyperprogression and pseudoprogression. Conclusion: Immunotherapy, by its major impact on cancer and by the new patterns generated on images, is revolutionary in the field of medical images. Nuclear medicine imaging is already established and will be able to help meet new challenges through its plasticity.

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Sub-cutaneous Fat Mass measured on multislice computed tomography of pretreatment PET/CT is a prognostic factor of stage IV non-small cell lung cancer treated by nivolumab

Cited by 40 publications

References 35 publications

Impact of BMI on Survival Outcomes of Immunotherapy in Solid Tumors: A Systematic Review

Impact of BMI on Survival Outcomes of Immunotherapy in Solid Tumors: A Systematic Review

Association between body mass index and survival outcomes for cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Immunotherapy by Immune Checkpoint Inhibitors and Nuclear Medicine Imaging: Current and Future Applications

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