- High baseline BMI is associated with better OS and PFS in patients with advanced NSCLC treated with atezolizumab, but not those treated with docetaxel.
- The association was strongest in patients positive for programmed cell death ligand 1 (PD-L1).
Why this matters
- Future clinical trials of immune checkpoint inhibitors in patients with advanced NSCLC should stratify for baseline BMI.
- Pooled data from 4 clinical trials.
- 2110 patients with advanced NSCLC received atezolizumab (n=1434) or docetaxel (n=676).
- Funding: Cancer Council South Australia; others.
- In the atezolizumab group, OS was significantly better in patients who were obese (HR, 0.64; 95% CI, 0.51-0.81) or overweight (HR, 0.81; 95% CI, 0.68-0.95) compared with those with normal BMI.
- Atezolizumab-treated patients with PD-L1-positive tumors had a better survival advantage with higher BMI vs those with PD-L1-negative tumors:
- With overweight: HR, 0.73 (95% CI, 0.58-0.91).
- With obesity: HR, 0.48 (95% CI, 0.34-0.66).
- PFS was significantly better with high BMI and atezolizumab:
- Obese+overweight: HR, 0.88 (P=.03).
- PFS was highest with high BMI and PD-L1-positive tumors:
- With overweight: HR, 0.86.
- With obesity: HR, 0.78 (P=.03).
- No significant association was found between BMI and PFS or OS in patients receiving docetaxel.
- Retrospective study.