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Review
. 2021 Dec;22(4):681-702.
doi: 10.1007/s11154-020-09597-y. Epub 2020 Oct 6.

Expected and paradoxical effects of obesity on cancer treatment response

Marco Gallo  1 , Valerio Adinolfi  2 , Viola Barucca  3 , Natalie Prinzi  4 , Valerio Renzelli  5 , Luigi Barrea  6 , Paola Di Giacinto  7 , Rosaria Maddalena Ruggeri  8 , Franz Sesti  9 , Emanuela Arvat  10 , Roberto Baldelli  7 ; EOLO Group; Emanuela Arvat, Annamaria Colao, Andrea Isidori, Andrea Lenzi, Roberto Baldell, M Albertelli, D Attala, A Bianchi, A Di Sarno, T Feola, G Mazziotti, A Nervo, C Pozza, G Puliani, P Razzore, S Ramponi, S Ricciardi, L Rizza, F Rota, E Sbardella, M C Zatelli
Affiliations
Review

Expected and paradoxical effects of obesity on cancer treatment response

Marco Gallo et al. Rev Endocr Metab Disord. 2021 Dec.

Abstract

Obesity, whose prevalence is pandemic and continuing to increase, is a major preventable and modifiable risk factor for diabetes and cardiovascular diseases, as well as for cancer. Furthermore, epidemiological studies have shown that obesity is a negative independent prognostic factor for several oncological outcomes, including overall and cancer-specific survival, for several site-specific cancers as well as for all cancers combined. Yet, a recently growing body of evidence suggests that sometimes overweight and obesity may associate with better outcomes, and that immunotherapy may show improved response among obese patients compared with patients with a normal weight. The so-called 'obesity paradox' has been reported in several advanced cancer as well as in other diseases, albeit the mechanisms behind this unexpected relationship are still not clear. Aim of this review is to explore the expected as well as the paradoxical relationship between obesity and cancer prognosis, with a particular emphasis on the effects of cancer therapies in obese people.

Keywords: Body mass index; Cancer; Cancer therapy; Obesity; Overweight; Treatment outcome.

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