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. 2022 Sep 20:9:981001.
doi: 10.3389/fmed.2022.981001. eCollection 2022.

Body mass index, as a novel predictor of hepatocellular carcinoma patients treated with Anti-PD-1 immunotherapy

Jierong Chen  1   2 , Lianghe Lu  1   3 , Chunhua Qu  1   2 , Gari A  1   2 , Fangqi Deng  1   2 , Muyan Cai  1   2 , Wei Chen  4 , Lie Zheng  1   5 , Jiewei Chen  1   2
Affiliations

Body mass index, as a novel predictor of hepatocellular carcinoma patients treated with Anti-PD-1 immunotherapy

Jierong Chen et al. Front Med (Lausanne). .

Abstract

Immunocheckpoint inhibitors have shown significant efficacy in the treatment of hepatocellular carcinoma (HCC), but there are individual differences. The aim of this study was to explore body mass index (BMI) as a predictor of anti-PD-1 efficacy in patients with HCC. We retrospectively analyzed 101 HCC patients who treated with anti-PD-1 at Sun Yat-sen University Cancer Center from July 2018 to November 2019 and divided them into overweight (BMI > 24.9) and non-overweight (BMI ≤ 24.9) groups based on baseline BMI levels. BMI > 24.9 accounted for 22 cases (21.8%) and BMI ≤ 24.9 accounted for 79 cases (78.2%) in the study cohort. Overweight patients had higher disease control rates than non-overweight patients (P = 0.019, respectively). The mean progression-free survival (PFS) in overweight patients (10.23 months) was significantly longer than that of non-overweight patients (6.85 months; P = 0.027). Among patients with immune-related adverse events (irAEs), the mean PFS was also significantly longer in overweight patients (7.72 months) than in non-overweight patients (5.31 months, P = 0.034). Multivariate analysis showed that BMI was an independent prognostic factor for PFS in HCC patients treated with anti-PD-1 (hazard ratio: 0.47, P = 0.044). Thus, higher BMI predicts a better prognosis among HCC patients treated with anti-PD-1. In clinical practice, patients' BMI can provide a useful tool for predicting the efficacy of anti-PD-1 therapy.

Keywords: anti-PD-1 antibody; body mass index; hepatocellular carcinoma; immune-related adverse events; progression-free survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves of patients treated with anti-PD1 for hepatocellular carcinoma according to BMI levels. The mean PFS of overweight patients was significantly higher than that of non-overweight patients (log-rank test). BMI, body mass index. non-over weight BMI ≤ 24.9, over weight BMI > 24.9.
Figure 2
Figure 2
Kaplan-Meier survival curves of hepatocellular carcinoma patients treated with anti- PD-1 were analyzed in those without immune- related adverse events according to BMI levels. The PFS of overweight patients with irAEs was significantly longer than that of non-overweight patients (log-rank test). BMI, body mass index. non-over weight BMI ≤ 24.9, over weight BMI > 24.9.
Figure 3
Figure 3
Kaplan-Meier survival curves of hepatocellular carcinoma patients treated with anti- PD-1 were analyzed in those with immune- related adverse events according to BMI levels. Among the irAEs+ patients, overweight patients had longer PFS than non-overweight patients, and no disease progression was observed in the three overweight patients after anti-PD-1 treatment (log-rank test). BMI, body mass index. non-over weight BMI ≤ 24.9, over weight BMI > 24.9.
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