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Meta-Analysis
. 2023 Nov 22:14:1261202.
doi: 10.3389/fimmu.2023.1261202. eCollection 2023.

Prognostic value of body composition on survival outcomes in melanoma patients receiving immunotherapy

Tianrui Kuang #  1   2 , Lilong Zhang #  1   2 , Zhendong Qiu  1   2 , Yanbing Zhang  1 , Weixing Wang  1   2
Affiliations
Meta-Analysis

Prognostic value of body composition on survival outcomes in melanoma patients receiving immunotherapy

Tianrui Kuang et al. Front Immunol. .

Abstract

Objective: The influence of body composition on the effectiveness of immune checkpoint inhibitors (ICIs) in patients with melanoma is still uncertain in clinical practice. Therefore, the objective of this study was to examine the potential association between body composition and clinical outcomes in patients with melanoma undergoing ICIs treatment.

Methods: A systematic literature search was performed across several databases, including PubMed, Embase, Cochrane Library and Google Scholar, to gather relevant studies. The primary outcomes of interest were overall survival (OS) and progression-free survival (PFS), assessed by hazard ratios (HR). Secondary outcomes, such as adverse events (AE), were evaluated using odds ratios (OR).

Results: This meta-analysis comprised ten articles involving a total of 1,283 patients. Systemic analysis of all collected evidence revealed that body composition, including low skeletal muscle index (SMI) (OS: HR = 1.66, 95% CI = 1.13-2.43, p = 0.010; PFS: HR = 1.28, 95% CI = 1.06-1.55, p = 0.009), high subcutaneous adipose tissue density (SMD) (OS: HR = 1.93, 95% CI = 1.09-3.44, p = 0.025; PFS: HR = 1.31, 95% CI = 1.06-1.63, p = 0.012), and sarcopenia (OS: HR = 1.25, 95% CI = 1.03-1.51, p = 0.022; PFS: HR = 1.25, 95% CI = 1.03-1.51, p = 0.022), were significantly associated with OS and PFS in melanoma patients treated with ICIs. However, these markers did not show a significant association with treatment-related adverse events. Interestingly, no significant correlation was found between visceral fat index (VFI) (OS: HR = 0.71, 95% CI = 0.29-1.76, p = 0.462; PFS: HR = 0.98, 95% CI = 0.93-1.02, p = 0.274) and OS or PFS in melanoma patients under ICIs treatment.

Conclusion: Body composition was found to be associated with decreased treatment response and lower long-term efficacy in patients with melanoma undergoing immune checkpoint inhibitor (ICI) therapy. However, it is important to note that body composition did not appear to contribute to increased incidence of adverse events in these patients.

Keywords: body composition; immune checkpoint inhibitors; melanoma; sarcopenia; skeletal muscle density; skeletal muscle index; visceral fat index.

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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
The flow diagram of identifying eligible studies.
Figure 2
Figure 2
Forest plots demonstrating the relationship between SMI and ICI Efficacy in melanoma patients. (A). SMI and overall survival (B). SMI and progression-free survival (C). SMI and treatment-related toxicity.
Figure 3
Figure 3
Forest plots demonstrating the relationship between sarcopenia and ICI Efficacy in melanoma patients. (A). sarcopenia and overall survival (B). sarcopenia and progression-free survival (C). sarcopenia and treatment-related toxicity.
Figure 4
Figure 4
Forest plots demonstrating the relationship between SMD and ICI Efficacy in melanoma patients. (A). SMD and overall survival (B). SMD and progression-free survival.
Figure 5
Figure 5
Forest plots demonstrating the relationship between VATI and ICI Efficacy in melanoma patients. (A). VATI and overall survival (B). VATI and progression-free survival.
Figure 6
Figure 6
Sensitivity analysis of the association between SMI and ICI Efficacy in melanoma patients. (A). SMI and overall survival (B). SMI and progression-free survival.
See this image and copyright information in PMC

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