ArticleJournal for immunotherapy of cancer2019
A multicenter study of body mass index in cancer patients treated with anti-PD-1/PD-L1 immune checkpoint inhibitors: when overweight becomes favorable.
Article in Journal for immunotherapy of cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 270 papers, 5 of them syntheses that pooled it.
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Who cites it
270 citing papers in PubMed, 5 syntheses or guidelines pooled it, 410 citations in OpenAlex.
- Sex-based heterogeneity in response to first-line immunotherapy plus chemotherapy in advanced esophageal squamous-cell carcinoma: a meta-analysis.Frontiers in immunology · 2026Pooled it
- BMI Association With Treatment Outcomes in Head and Neck Cancer Patients Receiving Immunotherapy: A Comprehensive Review and Meta-Analysis.Cancer reports (Hoboken, N.J.) · 2025Pooled it
- Do proton pump inhibitors alter the response to immune checkpoint inhibitors in cancer patients? A meta-analysis.Frontiers in immunology · 2023Pooled it
- Advances in the Prevention and Treatment of Obesity-Driven Effects in Breast Cancers.Frontiers in oncology · 2022Pooled it
- The predictive value of body mass index on prognosis and adverse events of cancers treated with immunotherapy: a systematic review and meta-analysis.Cancer immunology, immunotherapy : CII · 2021Pooled it
- Immune checkpoints and immunoregulation in metabolic diseases and cancers: pathological mechanisms and therapeutic potential.Signal transduction and targeted therapy · 2026Review
- Article
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- Association of body mass index and serum markers with immune-related adverse events in lung cancer patients receiving immune checkpoint inhibitors.Journal of thoracic disease · 2026Article
- Clinically interpretable nomogram combining body composition and clinicopathological features for one year survival prediction in advanced solid tumors.Scientific reports · 2026Article
- Obesity and Cancer: From Systemic Metabolic Reprogramming to Immunotherapy Paradox.Metabolites · 2026Review
- Reproducible safety and efficacy of durvalumab with or without tremelimumab for hepatocellular carcinoma in clinical practice: Results of the DT-real study.JHEP reports : innovation in hepatology · 2026Article
- The impact of concomitant medications on treatment outcomes in patients with cancer receiving immune checkpoint inhibitors.Nature reviews. Cancer · 2026Review
- An integrated body composition- immunonutritional signature for predicting immunotherapy response and prognosis in gastric cancer: a multicenter retrospective cohort study.Frontiers in oncology · 2026Article
- Emerging Predictive Biomarkers of Immunotherapy Sensitivity in Patients with Non-Small Cell Lung Cancer.ImmunoTargets and therapy · 2026Review
- The impact of chronic comorbidities on cancer immunoediting: challenges and opportunities for immunotherapies.Frontiers in immunology · 2026Review
- Metabolic syndrome as an independent predictor of response and survival in locally advanced gastric cancer treated with neoadjuvant immunochemotherapy.Frontiers in oncology · 2026Article
210 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
45 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent evidence suggested a potential correlation between overweight and the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients. PATIENTS AND
methodsWe conducted a retrospective study of advanced cancer patients consecutively treated with anti-PD-1/PD-L1 inhibitors, in order to compare clinical outcomes according to baseline BMI levels as primary analysis. Based on their BMI, patients were categorized into overweight/obese (≥ 25) and non-overweight (< 25). A gender analysis was also performed, using the same binomial cut-off. Further subgroup analyses were performed categorizing patients into underweight, normal weight, overweight and obese.
resultsBetween September 2013 and May 2018, 976 patients were evaluated. The median age was 68 years, male/female ratio was 663/313. Primary tumors were: NSCLC (65.1%), melanoma (18.7%), renal cell carcinoma (13.8%) and others (2.4%). ECOG-PS was ≥2 in 145 patients (14.9%). PD-1/PD-L1 inhibitors were administered as first-line treatment in 26.6% of cases. Median BMI was 24.9: 492 patients (50.6%) were non-overweight, 480 patients (50.4%) were overweight/obese. 25.2% of non-overweight patients experienced irAEs of any grade, while 55.6% of overweight/obese patients (p < 0.0001). ORR was significantly higher in overweight/obese patients compared to non-overweight (p < 0.0001). Median follow-up was 17.2 months. Median TTF, PFS and OS were significantly longer for overweight/obese patients in univariate (p < 0.0001, for all the survival intervals) and multivariate models (p = 0.0009, p < 0.0001 and p < 0.0001 respectively). The significance was confirmed in both sex, except for PFS in male patients (p = 0.0668).
conclusionsOverweight could be considered a tumorigenic immune-dysfunction that could be effectively reversed by ICIs. BMI could be a useful predictive tool in clinical practice and a stratification factor in prospective clinical trials with ICIs.
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