ArticleClinical cancer research : an official journal of the American Association for Cancer Research2022
Associations between Pretreatment Body Composition Features and Clinical Outcomes among Patients with Metastatic Clear Cell Renal Cell Carcinoma Treated with Immune Checkpoint Blockade.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- The prognostic impact of systemic inflammation and nutritional indicators on targeted therapy for renal cell carcinoma: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- Before-treatment body mass index as a prognostic factor in cancer patients receiving immune checkpoint inhibitors: a systematic review and dose-response meta-analysis.Frontiers in immunology · 2026Pooled it
- Low skeletal muscle mass predicts treatment response in oncology: a meta-analysis.European radiology · 2023Pooled it
- Composite Inflammatory Score for Predicting Progression-Free Survival in Metastatic Clear Cell Renal Cell Carcinoma Treated With First-Line Toripalimab Plus Axitinib.The Kaohsiung journal of medical sciences · 2026Article
- Preoperative non-contrast CT-derived adiposity quantity and attenuation predict recurrence-free survival after nephrectomy for localized clear cell renal cell carcinoma.International urology and nephrology · 2026Article
- Metastatic Bone Disease Is Associated With Longitudinal Muscle Loss and Reduced Survival in Kidney Cancer.Journal of cachexia, sarcopenia and muscle · 2026Article
- Association of Body Composition with Tumor Proteomics and Survival in Patients with Clear Cell Renal Cell Carcinoma.Cancers · 2026Article
- Association of objectively assessed physical activity with immune cell infiltration of the tumor microenvironment in non-metastatic colon cancer.International journal of colorectal disease · 2026Observational
- Immune checkpoints and immunoregulation in metabolic diseases and cancers: pathological mechanisms and therapeutic potential.Signal transduction and targeted therapy · 2026Review
- The Prognostic Effect of Sarcopenia in Solid Cancers Treated with Immunotherapy: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Obesity and melanoma: unraveling the paradoxical survival benefit in immunotherapy.Cancer metastasis reviews · 2026Review
- Influence of body composition on the efficacy of nivolumab plus ipilimumab for metastatic clear cell renal cell carcinoma.Journal for immunotherapy of cancer · 2026Article
- Reassessing prognostic markers in metastatic renal cell carcinoma in the era of immune checkpoint inhibitors: the enduring value of body composition, nutritional, and inflammatory indices.International journal of clinical oncology · 2026Article
- Review
- Article
- Immunometabolism in cancer: a systemic perspective.Frontiers in immunology · 2025Review
- Exploring Potential Causality and Molecular Mechanisms between Heart Failure and Renal Failure: Insights from Mendelian Randomization Studies, the MIMIC-IV Database and the Gene Expression Omnibus Database.Journal of vascular research · 2025Article
- Association of Computed Tomography Scan-Assessed Body Composition with Immune and PI3K/AKT Pathway Proteins in Distinct Breast Cancer Tumor Components.International journal of molecular sciences · 2024Article
- The multifactorial effect of obesity on the effectiveness and outcomes of cancer therapies.Nature reviews. Endocrinology · 2024Review
- A multidimensional analysis of the impact of obesity on immune checkpoint inhibitor therapy efficacy.Cancer cell international · 2024Article
Corrections and comments
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Authors and funding
20 authors at 6 institutions in 2 countries.
Funding
Abstract
purposeHigh body mass index (BMI) may lead to improved immune-checkpoint blockade (ICB) outcomes in metastatic clear cell renal cell carcinoma (mccRCC). However, BMI is a crude body size measure. We investigated BMI and radiographically assessed body composition (BC) parameters association with mccRCC ICB outcomes. EXPERIMENTAL
designRetrospective study of ICB-treated patients with mccRCC. BMI and BC variables [skeletal muscle index (SMI) and multiple adiposity indexes] were determined using pretreatment CT scans. We examined the associations between BMI and BC variables with ICB outcomes. Therapeutic responses per RECIST v1.1 were determined. We compared whole-transcriptomic patterns with BC variables in a separate cohort of 62 primary tumor samples.
results205 patients with mccRCC were included in the cohort (74% were male, 71% were overweight/obese, and 53% were classified as low SMI). High-BMI patients experienced longer overall survival (OS) than normal-weight patients [unadjusted HR, 0.66; 95% confidence interval (CI), 0.45-0.97; P = 0.035]. The only BC variable associated with OS was SMI [unadjusted HR comparing low vs. high SMI 1.65 (95% CI: 1.13-2.43); P = 0.009]. However, this OS association became nonsignificant after adjusting for International Metastatic Renal Cell Carcinoma Database Consortium score and line of therapy. No OS association was seen for adiposity and no BC variable was associated with progression-free survival or radiological responses. Tumors from patients with low SMI displayed increased angiogenic, inflammatory, and myeloid signals.
conclusionsOur findings highlight the relevance of skeletal muscle in the BMI paradox. Future studies should investigate if addressing low skeletal muscle in metastatic patients treated with ICB can improve survival.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.