Higher BMI may benefit survival in myeloma
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Patients with relapsed or refractory multiple myeloma who had overweight or obesity showed a trend toward slightly improved progression-free survival and overall survival compared with patients at lower BMI, according to an exploratory FDA analysis presented at ASCO20 Virtual Scientific Program.
“Obesity has been implicated as a risk factor for the development of certain types of cancers, including multiple myeloma,” Rachel Ershler, MD, of the University of Maryland Medical Center, said during her presentation. “Previous studies in other tumor types suggest that overweight patients may have better outcomes. However, in relapsed refractory multiple myeloma, it is unknown whether body weight affects outcomes to therapy.”
The researchers conducted a retrospective analysis of 13 clinical trials in patients with relapsed or refractory multiple myeloma submitted to the FDA between 2012 and 2018. They divided patients into four groups based on their BMI: underweight, normal weight, overweight and obese. To estimate hazard rations, investigators performed multivariate analysis for PFS and OS adjusted for covariates (age, cytogenetic risk group, immunoglobulin subtype, ECOG status, and sex).
Of 5,898 patients included in the analysis (median age 65 years), ; 1.5% fell into the underweight category, 31% into normal weight, 38% in overweight, 23% withobesity and 7% with missing BMI data.
Analysis indicated that patients who were overweight and with obesity had a trend toward slightly improved PFS compared with normal weight patients (overweight vs. normal weight: HR = 0.9, 95% CI, 0.82-0.99; obese vs. normal weight: HR = 0.88; 95% CI, 0.79-0.97). Patients who were overweight and with obesity also demonstrated a trend toward improved OS compared to normal weight (HR = 0.91; 95% CI, 0.81-0.99; HR = 0.84; 95% CI, 0.75-0.95).
“Limitations include the small sample size for patients in the underweight category, and heterogeneity in the treatment regimens used in the clinical trials included in this analysis,” Erchler said. “Future studies are needed to evaluate safety and the impact of treatment regimens on efficacy outcome measures based on body weight in this relapsed refractory patient population.”
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Ershler R, et al. Abstract 8543. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
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