Obesity associated with longer survival in immunotherapy-treated head, neck cancer
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Key takeaways:
- Patients with higher BMI lived longer after immune checkpoint inhibitor therapy
- Patients with obesity also had reduced tracheostomy and gastrostomy tube dependence.
An analysis of patients with head and neck squamous cell carcinoma who received immune checkpoint inhibitors showed those with obesity survived longer than those with normal BMI.
Patients with obesity also had decreased gastrostomy and tracheostomy tube dependence, results of the retrospective population-based cohort study showed.
Prior studies have suggested a possible beneficial effect of obesity on survival among patients with cancer who receive immune checkpoint inhibitors; however, evidence is limited in head and neck cancer.
Researchers used the TriNetX Global Collaborative Network database to identify 166 patients (67.1% men) with HNSCC who received immune checkpoint inhibitors between 2012 and 2023. The cohort included 83 patients with a normal BMI (20-24.9 kg/m2) and 83 with obesity BMI ( 30 kg/m2).
Researchers assessed OS and functional outcomes — including dysphagia, tracheostomy dependence and gastrostomy tube dependence — for 5 years after treatment.
Patients with obesity BMI had improved OS at 6 months (HR = 0.54; 95% CI, 0.31-0.96), 3 years (HR = 0.56; 95% CI, 0.38-0.83) and 5 years (HR = 0.62; 95% CI, 0.44-0.86).
Patients with obesity had reduced gastrostomy tube dependence at 6 months (OR = 0.41; 95% CI, 0.21-0.8), 1 year (OR = 0.41; 95% CI, 0.21-0.78), 3 years (OR = 0.35; 95% CI, 0.18-0.65) and 5 years (OR = 0.34; 95% CI, 0.18-0.65). They also had reduced tracheostomy dependence at 1 year (OR = 0.52; 95% CI, 0.28-0.9), 3 years (OR = 0.45; 95% CI, 0.45-0.9) and 5 years (OR = 0.45; 0.45-0.9).
“Further investigation is required to understand the mechanism of these findings,” Eric V. Mastrolonardo, MD, otolaryngology resident at Thomas Jefferson University Hospital, and colleagues wrote.
Researchers acknowledged study limitations, including the fact they could not account for BMI changes after the start of treatment and the TriNetX platform’s inability to track PFS.
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Mastrolonardo EV, et al. JAMA Otolaryngol Head Neck Surg. 2024;doi:10.1001/jamaoto.2024.1568.
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