Table 1.
Human studies published before February 2020 investigating the effects of obesity on immune checkpoint blockade therapy for cancer.
| Study Authors | Date of Study | Type of Study | Cancer | Drug Name | Statistical Effects of Obesity |
|---|---|---|---|---|---|
| Human trials | |||||
| Cortellini et al. [70] | February 2019 | Retrospective | NSCLC, melanoma, renal cell carcinoma, others | Anti-PD-1/PD-L1 (pembrolizumab, nivolumab or atezolizumab) | Objective response rate, time to treatment failure (HR = 0.51 [95% CI: 0.44–0.60], progress-free survival (HR = 0.46 [95%CI: 0.39–0.54]) and overall survival (HR = 0.33 [95%CI: 0.28–0.41]), significantly improved in overweight/obese patients (p < 0.0001) |
| Donnelly et al. [77] | August 2019 | RCT | Metastatic melanoma | Anti-PD-1/anti-CTLA-4 (specific drugs unspecified) | No difference in PFS or OS between BMI levels in monotherapy however PFS for combination therapy was significant in obese patients (HR = 0.17 [95%CI: 0.04–0.65]) (p = 0.02) |
| Kichenadasse et al. [78] | December 2019 | RCT | Non-small cell lung cancer | Atezolizumab (anti-PD-L1) | BMI ≥ 30 increase in OS (HR = 0.36 [95%CI: 0.21–0.62]) (p < 0.001) |
| McQuade et al. [75] | February 2018 | Retrospective | Metastatic melanoma | Anti-PD-1/PD-L1, ipilimumab+ dacarbazine | Anti-PD-1/PD-L1: increased PFS (HR = 0.69 [95%CI: 0.45–1.06]) and OS (HR = 0.69 [95%CI: 0.42–1.12] for overweight and obese male patients compared to normal weight patients (not statistically significant), but not for female patients Anti-CTLA-4: increased PFS (HR = 0.55 [95%CI: 0.32–0.93]) and OS (HR = 0.40 [95%CI: 0.22–0.72]) in obese male patients compared to normal weight patients (not statistically significant), but not for female patients |
| Naik et al. [76] | March 2019 | Retrospective | Unresectable or metastatic melanoma | Pembrolizumab or nivolumab (anti-PD-1) or anti-PD-1+ ipilimumab (anti-CTLA-4) | Overweight (but not obese) patients had increased OS compared to normal weight patients (HR = 0.26 [95%CI: 0.1–0.71]) (p = 0.038) |
| Richtig et al. [79] | October 2018 | Retrospective | Metastatic melanoma | Anti-CTLA4 (ipilimumab) | Overweight and obese patients have higher response rates (p = 0.024, no other statistics provided) and a lower likelihood of brain metastases (8.6% vs. 32.5%, p = 0.012) compared to normal weight patients, as well as longer overall survival (HR = 1.81 [95%CI: 0.98–3.33], p = 0.056) |
| Wang et al. [54] | November 2018 | RCT | Lung cancer, melanoma, ovarian cancer, and others (unspecified) | Anti-PD-L1/anti-PD-1 (specific drugs unspecified) | Improvement in progression free survival (median: 237 vs. 141 days, p = 0.0034) and overall survival (median: 523 vs. 361 days, p = 0.0492) in obese (BMI > 30) compared to non-obese (BMI < 30) patients |
HR = hazard ratio, CI = confidence interval, OS = overall survival, PFS = progression-free survival.