To investigate the association of computed tomography-assessed body composition with survival outcomes of metastatic renal cell carcinoma (mRCC) received immunotherapy.
In this multicenter, retrospective study, we reviewed 251 mRCC patients who received anti-PD1 from five centers. We analyzed the relationship between BMI, skeletal muscle area (SM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and subcutaneous adipose percentage (SAT%) with progression-free survival (PFS) and overall survival (OS). The spatial localization T cells was investigated by multiplex immunofluorescence.
Among 224 evaluable patients, 23 (10.3%) patients were underweight, 118 (52.7%) had normal weight, 65 (29%) were overweight, and 18 patients (8%) were obese. The median age was 55 years and most patients were male (71%). No significant improvement in PFS (HR, 0.61; 95% CI, 0.27-1.42) or OS (HR, 1.09; 95% CI, 0.38-3.13) was observed for the obese patients. Besides, SM, VAT, and SAT were not associated with survival outcomes (all p > 0.05). Interestingly, SAT% independently predicted PFS (as continuous variable, HR: 0.02; 95% CI, 0.01-0.11) and OS (HR:0.05; 95% CI, 0.01-0.39), which remained significant in multivariate modeling (as continuous variable, adjusted HR for PFS, 0.01; 95% CI, 0.00-0.04; adjusted HR for OS, 0.08; 95% CI, 0.01-0.72). These associations were consistent in subgroup analysis of different gender, BMI, PD-L1 positive, and sarcopenia group. Tumor of high SAT% patients had a higher intratumoral PD1+ CD8+ T cell density and ratio.
High SAT% predicts better outcomes in mRCC patients treated with anti-PD1 and T cell location may account for the better response.
• CT-based subcutaneous adipose percentage independently predicted progression-free survival and overall survival. • Patients with a higher subcutaneous adipose percentage had a higher intratumoral PD1+ CD8+ T cell density and ratio.
European radiology. 2022 Dec 20 [Epub ahead of print]
Jun Wang, Pei Dong, Yuanyuan Qu, Wenhao Xu, Zhaohui Zhou, Kang Ning, Yulu Peng, Longbin Xiong, Zhen Li, Xiangpeng Zou, Zhenhua Liu, Mingzhao Li, Zhisong He, Junhang Luo, Xi Tian, Hailiang Zhang, Shengjie Guo, Hui Han, Fangjian Zhou, Shaohan Yin, Dingwei Ye, Chunping Yu, Zhiling Zhang
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China., Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China., Department of Urology, Peking University First Hospital, Beijing, China., Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China. ., State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. ., State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China. .