Background: Although recent studies have reported that obesity is a protective factor for survival in patients with advanced cancers treated with immune checkpoint inhibitors (ICIs), the prognostic value of CT-derived adipose composition parameters remains unclear. This study aimed to assess the association between CT-derived adipose composition parameters and clinical outcomes in cancer patients undergoing ICIs treatment.
Methods: A comprehensive search was conducted until May 2024 across several databases to gather relevant studies, including PubMed, Embase, Web of Science and Cochrane Library. Hazard ratios (HR) or odds ratios (OR) were used to assess the correlation between adiposity composition and clinical outcomes. The primary outcomes were overall survival (OS) and progression-free survival (PFS). The secondary outcomes were immune-related adverse events (irAEs).
Results: A total of 2118 patients in 17 studies were included in the meta-analysis. Systemic analysis of all collected evidence revealed that high subcutaneous fat area (SFA) (OS: HR = 0.61, 95 % CI = 0.46-0.81, P < 0.001; PFS: HR = 0.65, 95 % CI = 0.50-0.85, P = 0.001) and high visceral fat index (VFI) (OS: HR = 0.68, 95 % CI = 0.56-0.83, P < 0.001; PFS: HR = 0.79, 95 % CI = 0.67-0.92, P = 0.003) were significantly associated with OS and PFS in cancer patients treated with ICIs. High subcutaneous fat index (SFI) was associated with better OS (HR = 0.64, 95 % CI = 0.48-0.86, P = 0.003) but not PFS (HR = 0.78, 95 % CI = 0.59-1.03, P = 0.083). However, no significant correlation was found between inter-muscular fat index (IFI) (OS: HR = 0.94, 95 % CI = 0.56-1.60, P = 0.833; PFS: HR = 1.00, 95 % CI = 0.62-1.62, P = 0.998) and OS or PFS in cancer patients under ICIs treatment.
Conclusion: CT-derived adipose composition parameters such as SFA, SFI and VFI are predictive of clinical outcomes in cancer patients treated with ICIs. Prospective cohorts with larger samples are needed to validate this hypothesis-generating data in the future.
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| http://dx.doi.org/10.1016/j.intimp.2024.113699 | DOI Listing |
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