Supplementary Tables S6-S8 from Associations between Pretreatment Body Composition Features and Clinical Outcomes among Patients with Metastatic Clear Cell Renal Cell Carcinoma Treated with Immune Checkpoint Blockade
posted on 2023-04-01, 00:08authored byYasser Ged, Alejandro Sanchez, Sujata Patil, Andrea Knezevic, Emily Stein, Stacey Petruzella, Kate Weiss, Cihan Duzgol, Joshua Chaim, Oguz Akin, Marina Mourtzakis, Michael T. Paris, Jessica Scott, Fengshen Kuo, Ritesh Kotecha, A. Ari Hakimi, Chung-Han Lee, Robert J. Motzer, Martin H. Voss, Helena Furberg
Table S6. Associations between SMI and length of prior treatment exposure before starting ICB among the 144 patients that received ICB in the second+ line setting
Table S7. The prevalence of SMI by the number of prior treatments received before starting ICB among the 144 patients that received ICB in the second+ line setting
Table S8. Characteristics of the TCGA cohort used for gene expression analysis by SMI
Funding
National Cancer Institute (NCI)
United States Department of Health and Human Services
High body mass index (BMI) may lead to improved immune-checkpoint blockade (ICB) outcomes in metastatic clear cell renal cell carcinoma (mccRCC). However, BMI is a crude body size measure. We investigated BMI and radiographically assessed body composition (BC) parameters association with mccRCC ICB outcomes.
Retrospective study of ICB-treated patients with mccRCC. BMI and BC variables [skeletal muscle index (SMI) and multiple adiposity indexes] were determined using pretreatment CT scans. We examined the associations between BMI and BC variables with ICB outcomes. Therapeutic responses per RECIST v1.1 were determined. We compared whole-transcriptomic patterns with BC variables in a separate cohort of 62 primary tumor samples.
205 patients with mccRCC were included in the cohort (74% were male, 71% were overweight/obese, and 53% were classified as low SMI). High-BMI patients experienced longer overall survival (OS) than normal-weight patients [unadjusted HR, 0.66; 95% confidence interval (CI), 0.45–0.97; P = 0.035]. The only BC variable associated with OS was SMI [unadjusted HR comparing low vs. high SMI 1.65 (95% CI: 1.13–2.43); P = 0.009]. However, this OS association became nonsignificant after adjusting for International Metastatic Renal Cell Carcinoma Database Consortium score and line of therapy. No OS association was seen for adiposity and no BC variable was associated with progression-free survival or radiological responses. Tumors from patients with low SMI displayed increased angiogenic, inflammatory, and myeloid signals.
Our findings highlight the relevance of skeletal muscle in the BMI paradox. Future studies should investigate if addressing low skeletal muscle in metastatic patients treated with ICB can improve survival.