Impact of losing adipose tissue on outcomes from PD-1/PD-L1 inhibitor monotherapy in non-small cell lung cancer

Naoya Nishioka, Tateaki Naito, Taichi Miyawaki, Michitoshi Yabe, Kosei Doshita, Hiroaki Kodama, Eriko Miyawaki, Yuko Iida, Nobuaki Mamesaya, Haruki Kobayashi, Shota Omori, Ryo Ko, Kazushige Wakuda, Akira Ono, Hirotsugu Kenmotsu, Haruyasu Murakami, Koichi Takayama, Toshiaki Takahashi

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Adipose tissue induces inflammation, which desensitizes the efficacy of immunotherapy. However, several reports show that the therapeutic effect of programed cell death 1 (PD-1)/programed death-ligand 1 (PD-L1) inhibitor(s) monotherapy is significantly better in obese patients. Therefore, the effect of adipose tissue on immunotherapy is unclear. Methods: In this study, we retrospectively reviewed patients with advanced non-small cell lung cancer (NSCLC) who received PD-1/PD-L1 inhibitor monotherapy between May 2016 and December 2018. We classified patients into total adipose tissue maintenance or loss groups according to adipose tissue change during the 6 months before treatment and compared the therapeutic effect of PD-1/PD-L1 inhibitors between these groups along with the presence or absence of cachexia, a poor prognostic factor. Results: Of the 74 patients, 40 (54.1%) were cachexic. Among cachexic patients, we found no clear difference in the overall response rate (ORR) and progression-free survival (PFS) between the total adipose tissue maintenance and loss group. However, among noncachexic patients, the total adipose tissue loss group had a higher ORR (64.7% vs. 23.5%, p < 0.05) and longer PFS (18.5 months vs. 2.86 months, p = 0.037) than the maintenance group. Conclusions: This study showed that decreasing adipose tissue without cachexia might favor the therapeutic effects of immunotherapy.

Original languageEnglish
Pages (from-to)1496-1504
Number of pages9
JournalThoracic Cancer
Volume13
Issue number10
DOIs
Publication statusPublished - May 2022
Externally publishedYes

Keywords

  • adipose tissue
  • cachexia
  • inflammation
  • PD-1/PD-L1 inhibitors

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