Metabolic disease and adverse events from immune checkpoint inhibitors
Objective/UNASSIGNED:Obese and overweight body mass index (BMI) categories have been associated with increased immune-related adverse events (irAEs) in patients with cancer receiving immune checkpoint inhibitors (ICIs); however, the impact of being overweight in conjunction with related metabolic syndrome-associated factors on irAEs have not been investigated. We aimed to evaluate the impact of overweight and obese BMI according to metabolic disease burden on the development of irAEs. Design and Methods/UNASSIGNED:)/low metabolic risk, and (4) overweight/high metabolic risk. Results/UNASSIGNED:Of 411 patients in our cohort, 374 were eligible for analysis. Overall, 111 (30%) patients developed â‰¥grade 2 irAEs. In Cox analysis, overweight/low metabolic risk was significantly associated with â‰¥grade 2 irAEs (hazard ratio [HR]: 2.0, 95% confidence interval [95% CI]: 1.2-3.4) when compared to normal weight/low metabolic risk, while overweight/high metabolic risk (HR: 1.3, 95% CI: 0.7-2.2) and normal weight/high metabolic risk (HR: 1.5, 95% CI: 0.7-3.0) were not. Conclusions/UNASSIGNED:Overweight patients with fewer metabolic comorbidities were at increased risk for irAEs. This study provides an important insight that BMI should be evaluated in the context of associated metabolic comorbidities in assessing risk of irAE development and ICI immune response.