The association of body mass index with safety and effectiveness of first-line carboplatin-based chemotherapy in patients with metastatic non-small cell lung cancer

•Progression free survival is higher in overweight patients treated with carboplatin.•Overall survival higher in overweight patients treated with carboplatin.•Survival is comparable for obese patients and normal weight patients.•Obesity increases the risk of carboplatin-induced severe thrombocytopenia. Carboplatin is an anticancer drug used for treatment of various types of cancer including non-small cell lung cancer (NSCLC). Dosing is based on estimated glomerular filtration rate (GFR) using the Cockcroft-Gault formula. In overweight patients, the GFR is more likely overestimated, resulting in a potentially overdose of carboplatin affecting treatment response. This study investigated the association of body mass index (BMI) on overall survival (OS) and progression-free survival (PFS) in stage-IV NSCLC patients treated with first-line carboplatin-based chemotherapy. Secondary safety endpoints were thrombocytopenia and toxicity-related hospitalizations. This was a retrospective multicenter cohort study. Patients were categorized according to BMI