Metabolic disease and adverse events from immune checkpoint inhibitors
Objective 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-asso...
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| Veröffentlicht in: | European journal of endocrinology 2021-06, Vol.184 (6), p.857-865 |
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| creator | Leiter, Amanda Carroll, Emily De Alwis, Sonia Brooks, Danielle Ben Shimol, Jennifer Eisenberg, Elliot Wisnivesky, Juan P Galsky, Matthew D Jane Gallagher, Emily |
| description | Objective 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 We conducted a retrospective observational study of patients receiving ICIs at a cancer center. Our main study outcome was development of ≥grade 2 (moderate) irAEs. Our main predictor was weight/metabolic disease risk category: (1) normal weight (BMI 18.5–24.9 kg/m2)/low metabolic risk ( |
| doi_str_mv | 10.1530/EJE-20-1362 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_34552304</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2537151858</sourcerecordid><originalsourceid>FETCH-LOGICAL-b451t-adf5ad09a0a2ed212af1516d6619cecd9504c0ce74efb5461c2129049dd511433</originalsourceid><addsrcrecordid>eNp9kc1rGzEQxUVJqB23p97DQi6BsKm0kvbjUgjGzgcOvbTQm9BKs7Xc3ZUr7Rry32eKHZPmkNM8mB9v3vAI-cLoNZOcfl08LNKMpozn2QcyZaKo0rzkv07IlJZUpCIXfELOYtxQylDTj2TChZQZp2JKlo8w6Nq3ziTWRdAREt3bRNsdBNSwg36ISRN8l7iuG3tIzBrMn613_ZC4fu1qN_gQP5HTRrcRPh_mjPxcLn7M79LV99v7-c0qrYVkQ6ptI7WllaY6A5uxTDdMstzmOasMGFtJKgw1UAhoailyZpCpqKislYwJzmfk2953O9YdWIPpgm7VNrhOhyfltVP_b3q3Vr_9TpV4vyoYGlweDIL_O0IcVOeigbbVPfgxqkwWsuRlUVSIXrxBN34MPb6HFC8weInojFztKRN8jAGaYxhG1b9-FPajMtTYD9Lnr_Mf2ZdCEGB7oHY-GodfuMYZ_a7pM94ym6w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2537151858</pqid></control><display><type>article</type><title>Metabolic disease and adverse events from immune checkpoint inhibitors</title><source>MEDLINE</source><source>Oxford Academic Journals (OUP)</source><creator>Leiter, Amanda ; Carroll, Emily ; De Alwis, Sonia ; Brooks, Danielle ; Ben Shimol, Jennifer ; Eisenberg, Elliot ; Wisnivesky, Juan P ; Galsky, Matthew D ; Jane Gallagher, Emily</creator><creatorcontrib>Leiter, Amanda ; Carroll, Emily ; De Alwis, Sonia ; Brooks, Danielle ; Ben Shimol, Jennifer ; Eisenberg, Elliot ; Wisnivesky, Juan P ; Galsky, Matthew D ; Jane Gallagher, Emily</creatorcontrib><description>Objective 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 We conducted a retrospective observational study of patients receiving ICIs at a cancer center. Our main study outcome was development of ≥grade 2 (moderate) irAEs. Our main predictor was weight/metabolic disease risk category: (1) normal weight (BMI 18.5–24.9 kg/m2)/low metabolic risk (<2 metabolic diseases (diabetes, dyslipidemia, hypertension)), (2) normal weight/high metabolic risk (≥2 metabolic diseases), (3) overweight (BMI ≥ 25 kg/m2)/low metabolic risk, and (4) overweight/high metabolic risk. Results Of 411 patients in our cohort, 374 were eligible for analysis. Overall, 111 (30%) patients developed ≥grade 2 irAEs. In Cox analysis, overweight/low metabolic risk was significantly associated with ≥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 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.</description><identifier>ISSN: 0804-4643</identifier><identifier>EISSN: 1479-683X</identifier><identifier>DOI: 10.1530/EJE-20-1362</identifier><identifier>PMID: 34552304</identifier><language>eng</language><publisher>England: Bioscientifica Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Body weight ; Clinical Study ; Cohort Studies ; Diabetes mellitus ; Disease ; Drug-Related Side Effects and Adverse Reactions - epidemiology ; Drug-Related Side Effects and Adverse Reactions - immunology ; Drug-Related Side Effects and Adverse Reactions - pathology ; Dyslipidemia ; Female ; Follow-Up Studies ; Humans ; Immune checkpoint inhibitors ; Immune Checkpoint Inhibitors - administration & dosage ; Immune Checkpoint Inhibitors - adverse effects ; Immune response ; Male ; Metabolic Diseases - complications ; Metabolic Diseases - epidemiology ; Metabolic Diseases - immunology ; Metabolic disorders ; Metabolic syndrome ; Metabolic Syndrome - complications ; Metabolic Syndrome - epidemiology ; Metabolic Syndrome - immunology ; Middle Aged ; Neoplasms - complications ; Neoplasms - drug therapy ; Neoplasms - epidemiology ; Neoplasms - immunology ; Obesity - complications ; Obesity - epidemiology ; Obesity - immunology ; Overweight ; Overweight - complications ; Overweight - epidemiology ; Overweight - immunology ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Young Adult</subject><ispartof>European journal of endocrinology, 2021-06, Vol.184 (6), p.857-865</ispartof><rights>2021 European Society of Endocrinology</rights><rights>Copyright BioScientifica Ltd. Jun 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b451t-adf5ad09a0a2ed212af1516d6619cecd9504c0ce74efb5461c2129049dd511433</citedby><orcidid>0000-0001-9072-5512</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34552304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leiter, Amanda</creatorcontrib><creatorcontrib>Carroll, Emily</creatorcontrib><creatorcontrib>De Alwis, Sonia</creatorcontrib><creatorcontrib>Brooks, Danielle</creatorcontrib><creatorcontrib>Ben Shimol, Jennifer</creatorcontrib><creatorcontrib>Eisenberg, Elliot</creatorcontrib><creatorcontrib>Wisnivesky, Juan P</creatorcontrib><creatorcontrib>Galsky, Matthew D</creatorcontrib><creatorcontrib>Jane Gallagher, Emily</creatorcontrib><title>Metabolic disease and adverse events from immune checkpoint inhibitors</title><title>European journal of endocrinology</title><addtitle>Eur J Endocrinol</addtitle><description>Objective 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 We conducted a retrospective observational study of patients receiving ICIs at a cancer center. Our main study outcome was development of ≥grade 2 (moderate) irAEs. Our main predictor was weight/metabolic disease risk category: (1) normal weight (BMI 18.5–24.9 kg/m2)/low metabolic risk (<2 metabolic diseases (diabetes, dyslipidemia, hypertension)), (2) normal weight/high metabolic risk (≥2 metabolic diseases), (3) overweight (BMI ≥ 25 kg/m2)/low metabolic risk, and (4) overweight/high metabolic risk. Results Of 411 patients in our cohort, 374 were eligible for analysis. Overall, 111 (30%) patients developed ≥grade 2 irAEs. In Cox analysis, overweight/low metabolic risk was significantly associated with ≥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 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Mass Index</subject><subject>Body weight</subject><subject>Clinical Study</subject><subject>Cohort Studies</subject><subject>Diabetes mellitus</subject><subject>Disease</subject><subject>Drug-Related Side Effects and Adverse Reactions - epidemiology</subject><subject>Drug-Related Side Effects and Adverse Reactions - immunology</subject><subject>Drug-Related Side Effects and Adverse Reactions - pathology</subject><subject>Dyslipidemia</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immune checkpoint inhibitors</subject><subject>Immune Checkpoint Inhibitors - administration & dosage</subject><subject>Immune Checkpoint Inhibitors - adverse effects</subject><subject>Immune response</subject><subject>Male</subject><subject>Metabolic Diseases - complications</subject><subject>Metabolic Diseases - epidemiology</subject><subject>Metabolic Diseases - immunology</subject><subject>Metabolic disorders</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - complications</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Metabolic Syndrome - immunology</subject><subject>Middle Aged</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - drug therapy</subject><subject>Neoplasms - epidemiology</subject><subject>Neoplasms - immunology</subject><subject>Obesity - complications</subject><subject>Obesity - epidemiology</subject><subject>Obesity - immunology</subject><subject>Overweight</subject><subject>Overweight - complications</subject><subject>Overweight - epidemiology</subject><subject>Overweight - immunology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0804-4643</issn><issn>1479-683X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1rGzEQxUVJqB23p97DQi6BsKm0kvbjUgjGzgcOvbTQm9BKs7Xc3ZUr7Rry32eKHZPmkNM8mB9v3vAI-cLoNZOcfl08LNKMpozn2QcyZaKo0rzkv07IlJZUpCIXfELOYtxQylDTj2TChZQZp2JKlo8w6Nq3ziTWRdAREt3bRNsdBNSwg36ISRN8l7iuG3tIzBrMn613_ZC4fu1qN_gQP5HTRrcRPh_mjPxcLn7M79LV99v7-c0qrYVkQ6ptI7WllaY6A5uxTDdMstzmOasMGFtJKgw1UAhoailyZpCpqKislYwJzmfk2953O9YdWIPpgm7VNrhOhyfltVP_b3q3Vr_9TpV4vyoYGlweDIL_O0IcVOeigbbVPfgxqkwWsuRlUVSIXrxBN34MPb6HFC8weInojFztKRN8jAGaYxhG1b9-FPajMtTYD9Lnr_Mf2ZdCEGB7oHY-GodfuMYZ_a7pM94ym6w</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Leiter, Amanda</creator><creator>Carroll, Emily</creator><creator>De Alwis, Sonia</creator><creator>Brooks, Danielle</creator><creator>Ben Shimol, Jennifer</creator><creator>Eisenberg, Elliot</creator><creator>Wisnivesky, Juan P</creator><creator>Galsky, Matthew D</creator><creator>Jane Gallagher, Emily</creator><general>Bioscientifica Ltd</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9072-5512</orcidid></search><sort><creationdate>20210601</creationdate><title>Metabolic disease and adverse events from immune checkpoint inhibitors</title><author>Leiter, Amanda ; Carroll, Emily ; De Alwis, Sonia ; Brooks, Danielle ; Ben Shimol, Jennifer ; Eisenberg, Elliot ; Wisnivesky, Juan P ; Galsky, Matthew D ; Jane Gallagher, Emily</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b451t-adf5ad09a0a2ed212af1516d6619cecd9504c0ce74efb5461c2129049dd511433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body Mass Index</topic><topic>Body weight</topic><topic>Clinical Study</topic><topic>Cohort Studies</topic><topic>Diabetes mellitus</topic><topic>Disease</topic><topic>Drug-Related Side Effects and Adverse Reactions - epidemiology</topic><topic>Drug-Related Side Effects and Adverse Reactions - immunology</topic><topic>Drug-Related Side Effects and Adverse Reactions - pathology</topic><topic>Dyslipidemia</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Immune checkpoint inhibitors</topic><topic>Immune Checkpoint Inhibitors - administration & dosage</topic><topic>Immune Checkpoint Inhibitors - adverse effects</topic><topic>Immune response</topic><topic>Male</topic><topic>Metabolic Diseases - complications</topic><topic>Metabolic Diseases - epidemiology</topic><topic>Metabolic Diseases - immunology</topic><topic>Metabolic disorders</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - complications</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Metabolic Syndrome - immunology</topic><topic>Middle Aged</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - drug therapy</topic><topic>Neoplasms - epidemiology</topic><topic>Neoplasms - immunology</topic><topic>Obesity - complications</topic><topic>Obesity - epidemiology</topic><topic>Obesity - immunology</topic><topic>Overweight</topic><topic>Overweight - complications</topic><topic>Overweight - epidemiology</topic><topic>Overweight - immunology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leiter, Amanda</creatorcontrib><creatorcontrib>Carroll, Emily</creatorcontrib><creatorcontrib>De Alwis, Sonia</creatorcontrib><creatorcontrib>Brooks, Danielle</creatorcontrib><creatorcontrib>Ben Shimol, Jennifer</creatorcontrib><creatorcontrib>Eisenberg, Elliot</creatorcontrib><creatorcontrib>Wisnivesky, Juan P</creatorcontrib><creatorcontrib>Galsky, Matthew D</creatorcontrib><creatorcontrib>Jane Gallagher, Emily</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leiter, Amanda</au><au>Carroll, Emily</au><au>De Alwis, Sonia</au><au>Brooks, Danielle</au><au>Ben Shimol, Jennifer</au><au>Eisenberg, Elliot</au><au>Wisnivesky, Juan P</au><au>Galsky, Matthew D</au><au>Jane Gallagher, Emily</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metabolic disease and adverse events from immune checkpoint inhibitors</atitle><jtitle>European journal of endocrinology</jtitle><addtitle>Eur J Endocrinol</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>184</volume><issue>6</issue><spage>857</spage><epage>865</epage><pages>857-865</pages><issn>0804-4643</issn><eissn>1479-683X</eissn><abstract>Objective 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 We conducted a retrospective observational study of patients receiving ICIs at a cancer center. Our main study outcome was development of ≥grade 2 (moderate) irAEs. Our main predictor was weight/metabolic disease risk category: (1) normal weight (BMI 18.5–24.9 kg/m2)/low metabolic risk (<2 metabolic diseases (diabetes, dyslipidemia, hypertension)), (2) normal weight/high metabolic risk (≥2 metabolic diseases), (3) overweight (BMI ≥ 25 kg/m2)/low metabolic risk, and (4) overweight/high metabolic risk. Results Of 411 patients in our cohort, 374 were eligible for analysis. Overall, 111 (30%) patients developed ≥grade 2 irAEs. In Cox analysis, overweight/low metabolic risk was significantly associated with ≥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 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.</abstract><cop>England</cop><pub>Bioscientifica Ltd</pub><pmid>34552304</pmid><doi>10.1530/EJE-20-1362</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9072-5512</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Body Mass Index Body weight Clinical Study Cohort Studies Diabetes mellitus Disease Drug-Related Side Effects and Adverse Reactions - epidemiology Drug-Related Side Effects and Adverse Reactions - immunology Drug-Related Side Effects and Adverse Reactions - pathology Dyslipidemia Female Follow-Up Studies Humans Immune checkpoint inhibitors Immune Checkpoint Inhibitors - administration & dosage Immune Checkpoint Inhibitors - adverse effects Immune response Male Metabolic Diseases - complications Metabolic Diseases - epidemiology Metabolic Diseases - immunology Metabolic disorders Metabolic syndrome Metabolic Syndrome - complications Metabolic Syndrome - epidemiology Metabolic Syndrome - immunology Middle Aged Neoplasms - complications Neoplasms - drug therapy Neoplasms - epidemiology Neoplasms - immunology Obesity - complications Obesity - epidemiology Obesity - immunology Overweight Overweight - complications Overweight - epidemiology Overweight - immunology Retrospective Studies Risk Assessment Severity of Illness Index Young Adult |
| title | Metabolic disease and adverse events from immune checkpoint inhibitors |
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