A recent study has explored the effects of obesity on the outcomes of adoptive cell therapy (ACT) in patients with advanced solid tumours, shedding light on the complex relationship between body weight and cancer treatment efficacy. This retrospective multicohort analysis, examined 95 patients who received ACT across various clinical trials from 2017 to 2023.
The research delves into the so-called “obesity paradox,” which describes the paradoxical observation that obesity, despite its association with increased cancer risk, may offer improved survival for patients treated with immune checkpoint inhibitors. The study found that patients with obesity had significantly better overall survival rates compared to those with normal weight, with a hazard ratio of 0.56 (95% CI: 0.31-0.99; P=0.045). Surprisingly, no weight difference was observed in response rates between groups, but patients with obesity had a notably lower rate of immune effector cell–associated neurotoxicity syndrome (ICANS) compared to those with normal weight (0% vs 23.1%; P=0.049).
While the findings suggest that obesity might improve survival and reduce some treatment-related toxicities, the study acknowledges its exploratory nature, citing the limitations of using body mass index (BMI) as a sole measure of obesity. Further research is needed to fully understand how obesity and related factors, such as body composition, diet, and genetics, influence immune-modifying therapies like ACT.
Helena Bradbury, EMJ
Reference
Tao D et al. Obesity and Outcomes in Adoptive Cellular Therapy in Solid Tumors. JAMA Netw Open. 2024;7(11):e2447617.
