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Table 2 Hazard ratios for the association of BMI with OS and PFS (along with interactions) and odds ratios for the association of BMI with durable clinical benefit among patients treated with anti-PD-1 based checkpoint inhibition

From: Complex inter-relationship of body mass index, gender and serum creatinine on survival: exploring the obesity paradox in melanoma patients treated with checkpoint inhibition

Outcome (N = 136)b Effect Estimate
Overall Survival (OS) Unadjusted Hazard Ratio (95% CI) p-value Adjusted Hazard Ratioa (95% CI) p-value
Overweight/Class-I Obese vs. Normal Weight (reference) 0.41 (0.24–0.72) 0.002 0.26 (0.1–0.71) 0.008
Class-II/III Obese vs. Normal Weight 0.88 (0.41–1.91) 0.756 0.42 (0.1–1.77) 0.238
Interaction Modelc 1 (OS)
 Interaction of BMI (Overweight/Class-I vs. normal weight) with gender (males vs. females) 0.19 (0.04–0.95) 0.044
Interaction Model 1 (OS)
 Overweight/Class-I Obese (vs. normal weight) HR in females 0.56 (0.16–1.89) 0.346
Interaction Model 1 (OS)
 Overweight/Class-I Obese (vs. normal weight) HR in males 0.11 (0.03–0.4) 0.001
Interaction Model 2 (OS)
 Interaction of BMI (Overweight/Class-I vs. normal weight) with serum creatinine (> = 0.9 mg/dL vs. < 0.9 mg/dL)c 0.11 (0.02–0.7) 0.020
Interaction Model 2 (OS)
 Overweight/Class-I Obese (vs. normal weight) HR in patients with serum creatinine < 0.9 mg/dL 0.43 (0.15–1.24) 0.119
Interaction Model 2 (OS)
 Overweight/Class-I Obese (vs. normal weight) HR in patients with serum creatinine > = 0.9 mg/dL 0.045 (0.08–0.262) 0.001
Progression Free Survival (PFS)
 Overweight/Class-I Obese vs. Normal Weight (reference) 0.5 (0.31–0.81) 0.005 0.43 (0.19–0.95) 0.038
Class-II/III Obesity vs. Normal Weight 1.03 (0.53–2) 0.932 1 (0.34–2.94) 0.991
Interaction Model 1 (PFS)
 Interaction of BMI (overweight/Class-I vs. normal weight) with gender (males vs. females) 0.29 (0.07–1.18) 0.084
Interaction Model 1 (PFS)
 Overweight/Class-I Obese (vs. normal weight) HR in females 0.80 (0.27–2.41) 0.695
Interaction Model 1 (PFS)
 Overweight/Class-I Obese (vs. normal weight) HR in males 0.23 (0.08–0.66) 0.006
Interaction Model 2 (PFS)
 Interaction of BMI (overweight/Class-I vs. normal weight) with serum creatinine (> = 0.9 mg/dL vs. < 0.9 mg/dL) 0.17 (0.04–0.77) 0.021
Interaction Model 2 (PFS)
 Overweight/Class-I Obese (vs. normal weight) HR in patients with serum creatinine < 0.9 mg/dL 0.71 (0.29–1.77) 0.464
Interaction Model 2 (PFS)
 Overweight/Class-I Obese (vs. normal weight) HR in patients with serum creatinine > = 0.9 mg/dL 0.12 (0.03–0.45) 0.002
Durable Clinical Benefit (N = 132)b Unadjusted Odds Ratio (95% CI) p-value Adjusted Odds Ratiod (95% CI) p-value
Overweight/Class-I Obese vs. Normal Weight (reference) 2.76 (1.18–6.46) 0.020 11.4 (1.65–78.6) 0.013
Class-II/III Obesity vs. Normal Weight 0.91 (0.23–3.54) 0.891 3.3 (0.22–50.5) 0.391
Interaction Model 1 (DCB)
 Interaction of BMI (overweight/Class-I vs. normal weight) with gender (males vs. females) 10.39 (0.17–634.68) 0.265
Interaction Model 1 (DCB)
 Overweight/Class-I Obese (vs. normal weight) in females 2.91 (0.16–54.05) 0.473
Interaction Model 1 (DCB)
 Overweight/Class-I Obese (vs. normal weight) in males 30.27 (2.01–455.72) 0.014
Interaction Model 2 (DCB)
 Interaction of BMI (overweight/Class-I vs. normal weight) with creatinine (> = 0.9 mg/dL vs. < 0.9 mg/dL) 2.82 (0.03–229.67) 0.644
Interaction Model 2 (DCB)
 Overweight/Class-I Obese (vs. normal weight) HR in patients with serum creatinine < 0.9 mg/dL 8.03 (0.85–76.27) 0.070
Interaction Model 2 (DCB)
 Main effect (Serum Creatinine > = 0.9 mg/dL): Overweight/Class-I Obese (vs. normal weight) HR in patients with serum creatinine > = 0.9 mg/dL 22.66 (0.51–1013.5) 0.108
  1. a Adjusted for the following covariates: age (<=45, > 45–75 and > 75 years), gender, serum creatinine (< 0.9 and > = 0.9 mg/dL), treatment (monotherapy/combination), current drinker (vs. non-current/never-drinker), smoking history (ever vs. never), KPS (<=70 and > 70), LDH (<=231 vs. > 231 U/L), stage at baseline, Charlson’s score (< 10 vs. > = 10), hemoglobin (< 11.5 vs. > = 11.5 g/dL), ANC (<=8 and > 8 K/uL), ALC (< 3 and > =3 K/uL), albumin (< 3.5 g/dL), autoimmune disease, diabetes, CV disease, CKD, BRAF mutation, NRAS mutation, hypertension, hyperlipidemia, comedications (anti-platelet agents, statins, metformin, ACE/ARB inhibitors), prior treatments (immunotherapy/CTLA-4, radiation, chemotherapy and targeted therapy), fasting glucose (<=110 vs. > 110 mg/dL), type of melanoma,; N = 127 after excluding three patients who were underweight, 8 patients with missing LDH values and 1 patient whose KPS could not assessed (missing)
  2. b Three underweight patients were excluded
  3. c Interactions were studied in separate models along with main effects and adjusted for the same covariates as the main models
  4. d Adjusted for the same covariates listed for OS and PFS (except KPS which was included as a continuous variable); N = 123 (excluding 3 underweight patients; DCB was not assessable/available for 4 patients; patients with missing data for LDH, KPS were not included for the adjusted analysis)