Assessment of Immune Checkpoint Inhibitors and Genomic Alterations by Body Mass Index in Advanced Renal Cell Carcinoma

Abstract

An elevated body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) has been associated with an increased risk of renal cell carcinoma (RCC).¹ Previously, higher BMI was shown to be a positive prognostic factor for patients with metastatic clear cell RCC (mRCC) who were treated during the vascular endothelial growth factor (VEGF)–targeted therapy era.² However, the treatment landscape has shifted to include immune checkpoint inhibitors (ICIs) for most patients. We investigated this obesity paradox in patients with mRCC who were treated with programmed cell death 1 protein/programmed cell death 1 ligand 1 (PD-1/PD-L1)–based ICIs and explored potential genomic alterations according to BMI status.