体重指数 (BMI) 与接受一线化疗、免疫疗法或化学免疫疗法治疗的晚期非小细胞肺癌 (NSCLC) 患者的生存结果之间的关系存在争议。我们的目的是在一项多中心队列研究中调查这些关联，特别是男性和女性患者中的关联。我们回顾性分析了七个队列的数据，其中包括 7021 名接受化疗（三个队列）、免疫治疗（两个队列）的晚期非小细胞肺癌患者。队列）和化学免疫治疗（两个队列），来自五个数据源，包括一个去识别化的全国性（美国）NSCLC 临床基因组数据库和两个随机、双盲、3 期临床试验。 BMI 分为体重不足、体重正常、超重或肥胖。体重不足的患者由于比例较小而被排除在外。主要终点是按治疗类型和性别分层的 BMI 与无进展生存期 (PFS) 和总生存期 (OS) 之间的关联，使用 Kaplan-Meier 方法和调整的 Cox 模型进行评估。进行荟萃分析以结合调整后的风险比。在汇总分析中，肥胖与接受化疗的患者的 OS 改善显着相关（风险比 [HR] = 0.84，95% 置信区间 (CI) 0.76-0.93），但与 PFS 无关（HR = 0.91，95% CI 0.82-1.02）。接受化疗的患者的 BMI 与 OS 的相关性因性别而异，男性中呈负相关（HR = 0.74，95% CI 0.64-0.84），但在女性中没有观察到相关性（HR = 0.96，95% CI 0.81-1.13） ，P交互= 0.018）。在接受免疫治疗或化学免疫治疗的患者中，未检测到 BMI 对 OS 或 PFS 的影响。肥胖患者的肿瘤突变负荷水平最低，程序性死亡配体 1 表达水平和 ESTIMATE 评分相似。肥胖可能与接受化疗的男性患者总生存期增加有关，而与接受化疗的男性患者的总生存期增加无关。免疫疗法或化学免疫疗法。© 2024。作者。

The association of body mass index (BMI) with survival outcomes in patients with advanced non-small cell lung cancer (NSCLC) treated with first-line chemotherapy, immunotherapy, or chemoimmunotherapy is controversial. We aimed to investigate these associations, including associations in male and female patients specifically, in a multicenter cohort study.We retrospectively analyzed data from seven cohorts comprising 7021 advanced non-small cell lung cancer patients who received chemotherapy (three cohorts), immunotherapy (two cohorts), and chemoimmunotherapy (two cohorts) from five data sources, including a de-identified nationwide (US-based) NSCLC clinico-genomic database and two randomized, double-blind, phase 3 clinical trials. BMI was categorized as underweight, normal weight, overweight, or obese. Underweight patients were excluded because of their small proportion. The primary endpoints were the associations between BMI and progression-free survival (PFS) and overall survival (OS) stratified by treatment type and sex, which were assessed using Kaplan-Meier methods and adjusted Cox modeling. Meta-analyses were performed to combine the adjusted hazard ratios.In the pooled analysis, obesity was significantly associated with improved OS in patients receiving chemotherapy (hazard ratios [HR] = 0.84, 95% confidence interval (CI) 0.76-0.93), but there was no association with PFS (HR = 0.91, 95% CI 0.82-1.02). The association of BMI with OS for patients receiving chemotherapy differed by sex, with an inverse association in men (HR = 0.74, 95% CI 0.64-0.84), but no association observed in women (HR = 0.96, 95% CI 0.81-1.13, Pinteraction = 0.018). No impact of BMI on OS or PFS was detected in patients receiving immunotherapy or chemoimmunotherapy. Obese patients had the lowest level of tumor mutational burden, similar level of programmed death-ligand 1 expression and ESTIMATE scores.Obesity may be associated with an increased overall survival among male patients treated with chemotherapy, whereas not associated with the outcomes in patients treated with immunotherapy or chemoimmunotherapy.© 2024. The Author(s).