Key result
Good-risk lipid profile linked to ~15 months longer median overall survival versus poor-risk profiles.
Why the study?
The prognostic role of specific lipid profile components in patients with solid cancer treated with immune checkpoint inhibitors is not well understood.
Does baseline blood lipid profile predict progression-free and overall survival in patients with advanced solid tumors treated with immune checkpoint inhibitors?
Cohort (n=430)
Yes
Does baseline blood lipid profile predict progression-free and overall survival in patients with advanced solid tumors treated with immune checkpoint inhibitors?
p-value: p=<.001
A baseline lipid profile characterized by low total cholesterol and high triglycerides is an independent poor prognostic factor for survival in patients with solid tumors treated with immune checkpoint inhibitors.
May support lipid-based risk stratification in ICI-treated solid tumors; leaves open its clinical utility pending prospective validation.
BACKGROUND: Specific components of lipid profile seem to differently impact on immune activity against cancer and unraveling their prognostic role in patients with solid cancer treated with immune checkpoint inhibitors (ICIs) is needed. MATERIALS AND METHODS: We retrospectively collected baseline clinicopathological characteristics including circulating lipid profile (total cholesterol [TC], triglycerides [TG], low-density lipoproteins [LDL], high-density lipoproteins [HDL]) of patients with consecutive solid cancer treated with ICIs, and we investigated their role in predicting clinical outcomes. RESULTS: At a median follow-up of 32.9 months, among 430 enrolled patients, those with TC ≥ 200 mg/dl showed longer median progression-free survival (mPFS; 6.6 vs. 4.7 months, P = .4), although not reaching statistical significance, and significantly longer median overall survival (mOS; 19.4 vs. 10.8 months, P = .02) compared to those with TC < 200 mg/dl. Conversely, patients with TG ≥150 mg/dl displayed shorter PFS (3.4 vs. 5.1 months, P = .02) and OS (7.1 vs. 12.9 months, P = .009) compared to those with TG <150 mg/dl. TC and TG were then combined in a "LIPID score" identifying three subgroups: good-risk (GR) (TC ≥200 mg/dl and TG <150 mg/dl), intermediate-risk (IR) (TC <200 mg/dl and TG <150 mg/dl or TC ≥200 mg/dl and TG ≥150 mg/dl) and poor-risk (PR) (TC <200 mg/dl and TG ≥150 mg/dl). The mPFS of GR, IR, and PR groups was 7.8, 4.3, and 2.5 months, respectively (P = .005); mOS of GR, IR, and PR was 20.4, 12.4, and 5.3 months, respectively (P < .001). At multivariable analysis, the PR profile represented an independent poor prognostic factor for both PFS and OS. CONCLUSIONS: We developed a lipid score that defined subgroups of patients with cancer who differently benefit from ICIs. Further mechanistic insights are warranted to clarify the prognostic and predictive role of lipid profile components in patients treated with ICIs.
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Pecci et al. (2023) conducted a cohort in Advanced Solid Tumors (n=430). Blood lipid profile (total cholesterol and triglycerides) vs. Different lipid profile subgroups was evaluated on Overall survival (p=<.001). A good-risk lipid profile (TC ≥200 mg/dl, TG <150 mg/dl) was associated with longer median overall survival compared to intermediate and poor-risk profiles (20.4 vs 12.4 vs 5.3 months, P<0.001).
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