THE IMPACT OF BODY MASS INDEX ON THE RISK OF DEVELOPING SERIOUS ADVERSE EVENTS IN PATIENTS WITH METASTATIC NON-SMALL CELL LUNG CANCER

One of the essential drugs used to treat patients with metastatic non-small cell lung cancer (mNSCLC) is bevacizumab. Bevacizumab is associated with a significant number of severe adverse events. The relationship between body composition and the risk of hemorrhagic, thromboembolic events, and hypertension remains unclear. Therefore, our study aimed to establish a correlation between survival, these adverse events, and body mass index (BMI). Materials and methods. Eighty-seven patients with mNSCLC treated in the Sumy Regional Clinical Oncology Center were involved in the retrospective study. Data on sex, age, weight, height of patients, results of coagulogram, and blood count tests were collected from the primary medical documentation no more than one week before the start of bevacizumab therapy. BMI was calculated based on data on the weight and height of patients according to the formula: weight/height2 (kilograms/per square meter). Patients with BMI <25 kg/m2 were included in the underweight and normal weight groups. Those whose BMI was ≥25 kg/m2 were included in the overweight and obese group. Adverse event severity was determined using the Common Terminology Criteria for Adverse Events (CTCAE, version 5). Chi2 test for categorical variables, Fisher’s exact test, multivariate Cox regression analysis and Kaplan-Meier method were used for statistical analysis. Results. According to the results of univariate analysis, it was established that each clinicopathological characteristic does not have a statistically significant correlation with BMI. However, multivariate analysis showed that patient sex (P=0.011) and blood platelet level (P=0.045) correlated with OS. The median overall survival (OS) in women was 16.0 months versus 9.1 months in men. Median OS in patients with platelets less than 280 g/L was 13.5 months versus 7.4 months in those with 280 g/L or higher. Conclusions. BMI does not impact on OS and risk of thromboembolism, bleeding, and hypertension in patients with mNSCLC receiving bevacizumab therapy. Women and those whose baseline platelet count is less than 280 g/L have better survival.