Prognostic Impact of Body Mass index in Lung Cancer Patients Receiving Immune Checkpoint Inhibitors: An Updated Systematic Review and Meta-Analysis.

IntroductionBody mass index (BMI) is a common clinical parameter associated with cancer prognosis, but its association with survival outcomes in lung cancer patients receiving immune checkpoint inhibitors (ICIs) remains unclear. This study aimed to clarify the prognostic value of BMI in ICI-treated lung cancer patients.MethodsA systematic review and meta-analysis were conducted based on online databases including PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov up to December 1, 2024. Eligible studies included lung cancer patients treated with ICIs and reported hazard ratios (HRs) for overall survival (OS) and/or progression-free survival (PFS) stratified by BMI. Random-effects models were used to determine HRs with 95% confidence intervals (CIs).ResultsA total of 30 studies involving 5987 patients were included. High BMI was significantly associated with better OS (HR = 0.69, 95%CI = 0.60-0.80) and PFS (HR = 0.82, 95%CI = 0.72-0.93). The subgroup analysis showed improved survival outcomes particularly in patients with BMI ≥ 30 kg/m² as compared with others. However, this association was not statistically significant in small-cell lung cancer.ConclusionHigh BMI was associated with a better prognosis than low BMI in ICI-treated patients with lung cancer. Due to study limitations, the prognostic impact of BMI still requires further clarification with additional evidence.