A common immune-related adverse event (irAE) with immune checkpoint inhibitors (ICIs) is thyroid dysfunction (TD-irAEs). The clinical presentation can be varied, and its association with prognosis remains unclear. We investigated the characteristics of TD-irAEs and their association with clinical outcomes among cancer patients treated with ICIs in a real-life setting. Response to treatment was assessed using RECIST v1.1. We calculated the probability of recurrence and survival associated with TD-irAEs using multivariable-adjusted regression and Cox proportional hazards models. In this single-center retrospective analysis, we included 238 patients (72% male) with a median age of 69.5 years. Primary tumors were melanoma (23.1%), lung (60.5%), or urothelial cancer (16.4%), treated with atezolizumab (23.1%), pembrolizumab (44.5%), ipilimumab (0.4%), and/or nivolumab (25.6%). Seventy (29%) patients developed TD-irAEs in a median time of 69 days (41–181). The incidence of TD-irAEs with combination therapy was higher than with monotherapy (67% vs 6.3%, P = 0.011). TD-irAE patients showed a higher objective response rate (ORR) than those without TD-irAEs (60% vs 42.3%, P = 0.013) and longer overall survival (OS) 45 vs 16 months, P < 0.006. Patients who developed TD-irAEs had a relative reduction of 77% (OR 0.23, 95% CI 0.11–0.47) in the risk of progression and of 47% in the risk of mortality (HR 0.53, 95% CI 0.36–0.80), independent of age, sex, primary tumor, or ICI regimen. TD-irAEs occur in nearly 30% of our patients receiving ICIs. In our analysis, TD-irAEs appeared to be associated with higher ORR and longer OS and showed a reduction in the risk of progression and mortality.

Unhealthy dietary habits and sedentarism coexist with a rising incidence of excess weight and associated comorbidities. We aimed to analyze the dietary and drinking patterns of patients with excess weight, their main characteristics, plausible gender differences and impact on cardiometabolic risk factors, with a particular focus on the potential contribution of beer consumption. Data from 200 consecutive volunteers (38 ± 12 years; 72% females) living with overweight or class I obesity attending the obesity unit to lose weight were studied. Food frequency questionnaires and 24 h recalls were used. Reduced-rank regression (RRR) analysis was applied to identify dietary patterns (DPs). Anthropometry, total and visceral fat, indirect calorimetry, physical activity level, comorbidities and circulating cardiometabolic risk factors were assessed. Study participants showed high waist circumference, adiposity, insulin resistance, dyslipidemia, pro-inflammatory adipokines and low anti-inflammatory factors like adiponectin and interleukin-4. A low-fiber, high-fat, energy-dense DP was observed. BMI showed a statistically significant (p < 0.05) correlation with energy density (r = 0.80) as well as percentage of energy derived from fat (r = 0.61). Excess weight was associated with a DP low in vegetables, legumes and whole grains at the same time as being high in sweets, sugar-sweetened beverages, fat spreads, and processed meats. RRR analysis identified a DP characterized by high energy density and saturated fat exhibiting negative loadings (>−0.30) for green leafy vegetables, legumes, and fruits at the same time as showing positive factor loadings (>0.30) for processed foods, fat spreads, sugar-sweetened beverages, and sweets. Interestingly, for both women and men, wine represented globally the main source of total alcohol intake (p < 0.05) as compared to beer and distillates. Beer consumption cannot be blamed as the main culprit of excess weight. Capturing the DP provides more clinically relevant and useful information. The focus on consumption of single nutrients does not resemble real-world intake behaviors.

Background: The impact of body-mass index (BMI) on immune checkpoint inhibitor efficacy and toxicity has not been clearly characterized. We analyzed the association between BMI, and body fat (%BF), with the efficacy and toxicity of ICIs across three solid tumors in a real-life setting. Methods: Melanoma, lung and urothelial cancer patients treated with ICIs at our institution were included. BMI (kg/m2) and %BF (CUN-BAE) were calculated retrospectively. We studied the association between BMI/%BF and objetive-response-rate (ORR), progression-free survival (PFS), overall survival (OS) and immune-related adverse events (irAEs). Results: Among the 356 patients included, 177 (49.7%) had a BMI ≥ 25 kg/m2. Mean BMI was 25.3 ± 4.2 kg/m2, and %BF 30.5 ± 6.3%. ORR was achieved in 155 patients (46.8%). Median PFS and OS was 4 and 11 months, respectively. There were no differences in ORR across BMI categories. In contrast, normal %BF was associated with better ORR in men (81.8% vs. 41.7%, p = 0.024), but not in women ( p = 0.074). Additionally, no association was observed between BMI/%BF and irAEs ( p = 0.762). Notably, those developing any-grade irAEs showed better ORR ( p < 0.001), PFS (HR 1.6, p < 0.001) and OS (HR 1.7, p < 0.001), even adjusting by BMI/%BF, age, gender, primary tumor or ICI regimen. Conclusions: Our results suggest that in patients with advanced cancers treated with ICIs, BMI was not correlated with clinical outcomes or survival. However, men with normal %BF showed better ORR compared to men with excess-%BF, but this pattern was not observed in women. These findings support to consider gender and body composition as stratification factors in trials.