A Retrospective Study of Body Composition and Survival Outcomes in Patients with Melanoma Undergoing Immunotherapy
| Wednesday, August 13, 2025 |
| 2:05 PM - 2:11 PM |
| Ballroom 2 and 3 |
Overview
Mr Harrison Long
Speaker
Harrison Long
Student
University of Melbourne
A Retrospective Study of Body Composition and Survival Outcomes in Patients with Melanoma Undergoing Immunotherapy
Abstract
Background: Melanoma is a leading cause of cancer-related death in Australia. Higher BMI has been associated with improved outcomes, particularly in male patients with melanoma receiving immunotherapy.ยน This study aimed to determine whether increased adiposity and skeletal muscle mass, as assessed by FDG-PET/CT scans, are associated with improved outcomes in patients with melanoma undergoing immunotherapy
Methods: This was a single-centre retrospective study. Patients with unresectable advanced melanoma receiving immunotherapy between 2010 and 2024 at the Peter MacCallum Cancer Centre were identified (n=1303). Patients were included if they had a baseline FDG-PET/CT scan and BMI data recorded (n=710). In addition to collection of demographic and outcome data, body composition analysis was performed on cross-sectional imaging taken at the level of L3.
Results: Male patients with obese and overweight BMIs showed significantly improved overall survival (OS) compared to those with a normal BMI (HR 0.61, 95%CI: 0.43-0.86, p=0.004); HR 0.71, 95%CI: 0.52-0.96, p=0.029), with no significant difference seen in female patients. This finding was supported by a significant difference in PERCIST response between obese and non-obese male patients (p=0.019 and 0.021 for first and best response respectively). When total adiposity was examined, there was no significant difference in OS, however there was a difference in progression-free survival in males with high total adiposity (HR 0.78, 95%CI: 0.62-0.99, p=0.039).
In contrast, sarcopenia was negatively associated with OS in male and female cohorts (Male: HR 1.38, 95%CI: 1.03-1.84, p=0.032; Female: HR 1.45, 95%CI: 1.02-2.08, p=0.041).
Conclusion: Overweight/obese BMI and high total adiposity were associated with improved survival and metabolic response in male patients. In contrast, sarcopenia predicted poorer survival in both sexes, underscoring the predictive significance of body composition in melanoma immunotherapy outcomes.
Acknowledgements: This work was supported by an NHMRC grant (#2020050) to KES.
1. McQuade et al. Lancet Oncol. 2018;19(3):310-22.
Methods: This was a single-centre retrospective study. Patients with unresectable advanced melanoma receiving immunotherapy between 2010 and 2024 at the Peter MacCallum Cancer Centre were identified (n=1303). Patients were included if they had a baseline FDG-PET/CT scan and BMI data recorded (n=710). In addition to collection of demographic and outcome data, body composition analysis was performed on cross-sectional imaging taken at the level of L3.
Results: Male patients with obese and overweight BMIs showed significantly improved overall survival (OS) compared to those with a normal BMI (HR 0.61, 95%CI: 0.43-0.86, p=0.004); HR 0.71, 95%CI: 0.52-0.96, p=0.029), with no significant difference seen in female patients. This finding was supported by a significant difference in PERCIST response between obese and non-obese male patients (p=0.019 and 0.021 for first and best response respectively). When total adiposity was examined, there was no significant difference in OS, however there was a difference in progression-free survival in males with high total adiposity (HR 0.78, 95%CI: 0.62-0.99, p=0.039).
In contrast, sarcopenia was negatively associated with OS in male and female cohorts (Male: HR 1.38, 95%CI: 1.03-1.84, p=0.032; Female: HR 1.45, 95%CI: 1.02-2.08, p=0.041).
Conclusion: Overweight/obese BMI and high total adiposity were associated with improved survival and metabolic response in male patients. In contrast, sarcopenia predicted poorer survival in both sexes, underscoring the predictive significance of body composition in melanoma immunotherapy outcomes.
Acknowledgements: This work was supported by an NHMRC grant (#2020050) to KES.
1. McQuade et al. Lancet Oncol. 2018;19(3):310-22.
Biography
Harrison Long is a fourth-year medical student at the University of Melbourne. He carried out his work on investigating the obesity paradox as part of the MD Discovery Project, in the Molecular Oncology Laboratory at the Peter MacCallum Cancer Centre. He has an interest in oncology research with a focus on discovering new aspects of cancer biology and immunology.
Session Chair
Jessica Smith
Medical Oncologist
Macquarie University Hospital
