PO.IM02.03 · 免疫学
Dietary animal protein intake and progression-free survival (PFS) of patients (pts) with advanced urothelial cancer (UC) and renal cell carcinoma (RCC) on immune checkpoint blockade (ICB)
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摘要 Abstract
Background: Dietary fiber intake has been associated with longer PFS on ICB in observational studies, putatively due to effects of fiber on the gut microbiome. However, associations in observational studies may be due to confounding rather than causal relationships. Dietary animal protein intake impacts health and can be correlated with fiber intake. We investigated whether animal protein intake is associated with ICB outcomes in UC and RCC and whether confounding by animal protein intake might account for associations of fiber intake with ICB outcomes.
Methods: We conducted a retrospective analysis of a prospectively collected cohort, wherein baseline dietary data were collected using the Willett Food Frequency Questionnaire from pts with advanced UC or RCC initiating ICB at Memorial Sloan Kettering. Associations of diet with clinical outcomes were assessed using univariable and multivariable Cox proportional hazards regression.
Results: From 2/2021-6/2022, 86 pts eligible for this analysis were enrolled (UC n = 38; RCC n = 48; median follow-up 14.6 months). Median animal protein intake was 44 g/day (interquartile range [IQR] 31-54), below the American average of 88 g/day. Median fiber intake was 17.2 g/day (IQR 13-24), similar to the American average of 15 g/day. Intake of animal protein and fiber were correlated (Spearman's rho 0.46, p < 0.001). There were no statistically significant associations of animal protein intake above vs below the median with PFS in either univariable or multivariable models (Table 1). Dietary fiber intake was associated with longer PFS even after adjusting for animal protein intake and clinical covariables (Table 1).
Conclusion: Dietary animal protein intake was not associated with PFS among pts with UC and RCC on ICB. The association of dietary fiber with longer PFS could not be attributed to confounding by animal protein intake.
Hazard ratios for progression-free survival by average daily intake of animal protein and fiber Animal protein intake at or above the cohort median (44 g/day) Fiber intake at or above the American average (15 g/day) Outcomes HR (95% CI) p HR (95% CI) p Univariable 0.74 (0.43-1.26) 0.27 0.45 (0.26-0.77) 0.004 Multivariable 1* 0.94 (0.53-1.68) 0.85 0.46 (0.26-0.82) 0.009 Multivariable 2** 0.82 (0.45-1.50) 0.53 0.49 (0.26-0.92) 0.026 *Multivariable model 1 included animal protein and fiber intake simultaneously. **Multivariable model 2 further adjusted multivariable model 1 for age, performance status, cancer type, and stage (IV vs III).
利益披露 Disclosure
T. B. Winslow, None.
R. Kotecha,
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Exelixis ).
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N. Ratna, None..
D. Gavrilov, None..
C. Duzgol, None..
M. Akhlaq, None..
M. Teo, None..
A. M. Regazzi, None.
S. Funt,
Astrazeneca ).
Genentech/Roche ).
ALX Oncology ).
Merck ).
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Allogene Therapeutics Stock.
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D. H. Aggen,
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D. Lage,
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N. Shah,
Bristol Myers Squibb Other, Professional Services and Activities.
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