Improved Outcomes for Obese Men with Metastatic Melanoma

A recent multicohort study in The Lancet Oncology found that obese men who underwent treatment for metastatic melanoma have a 47 percent reduced mortality rate compared with non-obese men. The obese male patients’ overall survival (OS) rate was nearly twice that of male patients with a healthy body mass index (BMI).

Jennifer McQuade, MD, lead author of the study and instructor of Melanoma Medical Oncology at The University of Texas MD Anderson Cancer Center, was surprised by the findings, as researchers previously believed that obesity would provoke detrimental results. “The question is what underlying mechanism causes this advantage in obese men,” asked Dr. McQuade. “Can we take advantage of it to improve outcomes in patients with melanoma?”

Dr. McQuade’s team examined data of 2,046 patients treated with various therapies over a ten-year period. They data featured 1,918 patients grouped into six cohorts in their research. Two cohorts were treated with targeted therapy, two were treated with immunotherapy, and two were treated with chemotherapy. Overall, the patients were categorized by BMI: normal (36 percent), overweight (37 percent), and obese (27 percent).

The median OS for normal-BMI males in the dabrafenib and trametinib targeted therapy cohort was 19.8 months, while the median OS for obese males in the cohort was 33 months. This pattern repeats throughout the cohorts.

Dr. McQuade and her colleagues are working on making sense of their findings. “The public health message is not that obesity is good. Obesity is a proven risk factor for many diseases,” said Dr. McQuade. “We need to figure out what is driving this paradox and learn how to use this information to benefit all of our patients.”