The potential prognostic value of body mass index in patients with urothelial carcinoma and renal cell carcinoma treated with immunotherapy and tyrosine kinase inhibitor.

Renal cell carcinoma (RCC), is a type of cancer that begins in the kidneys. It affects hundreds of thousands of people each year worldwide. According to global estimates, around 403,000 people are diagnosed with RCC annually. In more than 30% of these cases metastatic renal cell carcinoma (mRCC) is diagnosed – this is where the cancer spreads to other parts of the body.

For people with mRCC, the first treatment often includes a combination of two types of medicine: immune-oncology (IO) therapy and tyrosine kinase inhibitors (TKIs). IO therapy helps the body’s own immune system fight the cancer. Tyrosine kinase inhibitors (TKIs) are drugs that block signals in cancer cells that help them grow and survive.

While these combination treatments can be effective, they can also cause serious side effects in some patients. Because of this, we urgently need better ways to predict which patients will benefit from these treatments. One way to do this is by identifying biomarkers—measurable signs in the body, such as certain genes, proteins or other characteristics, that can help assess the body’s response to the treatments.

In an earlier study, we found that body mass index (BMI)—a measure of body fat based on height and weight—may help predict how well patients respond to tyrosine kinase inhibitors. In this new project, we will investigate whether BMI can also help predict how well patients respond to IO therapy.

To do this, we will divide patients with mRCC into three groups based on their BMI and examine how these groups differ in terms of treatment outcomes and clinical features. By doing this, we hope to understand whether BMI can serve as a useful biomarker for selecting the most appropriate treatment for each patient.

Our research will help doctors make better, more personalized treatment decisions for people living with advanced kidney cancer. This could lead to improved outcomes and fewer harmful side effects for patients.

肾细胞癌（Renal cell carcinoma, RCC）是一种起源于肾脏的恶性肿瘤，每年在全球范围内影响数十万人。据全球统计数据显示，每年约有40.3万人被诊断为肾细胞癌。其中超过30%的病例会被确诊为转移性肾细胞癌（metastatic renal cell carcinoma, mRCC）——即癌细胞已扩散至身体其他部位。

对于转移性肾细胞癌患者，一线治疗通常采用两种药物联合方案：免疫肿瘤（immune-oncology, IO）治疗与酪氨酸激酶抑制剂（tyrosine kinase inhibitors, TKIs）。免疫肿瘤治疗可激活机体自身免疫系统对抗癌细胞；酪氨酸激酶抑制剂是一类能够阻断癌细胞内促进其生长与存活信号通路的药物。

尽管此类联合治疗方案具有一定疗效，但部分患者可能会出现严重的不良反应。因此，亟需开发更精准的方法来预测哪些患者能从这类治疗中获益。其中一种可行路径是识别生物标志物——即机体内可被检测的特征（如特定基因、蛋白质或其他生理指标），用于评估患者对治疗的响应情况。

在一项前期研究中，我们发现体重指数（body mass index, BMI）——一种基于身高与体重计算的体脂衡量指标——或可用于预测患者对酪氨酸激酶抑制剂的响应效果。在本新项目中，我们将探究BMI是否同样能够预测患者对免疫肿瘤治疗的响应效果。

为此，我们将根据患者的BMI将转移性肾细胞癌患者划分为三组，并对比各组在治疗结局与临床特征方面的差异。通过该分析，我们旨在明确BMI能否作为一项实用的生物标志物，用于为每位患者选择最适配的治疗方案。

本研究将帮助临床医生为晚期肾癌患者制定更优质、更具个性化的治疗决策，有望改善患者的治疗结局并减少有害不良反应的发生。