Loading
Prostate Cancer Treatment and Research / Prostate Cancer Diagnosis and Treatment / Cancer Risks and Factors · Journal article
Journal of Oncology Pharmacy Practice · August 18, 2026
Reinforces what was already believed, rather than introducing something new.
This retrospective cohort study of 330 mHSPC patients observed longer median rPFS in those with BMI≥25 kg/m² (supporting an obesity paradox), but BMI did not retain statistical independence in multivariate analysis when liver metastases, high-volume disease, hemoglobin, alkaline phosphatase, and treatment modality were controlled. The apparent BMI benefit appears to reflect better baseline performance status and laboratory values rather than a direct treatment effect.
Retrospective cohort study. Patients with newly diagnosed metastatic hormone-sensitive prostate cancer treated with first-line androgen receptor pathway inhibitors; stratified by baseline BMI.. Intervention: First-line androgen receptor pathway inhibitors (including enzalutamide and abiraterone), stratified by baseline BMI. Compared with: Patients stratified by BMI category (≥25 vs. <25 kg/m²) and treatment type. n = 330.
Median rPFS for entire cohort was 34 months over 47-month median follow-up Patients with BMI≥25 kg/m² demonstrated significantly longer median rPFS in univariate analysis BMI did not retain independent significance in multivariate analysis alongside liver metastases, high-volume disease, low hemoglobin, elevated alkaline phosphatase, and treatment modality
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should recognize that higher BMI associations with better rPFS in mHSPC appear to be driven by confounding factors (performance status, hemoglobin, disease burden) rather than a direct BMI effect. BMI should not be used as an independent prognostic or treatment-selection factor. Prospective study is needed to clarify metabolic influences on ARPI efficacy.
Retrospective cohort study of 330 patients reporting an obesity paradox in mHSPC; confirms known associations but BMI did not retain independent significance in multivariate analysis, limiting practice implications.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that higher BMI associations with better rPFS in mHSPC appear to be driven by confounding factors (performance status, hemoglobin, disease burden) rather than a direct BMI effect. BMI should not be used as an independent prognostic or treatment-selection factor. Prospective study is needed to clarify metabolic influences on ARPI efficacy.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Body mass index (BMI) has been associated with improved outcomes in several malignancies, including prostate cancer. However, the impact of BMI on treatment efficacy, particularly with androgen receptor pathway inhibitors (ARPIs), in metastatic hormone-sensitive prostate cancer (mHSPC) remains insufficiently characterized. This study aimed to evaluate the association between BMI and radiographic progression-free survival (rPFS) in patients with mHSPC receiving first-line therapies. Methods We retrospectively analyzed 330 patients with newly diagnosed mHSPC. Patients were stratified by their treatment regime and baseline BMI. rPFS was assessed using Kaplan–Meier analysis and Cox proportional hazards models. Multivariate analyses included clinically relevant covariates and factors significant in univariate analyses. Results With a median follow-up of 47 months, median rPFS for the entire cohort was 34 months. Patients with BMI≥25 kg/m 2 demonstrated significantly longer median rPFS. Higher BMI was associated with favorable baseline characteristics, including better ECOG performance status and higher hemoglobin levels. In multivariate analysis, liver metastases, high-volume disease, low hemoglobin, elevated alkaline phosphatase, and treatment modality remained independent predictors of rPFS, whereas BMI did not retain independent significance. Among overweight patients receiving ARPIs, enzalutamide showed a numerically longer rPFS compared with abiraterone, although this difference was not statistically significant. Conclusion Higher BMI was associated with prolonged rPFS in patients with mHSPC, supporting a potential obesity paradox in this population. While BMI was not an independent predictor in multivariate analysis, it may reflect underlying patient fitness and disease biology. These findings warrant prospective validation into metabolic factors influencing ARPI efficacy.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.