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172 Body mass index (BMI) and serum albumin level as a predictor of survival outcomes in advanced-stage melanoma patients treated with anti-PD1 therapy

Background Body mass index (BMI) and serum albumin are common measurements used to evaluate nutritional status. Recent studies have shown conflicting results correlating nutritional status with immune checkpoint inhibitor (ICI) therapy outcomes. 1,2 In this study, we investigate if baseline and change in BMI and serum albumin levels correlate with survival outcomes in advanced stage melanoma patients treated with anti-PD-1 therapy. Methods We conducted a single-center, retrospective review of unresectable stage III and IV melanoma patients treated with anti-PD-1 monotherapy (nivolumab or pembrolizumab) or ipi-limumab/nivolumab (I/N) between 2011 and 2022. Overall survival (OS) and progression-free survival (PFS) were meas-ured from the first dose of treatment to date of death and clinical or radiographic progression, respectively. The effect of baseline BMI, serum albumin levels, and their respective per-centage change at 3 months from treatment initiation on PFS and OS was assessed on a continuum level. Multivariate analy-ses were performed using Cox proportional hazard models, accounting for the following covariates: Age, gender, anti-PD-1 therapy type, primary melanoma type, pre-treatment LDH, BRAF status, presence of brain or liver metastasis, and prior adjuvant or non-anti-PD-1 treatment for advanced-stage melanoma. Results 202 patients were identified. Mean BMI was 30.1 and mean albumin level was 3.63 g/dL. Higher baseline BMI (HR 0.9825, 95% CI: 0.9657 – 0.9996, p=0.0445) and lower baseline albumin level (HR 2.4498, 95% CI: 1.2606 –