Evidence mapPaperPMID 41775432Full record

ArticleJournal for immunotherapy of cancer2026

Influence of body composition on the efficacy of nivolumab plus ipilimumab for metastatic clear cell renal cell carcinoma.

Kabir Grewal, Maria Julia Moura Nascimento Santos, Pankaj Kumar Chauhan, Kai Yu, Nizar M Tannir, Sagar S Mukhida, Neha Venkatesh, Amishi Y Shah, Amado J Zurita, Andrew C Johns and 8 more

Abstract read
In one paragraph

Article in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Kabir Grewal *Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Maria Julia Moura Nascimento Santos *Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Pankaj Kumar ChauhanDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Kai YuDepartment of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Nizar M TannirDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0001-5559-8060
Sagar S MukhidaDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Neha VenkateshDepartment of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Amishi Y ShahDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Amado J ZuritaDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0002-3805-7307
Andrew C JohnsDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Matthew T CampbellDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Sangeeta GoswamiDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Jianjun GaoDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Eric JonaschDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0003-0943-2806
Jennifer L McQuadeDepartment of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Omar AlhalabiDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0002-9658-2206
Pavlos MsaouelDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0001-6505-8308
Andrew W HahnDepartment of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA ahahn@mdanderson.org.ORCID http://orcid.org/0000-0002-4153-205X

Funding

Mechanisms of Hyperprogression to Immunotherapy in SMARCB1-Deficient Renal MalignanciesR37CA288448 · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2025 to 2025
$672k
Elucidating T Cell Ferroptosis in Renal Medullary Carcinoma: 3D Genome Architecture Rewiring and Therapeutic AlleviationR01CA285454 · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2025 to 2025
$671k
NCI NIH HHS R01 CA285454NCI NIH HHS R37 CA288448
6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitor therapy (ICI) with nivolumab+ipilimumab is a first-line (1L) standard for metastatic clear cell renal cell carcinoma (ccRCC), yet outcomes remain heterogeneous. Increasing evidence suggests that host factors influence the tumor microenvironment and response to ICI. Although higher body mass index (BMI) has been associated with improved outcomes in several malignancies, BMI is an imprecise surrogate for underlying adipose and muscle compartments. We evaluated the association between body composition and outcomes with 1L nivolumab+ipilimumab in metastatic ccRCC.

methodsWe retrospectively analyzed patients with mccRCC treated with 1L nivolumab+ipilimumab at MD Anderson Cancer Center between June 2015 and February 2024. Body composition was measured using an artificial intelligence segmentation tool at the L3 vertebra from pretreatment CT scans obtained within 45 days prior to starting therapy. Endpoints included real-world progression-free survival (PFS) and overall survival (OS). Multivariable Cox regression models, guided by directed acyclic graphs, evaluated associations between continuous body composition measures and outcomes, incorporating non-linear cubic splines. An exploratory analysis used single-cell RNA sequencing from 12 treatment-naïve patients with metastatic ccRCC, stratified by median Skeletal Muscle Mass Index (SMMi) and Subcutaneous Adipose Tissue Index (SATi) values.

resultsAmong 309 patients (80.3% male, median age 61.9 years; 61.8% intermediate-risk and 28.5% poor-risk), increasing SMMi and SATi were independently associated with shorter PFS (HR 1.50, 95% CI 1.05 to 2.15 per 3-unit increase; and HR 1.39, 95% CI 1.01 to 1.90 per 10-unit increase). The associations of BMI, visceral adiposity, and skeletal muscle density with PFS were inconclusive. OS associations for all body-composition measures were likewise indeterminate. In the single-cell cohort, low SMMi was associated with numerically higher T-cell fractions (p=0.064), fewer myeloid cell proportions (p=0.10), and higher IDO1 expression.

conclusionsGreater subcutaneous adiposity and skeletal muscle mass were associated with shorter PFS among patients with metastatic ccRCC treated with 1L nivolumab+ipilimumab. These findings support the concept that host body composition influences the heterogeneous clinical benefit observed with ICI in metastatic ccRCC.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBody CompositionCarcinoma, Renal CellIpilimumabKidney NeoplasmsNivolumabAgedFemaleHumansMaleMiddle AgedRetrospective StudiesIpilimumabNivolumabGenitourinary CancerImmune Checkpoint InhibitorImmunotherapyKidney Cancer

Identifiers

PMID41775432
PMCPMC12958928

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.