Body composition and physical activity as predictors of immune-related adverse events in patients undergoing cancer immunotherapy: a systematic review.
[INTRODUCTION] Host factors may affect immune-related adverse events (irAE) during immune checkpoint inhibitor (ICI) therapy.
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APA
De Nys L, Güney G, et al. (2026). Body composition and physical activity as predictors of immune-related adverse events in patients undergoing cancer immunotherapy: a systematic review.. Expert review of anticancer therapy, 1-12. https://doi.org/10.1080/14737140.2026.2625780
MLA
De Nys L, et al.. "Body composition and physical activity as predictors of immune-related adverse events in patients undergoing cancer immunotherapy: a systematic review.." Expert review of anticancer therapy, 2026, pp. 1-12.
PMID
41627877
Abstract
[INTRODUCTION] Host factors may affect immune-related adverse events (irAE) during immune checkpoint inhibitor (ICI) therapy. We systematically reviewed studies on body composition (BMI, CT/DXA-defined sarcopenia, sarcopenic obesity) and physical activity (PA) in relation to irAE incidence and severity in ICI-treated adults.
[METHODS] PubMed, Embase, Scopus, and Web of Science were searched from inception to 15 December 2024. Eligible studies assessed baseline body composition and/or PA in relation to irAE. Risk of bias was evaluated using the NIH tool and QUIPS. Findings were synthesized using structured narrative methods.
[RESULTS] Seven studies (2,590 patients) were included. Two large cohorts found overweight/obese patients had higher odds of any-grade irAE (OR = 1.4-1.5); one disease-specific cohort found no association. One CT-based study showed higher irAE risk with sarcopenia (OR = 2.64) and more with sarcopenic obesity (OR = 5.50). Two studies on PA were conflicting: one found higher PA reduced severe irAE risk (OR = 0.19), another found no association.
[CONCLUSIONS] Body composition and PA may help predict irAE in ICI-treated patients. Evidence is low to very low certainty: overweight/obesity may increase toxicity risk, higher PA may lower risk, and evidence for sarcopenia is limited. Standardized prospective studies are needed to confirm these associations.
[PROTOCOL REGISTRATION] https://www.crd.york.ac.uk/PROSPERO identifier is CRD420251084119.
[METHODS] PubMed, Embase, Scopus, and Web of Science were searched from inception to 15 December 2024. Eligible studies assessed baseline body composition and/or PA in relation to irAE. Risk of bias was evaluated using the NIH tool and QUIPS. Findings were synthesized using structured narrative methods.
[RESULTS] Seven studies (2,590 patients) were included. Two large cohorts found overweight/obese patients had higher odds of any-grade irAE (OR = 1.4-1.5); one disease-specific cohort found no association. One CT-based study showed higher irAE risk with sarcopenia (OR = 2.64) and more with sarcopenic obesity (OR = 5.50). Two studies on PA were conflicting: one found higher PA reduced severe irAE risk (OR = 0.19), another found no association.
[CONCLUSIONS] Body composition and PA may help predict irAE in ICI-treated patients. Evidence is low to very low certainty: overweight/obesity may increase toxicity risk, higher PA may lower risk, and evidence for sarcopenia is limited. Standardized prospective studies are needed to confirm these associations.
[PROTOCOL REGISTRATION] https://www.crd.york.ac.uk/PROSPERO identifier is CRD420251084119.