Predictive Value of Body Mass Index and Fasting Insulin Levels on Survival

Overview

This study investigates the prognostic significance of body mass index (BMI) and fasting insulin levels in patients with stage IV lung adenocarcinoma undergoing EGFR-TKI therapy. Low BMI and low fasting insulin were found to be independently associated with shorter overall survival.

Background

Lung adenocarcinoma (LUAD) is a leading cause of cancer-related mortality, with many patients presenting at an advanced stage. Understanding the impact of metabolic factors such as BMI and insulin levels on treatment outcomes is crucial.

Data Highlights

Key Findings

• High BMI, hyperglycemia, hyperinsulinemia, and T2DM were not associated with worse outcomes.
• Low BMI (<22.1 kg/m²) was linked to shorter overall survival (OS).
• Low fasting insulin (≤34 pmol/L) was associated with significantly shorter OS.
• EGFR-TKI therapy improved survival outcomes in the studied cohort.
• Patients with both low BMI and low insulin had poor prognosis if not treated with EGFR-TKI.

Clinical Implications

Clinicians should consider BMI and fasting insulin levels when assessing prognosis in patients with stage IV LUAD.

Conclusion

Low BMI and low fasting insulin levels are significant predictors of poor prognosis in stage IV LUAD, particularly in patients not receiving EGFR-TKI therapy.

Related Resources & Content

1. Frontiers in Immunology, 2026 -- Predicting response to immunochemotherapy in EGFR-mutant lung adenocarcinoma after third-generation TKI resistance using CT radiomics-based habitat imaging
2. The ASCO Post, 2017 -- Adjuvant Gefitinib Delays Recurrence in EGFR-Positive NSCLC
3. International Journal of Obesity, 2025 -- Weight loss as a predictor of reduced survival in patients with lung cancer: a systematic review with meta-analysis
4. New England Journal of Medicine -- Survival with Osimertinib plus Chemotherapy in EGFR-Mutated Advanced NSCLC
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7. Survival with Osimertinib plus Chemotherapy in EGFR-Mutated Advanced NSCLC | New England Journal of Medicine
8. Weight loss as a predictor of reduced survival in patients with lung cancer: a systematic review with meta-analysis | International Journal of Obesity
9. Impact of pre-therapeutic fasting plasma glucose on survival outcomes in advanced non-small cell lung cancer patients - PMC