Memorial Sloan Kettering Cancer Center
Presentation Abstract
Investigating the BMI Paradox in Kidney Cancer
My talk will focus on the epidemiological and clinical relevance of the body mass index (BMI) paradox that is observed in kidney cancer. First, I will briefly review the clinical aspects of kidney cancer and describe what the BMI paradox is (i.e., the finding that although high BMI is an established risk factor for developing kidney cancer, patients with high BMI at the time of diagnosis experience better clinical outcomes compared to those classified as normal weight). I will discuss recent findings from studies that refine BMI into body composition variables, which suggest that skeletal muscle, as opposed to adiposity variables, are potential drivers of the BMI paradox. Next, I will go over what we know about the potential mechanisms underlying these associations as it relates to tumor gene expression. Initial findings suggest that patients with low skeletal muscle index have tumors characterized by an upregulation of angiogenesis programs, which suggests these patients might benefit specifically from tyrosine kinase inhibitors that target these pathways. Studies are needed to determine the extent to which body composition features are predictive, as well as prognostic factors, particularly as it relates to immunotherapy, which is the most recently approved treatment for kidney cancer. I will conclude with gaps in knowledge; it is not clear a) whether adverse body composition features are a cause or consequence of aggressive tumor biology; and b) whether addressing body composition features through behavioral interventions like nutrition and exercise can improve clinical outcomes.
About Dr. Furberg
Dr. Helena Furberg is an Associate Attending Epidemiologist at Memorial Sloan Kettering Cancer Center in New York City. She earned a master’s degree and Ph.D. in cancer epidemiology from the University of North Carolina at Chapel Hill and completed two postdoctoral fellowships in molecular epidemiology and in genetics. Her research program is dedicated to identifying modifiable factors that influence cancer risk and prognosis, with a special focus on urological malignancies. For the past decade, she has been investigating the obesity paradox in kidney cancer, which is the observation that despite being a risk factor for developing the disease, patients with high body mass index at the time of diagnosis appear to survive longer than those who are classified as normal weight. Her molecular research suggests the obesity paradox may have a biological basis. She is currently leading a large-scale molecular epidemiology study of body composition and kidney cancer outcomes, which is funded by the National Cancer Institute. She is also supported by grants from the U.S. Department of Defense and private foundations.
Dr. Furberg did not disclose any conflicts of interest for this workshop.