Impact of Dyslipidemia on Clinical Outcomes Among Cancer Patients Treated With Immune Checkpoint Inhibitors

This study aimed to investigate the influence of baseline blood lipid profiles on therapeutic efficacy and adverse events (AEs) among cancer patients treated with immune checkpoint inhibitors (ICIs). We retrospectively analyzed patients with solid tumors who received ICIs, with a focus on their blood lipid profiles at baseline. Associations between dyslipidemia and clinical outcomes following ICI therapy were assessed using both univariate and multivariable analyses. A total of 99 eligible patients were included: 52 with renal cell carcinoma, 23 with urothelial carcinoma, and 24 with esophageal carcinoma. Among patients with renal cell carcinoma, low-density lipoprotein (LDL) cholesterol ≥ 140 mg/dL (p = 0.013) and high-density lipoprotein (HDL) cholesterol ≤ 40 mg/dL (p = 0.040) were significantly associated with shorter overall survival. Conversely, among patients with esophageal carcinoma, LDL cholesterol ≥ 120 mg/dL was associated with longer progression-free survival (p = 0.035). Among all patients, HDL cholesterol < 40 mg/dL was identified as a risk factor for Grade 3 or higher AEs (p = 0.018), especially liver injury (p = 0.033). Prior statin use was associated with a trend toward an improved response to ICIs among patients with renal cell carcinoma (p = 0.057). Baseline blood lipid profiles—particularly LDL and HDL cholesterol levels—may influence clinical outcomes among cancer patients receiving ICI therapy. These findings suggest that lipid profiles might serve as predictive biomarkers for the efficacy and safety of ICIs.