Cachexia - sarcopenia as a determinant of disease control rate and survival in non-small lung cancer patients receiving immune-checkpoint inhibitors

Autor: Sandy Jean-Baptiste, Amandine Coffy, Jean-Pierre Daurès, Jean-Louis Pujol, Sébastien Bommart, Benoît Roch, Estelle Palaysi
Přispěvatelé: Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Universitaire de Recherche Clinique, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), MORNET, Dominique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2020
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Oncology
Sarcopenia
Cancer Research
medicine.medical_specialty
Cachexia
Anti-PD-(L)1 antibodies
medicine.medical_treatment
[SDV.CAN]Life Sciences [q-bio]/Cancer
NSCLC
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Immune checkpoint inhibitors
03 medical and health sciences
0302 clinical medicine
[SDV.CAN] Life Sciences [q-bio]/Cancer
Internal medicine
Medicine
Lung cancer
business.industry
Proportional hazards model
Hazard ratio
[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy
Odds ratio
Immunotherapy
musculoskeletal system
medicine.disease
3. Good health
030104 developmental biology
Response Evaluation Criteria in Solid Tumors
030220 oncology & carcinogenesis
[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
[SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy
business
Zdroj: Lung Cancer
Lung Cancer, Elsevier, 2020, 143, pp.19-26. ⟨10.1016/j.lungcan.2020.03.003⟩
Lung Cancer, 2020, 143, pp.19-26. ⟨10.1016/j.lungcan.2020.03.003⟩
ISSN: 0169-5002
Popis: International audience; Purpose: The metabolic changes associated with cachexia – sarcopenia syndrome might down-regulate antitumor immunity. We hypothesized that this syndrome reduces efficiency of immune checkpoint inhibitors (ICPI) in non-small cell lung cancer (NSCLC).Methods: The records of 142 consecutive NSCLC patients receiving first- or second-line anti-Programmed cell death protein 1) ICPI were reviewed. Response evaluation according to Response Evaluation Criteria in Solid Tumors 1.1 was performed at the eighth week of immunotherapy. Pretreatment cachexia was defined as a body-weight loss of 5% or more in the previous 6 months. Sarcopenia was estimated with the third lumbar skeletal muscle mass index (mSMI) and was evaluated before immunotherapy and at the eighth week. A decrease by 5% or more of the mSMI was considered as an evolving sarcopenia. The endpoints were disease control rate (DCR), progression-free (PFS) and overall survival (OS).Logistic regression model and Cox model took into account others covariables known to influence ICPI efficiency, particularly Programmed Death –Ligand 1 tumor cell score, Eastern Cooperative Oncology Group performance status and common somatic mutational status.Results: In multivariate analysis, cachexia – sarcopenia syndrome reduced the probability of achieving a disease control and were associated with a shorter survival. Patients without cachexia had a better probability to achieve disease control in comparison with those who did not experience cachexia (59.9 % and 41.1 %, respectively; odds ratio 95 % (confidence interval [95 %CI]): 2.60 (1.03–6.58)). Patients with cachexia had a shorter OS when compared with those without cachexia (hazard ratios [HR] (95 %CI): 6.26 (2.23–17.57)). Patients with an evolving sarcopenia had a shorter PFS and OS, with HR (95 %CI): 2.45 (1.09–5.53) and 3.87 (1.60–9.34) respectively.Conclusion: Cachexia – sarcopenia syndrome negatively influences patients’ outcome during anti-PD-1 ICPI therapy
Databáze: OpenAIRE
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