Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer : Secondary analysis of the phase 3 CAIRO3 trial

Autor: Miriam Koopman, Felix E de Jongh, Ankie M.T. van der Velden, Bram Dorresteijn, Sophie A Kurk, Pim A. de Jong, Geert-Jan Creemers, Petra H.M. Peeters, Frans L. G. Erdkamp, Marion Jourdan, Anne M May, Peter A M Kint, Boelo J Poppema, Lieke H.J. Simkens, Manuel L. R. Tjin-A-Ton, B.C. Tanis, Cornelis J. A. Punt, Sandra A Radema
Přispěvatelé: Graduate School, AGEM - Digestive immunity, CCA - Cancer Treatment and Quality of Life, Oncology
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Oncology
Male
Cancer Research
Time Factors
Colorectal cancer
chemotherapy
Body composition
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
0302 clinical medicine
Risk Factors
Antineoplastic Combined Chemotherapy Protocols
Longitudinal Studies
Randomized Controlled Trials as Topic
Original Research
metastatic colorectal cancer
Palliative Care
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
Progression-Free Survival
030220 oncology & carcinogenesis
Disease Progression
Female
Colorectal Neoplasms
medicine.drug
medicine.medical_specialty
Randomization
Bevacizumab
education
body mass index
lcsh:RC254-282
survival
Maintenance Chemotherapy
Capecitabine
sarcopenia
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
Internal medicine
mental disorders
medicine
Journal Article
Humans
Radiology
Nuclear Medicine and imaging
Muscle
Skeletal
Aged
Retrospective Studies
Proportional hazards model
business.industry
Clinical Cancer Research
skeletal muscle mass
medicine.disease
Oxaliplatin
030104 developmental biology
Clinical Trials
Phase III as Topic
Sarcopenia
business
Tomography
X-Ray Computed
Body mass index
Zdroj: Cancer Medicine, 9(3), 1033. John Wiley and Sons Ltd
Cancer Medicine
Cancer Medicine, Vol 9, Iss 3, Pp 1033-1043 (2020)
Cancer medicine, 9(3), 1033-1043. John Wiley and Sons Ltd
Cancer Medicine, 9, 1033-1043
Cancer Medicine, 9, 3, pp. 1033-1043
ISSN: 2045-7634
Popis: Background Low skeletal muscle index (SMI) in metastatic colorectal cancer (mCRC) patients is associated with poor outcomes. The prognostic impact of SMI changes during consecutive palliative systemic treatments is unknown. Methods This is a retrospective analysis of the phase 3 CAIRO3 study. The CAIRO3 study randomized 557 patients between maintenance capecitabine + bevacizumab (CAP‐B) or observation, after six cycles capecitabine + oxaliplatin + bevacizumab (CAPOX‐B). Upon first disease progression (PD1), CAPOX‐B was reintroduced until second progression (PD2). SMI was assessed by computed tomography (CT) (total 1355 scans). SMI and body mass index (BMI) changes were analyzed for three time‐periods; p1: during initial CAPOX‐B, p2: randomization to PD1, and p3: PD1 to PD2. The association between absolute and change in SMI and BMI (both per 1 standard deviation) during p1‐p3, with PD1, PD2, and survival was studied by Cox regression models. Results This analysis included 450 of the 557 patients randomized in the CAIRO3 study. Mean SMI decreased during p1: mean −0.6 SMI units [95% CI −1.07;‐0.26] and p3: −2.2 units [−2.7;‐1.8], whereas during p2, SMI increased + 1.2 units [0.8‐1.6]. BMI changes did not reflect changes in SMI. SMI loss during p2 and p3 was significantly associated with shorter survival (HR 1.19 [1.09‐1.35]; 1.54 [1.31‐1.79], respectively). Sarcopenia at PD1 was significantly associated with early PD2 (HR 1.40 [1.10‐1.70]). BMI loss independent of SMI loss was only associated with shorter overall survival during p3 (HR 1.35 [1.14‐1.63]). Conclusions In mCRC patients, SMI loss during palliative systemic treatment was related with early disease progression and reduced survival. BMI did not reflect changes in SMI and could not identify patients at risk of poor outcome during early treatment lines.
Databáze: OpenAIRE
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