Sarcopenia and Visceral Adiposity Did Not Affect Efficacy of Immune-Checkpoint Inhibitor Monotherapy for Pretreated Patients With Advanced Non-Small Cell Lung Cancer.
Immune-checkpoint inhibitor
Intramuscular adipose tissue content
Non-small cell lung cancer
Psoas muscle index
Sarcopenia
Subcutaneous fat area
Visceral adiposity
Visceral fat area
Journal
World journal of oncology
ISSN: 1920-454X
Titre abrégé: World J Oncol
Pays: Canada
ID NLM: 101564097
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
16
08
2019
accepted:
18
12
2019
entrez:
26
2
2020
pubmed:
26
2
2020
medline:
26
2
2020
Statut:
ppublish
Résumé
This study aimed to investigate the association of computed tomography (CT)-assessed sarcopenia and visceral adiposity with efficacy and prognosis of immune-checkpoint inhibitor (ICI) therapy for pretreated non-small cell lung cancer (NSCLC). We retrospectively collected 74 patients with pretreated NSCLC who had initiated programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitor monotherapy between December 2015 and November 2018 at our hospital. As CT-assessed pretreatment markers, we used psoas muscle index (PMI), intramuscular adipose tissue content (IMAC), visceral-to-subcutaneous ratio (VSR) and visceral fat area (VFA) at lumbar vertebra L3 level. We divided 74 patients into high and low groups according to each Japanese sex-specific cut-off value. Using Kaplan-Meier curves and log-rank tests, we compared overall survival (OS) and progression-free survival (PFS). Adjusted by serum albumin, neutrophil-to-lymphocyte ratio, performance status and driver mutations, multivariate Cox proportional hazard analyses evaluated various variables as independent prognostic factors of OS and PFS. We could not find significant difference in response rate (RR) and disease control rate (DCR) between low and high groups according to any factors. The OS of patients with body mass index (BMI) < 18.5 was significantly shorter than that of patients with BMI ≥ 18.5 (median 3.3 vs. 15.8 months, P < 0.01), while there was no significant difference in OS and PFS according to PMI, IMAC, VSR and VFA. Multivariate analyses detected no significant prognostic factor in OS and PFS, except for low IMAC (hazard ratio 0.43, 95% confidence interval 0.18 - 0.998, P = 0.0496) as a favorable prognostic factor of longer OS. Neither PMI nor VSR, VFA might be a significant prognostic factor of PFS and OS of ICI monotherapy for pretreated NSCLC. According to our multivariate analyses, IMAC was a significant prognostic factor of OS, but not of PFS. Thus, neither sarcopenia nor visceral adiposity may be associated with the efficacy of ICI therapy.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to investigate the association of computed tomography (CT)-assessed sarcopenia and visceral adiposity with efficacy and prognosis of immune-checkpoint inhibitor (ICI) therapy for pretreated non-small cell lung cancer (NSCLC).
METHODS
METHODS
We retrospectively collected 74 patients with pretreated NSCLC who had initiated programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitor monotherapy between December 2015 and November 2018 at our hospital. As CT-assessed pretreatment markers, we used psoas muscle index (PMI), intramuscular adipose tissue content (IMAC), visceral-to-subcutaneous ratio (VSR) and visceral fat area (VFA) at lumbar vertebra L3 level. We divided 74 patients into high and low groups according to each Japanese sex-specific cut-off value. Using Kaplan-Meier curves and log-rank tests, we compared overall survival (OS) and progression-free survival (PFS). Adjusted by serum albumin, neutrophil-to-lymphocyte ratio, performance status and driver mutations, multivariate Cox proportional hazard analyses evaluated various variables as independent prognostic factors of OS and PFS.
RESULTS
RESULTS
We could not find significant difference in response rate (RR) and disease control rate (DCR) between low and high groups according to any factors. The OS of patients with body mass index (BMI) < 18.5 was significantly shorter than that of patients with BMI ≥ 18.5 (median 3.3 vs. 15.8 months, P < 0.01), while there was no significant difference in OS and PFS according to PMI, IMAC, VSR and VFA. Multivariate analyses detected no significant prognostic factor in OS and PFS, except for low IMAC (hazard ratio 0.43, 95% confidence interval 0.18 - 0.998, P = 0.0496) as a favorable prognostic factor of longer OS.
CONCLUSIONS
CONCLUSIONS
Neither PMI nor VSR, VFA might be a significant prognostic factor of PFS and OS of ICI monotherapy for pretreated NSCLC. According to our multivariate analyses, IMAC was a significant prognostic factor of OS, but not of PFS. Thus, neither sarcopenia nor visceral adiposity may be associated with the efficacy of ICI therapy.
Identifiants
pubmed: 32095185
doi: 10.14740/wjon1225
pmc: PMC7011908
doi:
Types de publication
Journal Article
Langues
eng
Pagination
9-22Informations de copyright
Copyright 2020, Minami et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
Références
Lung Cancer. 2017 Feb;104:52-57
pubmed: 28213000
Lancet. 2016 Apr 9;387(10027):1540-1550
pubmed: 26712084
Clin Nutr. 2016 Dec;35(6):1386-1393
pubmed: 27102408
J Hepatol. 2015 Jul;63(1):131-40
pubmed: 25724366
Future Oncol. 2018 Apr;14(10):919-926
pubmed: 29528255
Thorac Cancer. 2019 Feb;10(2):347-351
pubmed: 30600905
J Clin Oncol. 2016 Dec 10;34(35):4249-4255
pubmed: 27903146
Surg Oncol. 2015 Dec;24(4):353-8
pubmed: 26690825
Circ J. 2002 Nov;66(11):987-92
pubmed: 12419927
Nutrition. 2016 Nov-Dec;32(11-12):1200-5
pubmed: 27292773
Transplantation. 2017 Mar;101(3):565-574
pubmed: 27926595
Clin Med Insights Oncol. 2015 Nov 09;9:87-93
pubmed: 26604850
Br J Cancer. 2017 Jun 27;117(1):148-155
pubmed: 28588319
J Gastroenterol Hepatol. 2013 Sep;28(9):1507-14
pubmed: 23577962
N Engl J Med. 2016 Nov 10;375(19):1823-1833
pubmed: 27718847
Sci Rep. 2019 Feb 21;9(1):2447
pubmed: 30792455
Liver Transpl. 2014 Nov;20(11):1413-9
pubmed: 25088484
Ann Med. 2012 Feb;44(1):82-92
pubmed: 20964583
Support Care Cancer. 2016 Nov;24(11):4495-502
pubmed: 27236439
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
Thorac Cancer. 2018 Dec;9(12):1623-1630
pubmed: 30259689
Diabetol Metab Syndr. 2011 Jun 22;3:12
pubmed: 21696633
Eur J Cancer. 2016 Apr;57:58-67
pubmed: 26882087
J Thorac Oncol. 2013 Sep;8(9):1121-7
pubmed: 23887169