Impact of Sarcopenia and Inflammation on Patients with Advanced Non-Small Cell Lung Cancer (NCSCL) Treated with Immune Checkpoint Inhibitors (ICIs): A Prospective Study.
PDL1
biomarker
immunotherapy
lung cancer
sarcopenia
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
17 Dec 2021
17 Dec 2021
Historique:
received:
04
11
2021
revised:
11
12
2021
accepted:
13
12
2021
entrez:
24
12
2021
pubmed:
25
12
2021
medline:
25
12
2021
Statut:
epublish
Résumé
Sarcopenia is a condition characterized by loss of skeletal muscle mass associated with worse clinical outcomes in cancer patients. Data on sarcopenia in patients undergoing immune checkpoint inhibitors (ICI) therapy are still limited. The aim of this prospective observational study was to investigate the relationship between sarcopenia, ICI treatment response and immunological profile, in patients with advanced non-small cell lung cancer (NSCLC). Forty-seven stage IV NSCLC patient candidates for starting ICI, were enrolled from the Policlinico Umberto I outpatient Oncology. Patients underwent baseline blood test, inflammatory markers, cytokine assessment and body composition with dual-energy X-ray absorptiometry (DXA). Sarcopenia was defined with appendicular skeletal muscle mass over height Overall, 19/47 patients (40.4%) results were sarcopenic. Sarcopenic patients showed significantly shorter PFS than non-sarcopenic ones (20.3 weeks, 95% CI 7.5-33.1 vs. 61 weeks, 95% CI 22.5-99.4, Sarcopenic patients showed worse PFS and had a higher risk of PD compared to non-sarcopenic ones. Therefore, sarcopenia may reflect the increased metabolic activity of more aggressive tumors, which involves systemic inflammation and muscle wasting and could be considered a negative predictive factor for ICI response.
Sections du résumé
BACKGROUND
BACKGROUND
Sarcopenia is a condition characterized by loss of skeletal muscle mass associated with worse clinical outcomes in cancer patients. Data on sarcopenia in patients undergoing immune checkpoint inhibitors (ICI) therapy are still limited. The aim of this prospective observational study was to investigate the relationship between sarcopenia, ICI treatment response and immunological profile, in patients with advanced non-small cell lung cancer (NSCLC).
METHODS
METHODS
Forty-seven stage IV NSCLC patient candidates for starting ICI, were enrolled from the Policlinico Umberto I outpatient Oncology. Patients underwent baseline blood test, inflammatory markers, cytokine assessment and body composition with dual-energy X-ray absorptiometry (DXA). Sarcopenia was defined with appendicular skeletal muscle mass over height
RESULTS
RESULTS
Overall, 19/47 patients (40.4%) results were sarcopenic. Sarcopenic patients showed significantly shorter PFS than non-sarcopenic ones (20.3 weeks, 95% CI 7.5-33.1 vs. 61 weeks, 95% CI 22.5-99.4,
CONCLUSIONS
CONCLUSIONS
Sarcopenic patients showed worse PFS and had a higher risk of PD compared to non-sarcopenic ones. Therefore, sarcopenia may reflect the increased metabolic activity of more aggressive tumors, which involves systemic inflammation and muscle wasting and could be considered a negative predictive factor for ICI response.
Identifiants
pubmed: 34944975
pii: cancers13246355
doi: 10.3390/cancers13246355
pmc: PMC8699333
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Exp Gerontol. 2018 Sep;110:223-229
pubmed: 29928932
Age Ageing. 2014 Nov;43(6):748-59
pubmed: 25241753
Lancet Oncol. 2011 May;12(5):489-95
pubmed: 21296615
Age Ageing. 2019 Jan 1;48(1):16-31
pubmed: 30312372
Br J Cancer. 2021 Mar;124(7):1294-1300
pubmed: 33473170
Ageing Res Rev. 2020 Dec;64:101185
pubmed: 32992047
Lancet. 2019 Jun 29;393(10191):2636-2646
pubmed: 31171417
Thorac Cancer. 2019 Feb;10(2):347-351
pubmed: 30600905
J Korean Med Sci. 2021 Jan 04;36(1):e2
pubmed: 33398939
PLoS One. 2016 Aug 18;11(8):e0161125
pubmed: 27537502
Nat Rev Clin Oncol. 2013 Feb;10(2):90-9
pubmed: 23207794
Trends Mol Med. 2017 May;23(5):451-464
pubmed: 28396056
BMC Geriatr. 2018 Dec 12;18(1):308
pubmed: 30541467
Clin Cancer Res. 2005 Aug 15;11(16):5802-8
pubmed: 16115919
Front Oncol. 2018 Oct 22;8:457
pubmed: 30460194
Acta Derm Venereol. 2018 Apr 16;98(4):406-410
pubmed: 29327065
Lung Cancer. 2020 May;143:19-26
pubmed: 32200137
Am J Clin Nutr. 2010 Apr;91(4):1133S-1137S
pubmed: 20164322
Curr Oncol Rep. 2016 Sep;18(9):59
pubmed: 27484062
Clin Cancer Res. 2016 Nov 15;22(22):5487-5496
pubmed: 27185375
Bone. 2017 Nov;104:101-105
pubmed: 28625918
Ann Surg Oncol. 2011 Dec;18(13):3579-85
pubmed: 21822551
Arch Gerontol Geriatr. 2021 Jan - Feb;92:104262
pubmed: 33032183
Oncoimmunology. 2016 May 11;5(5):e1093722
pubmed: 27467926
Aging Clin Exp Res. 2017 Aug;29(4):745-752
pubmed: 27571781
Cancer Cell. 2019 Feb 11;35(2):238-255.e6
pubmed: 30753825
EBioMedicine. 2019 Nov;49:381-388
pubmed: 31662290
N Engl J Med. 2016 Nov 10;375(19):1823-1833
pubmed: 27718847
Sci Rep. 2019 Feb 21;9(1):2447
pubmed: 30792455
Longev Healthspan. 2013 May 02;2(1):8
pubmed: 24472098
Int J Biochem Cell Biol. 2005 Aug;37(8):1609-19
pubmed: 15878837
Clinics (Sao Paulo). 2015 Jul;70(7):524-30
pubmed: 26222823
Ann Oncol. 2018 Feb 1;29(2):524
pubmed: 28379318
J Thorac Oncol. 2015 Dec;10(12):1795-9
pubmed: 26484630
Clin Exp Immunol. 2020 Dec;202(3):353-362
pubmed: 32757277
Autoimmun Rev. 2018 May;17(5):518-529
pubmed: 29526638
Lancet Oncol. 2013 Apr;14(4):335-45
pubmed: 23499390
Oncologist. 2020 Mar;25(3):e528-e535
pubmed: 32162807
Int Immunol. 2021 Mar 1;33(3):127-148
pubmed: 33337480
Nature. 2008 Jul 24;454(7203):436-44
pubmed: 18650914
Lancet Oncol. 2016 Apr;17(4):519-531
pubmed: 26906526
Eur J Med Res. 2017 Jul 12;22(1):25
pubmed: 28701179
J Cancer Res Clin Oncol. 2020 May;146(5):1217-1225
pubmed: 32025867
J Clin Med. 2019 Apr 03;8(4):
pubmed: 30987236
J Clin Oncol. 2020 May 10;38(14):1505-1517
pubmed: 32150489
Nat Rev Immunol. 2015 Aug;15(8):486-99
pubmed: 26205583
Int Braz J Urol. 2020 Sep-Oct;46(5):705-715
pubmed: 32213202
Science. 2015 Apr 3;348(6230):74-80
pubmed: 25838376
Immunity. 2019 Jul 16;51(1):27-41
pubmed: 31315034
Oncotarget. 2016 Nov 22;7(47):77404-77415
pubmed: 27764805
Br J Cancer. 1993 Sep;68(3):465-8
pubmed: 8353036
Clin Nutr ESPEN. 2021 Jun;43:64-75
pubmed: 34024567
Int J Obes Relat Metab Disord. 2002 Mar;26(3):410-6
pubmed: 11896498
Nutrients. 2021 Jun 09;13(6):
pubmed: 34207529
Maturitas. 2017 Feb;96:10-15
pubmed: 28041587
Nat Rev Clin Oncol. 2015 Oct;12(10):584-96
pubmed: 26122183
J Interferon Res. 1992 Feb;12(1):17-21
pubmed: 1573279
Onco Targets Ther. 2018 Feb 23;11:955-965
pubmed: 29503570
Lung Cancer. 2017 Apr;106:1-7
pubmed: 28285682
Int Immunopharmacol. 2020 Nov;88:106907
pubmed: 33182031
Medicine (Baltimore). 2020 Feb;99(7):e19059
pubmed: 32049805
Eur J Cancer. 2016 Apr;57:58-67
pubmed: 26882087
J Thorac Oncol. 2018 Jan;13(1):97-105
pubmed: 29170120
Oncol Rep. 2009 Apr;21(4):1091-5
pubmed: 19288013
Nutrition. 2021 Oct;90:111345
pubmed: 34166897
Calcif Tissue Int. 2014 Apr;94(4):363-72
pubmed: 24390582
J Cachexia Sarcopenia Muscle. 2017 Aug;8(4):630-638
pubmed: 28513088