Changes in skeletal muscle and adipose tissue during cytotoxic chemotherapy for testicular germ cell carcinoma and associations with adverse events.

To quantify changes in body composition during cytotoxic chemotherapy for germ cell carcinoma of the testis (GCT) and evaluate associations between change in skeletal muscle and adipose tissue and chemotherapy-associated adverse events. This retrospective single-institution study evaluated men with GCT treated with cytotoxic chemotherapy from 2005 to 2018. We measured skeletal muscle index (SMI [cm 141 patients (median age, 30 years [IQR 25-39]) including 86 patients (61%) with non-seminomatous GCT were included. Patients received a median of 3 cycles of cisplatin-based chemotherapy, and 124 patients (88%) completed planned chemotherapy. Median observed changes in SMI, SMD, and SMG were -6% (P<0.0001), -2% (P=0.07), and -7% (P<0.0001), respectively, while FMI increased 5.3% (P<0.0001). Overall, 120 patients (85%) experienced at least one AE including one or more ≥grade 3 AE in 57 patients (48%). Decrease in SMI (OR: 0.89, P=0.02), decrease in SMG (OR: 0.88, P=0.01,) and post-chemotherapy SMG (OR: 0.94, P=0.05) were independently associated with higher incidence of AEs, while pre-chemotherapy skeletal muscle parameters and post-chemotherapy SMI and SMD were not associated with AEs (P>0.05 for all). Preoperative adipose tissue or change in adiposity was not associated with incidence of AEs. In men with GCT receiving cytotoxic chemotherapy, a decrease in skeletal muscle mass and quality during chemotherapy were associated with a higher incidence of chemotherapy-associated AEs. Adipose tissue was not associated with the incidence of AEs.

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Disclosures Dr. P Grivas (all unrelated COI in the last 3 years): Consulting: AstraZeneca; Astellas Pharma; Bayer; Bristol-Myers Squibb; Clovis Oncology; Dyania Health, EMD Serono; Exelixis; Foundation Medicine; Genentech/Roche; Genzyme; GlaxoSmithKline; Immunomedics/Gilead, Infinity Pharmaceuticals, Janssen; Merck; Mirati Therapeutics; Pfizer; Seattle Genetics, QED Therapeutics; Regeneron Pharmaceuticals; 4D Pharma PLC; UroGen. Research Funding to Institution: Merck; Mirati Therapeutics; Pfizer, Clovis Oncology, Bavarian Nordic, Immunomedics/Gilead, Debiopharm, Bristol-Myers Squibb, QED Therapeutics, GlaxoSmithKline,G1 Therapeutics. Dr. S. Psutka:Consulting: Merck, Research Funding: Prime Education Inc.; Bladder Cancer Advocacy Network Dr. F. J. Fintelmann, Related patent pending Dr. T. Yezefski, Consulting: Dendreon, Pfizer Dr. M. T. Schweizer, Paid consultant and/or received Honoria from Sanofi, AstraZeneca, PharmaIn and Resverlogix. He has received research funding to his institution from Zenith Epigenetics, Bristol Myers Squibb, Merck, Immunomedics, Janssen, AstraZeneca, Pfizer, Madison Vaccines, Hoffman-La Roche, Tmunity, SignalOne Bio and Ambrx, Inc. Dr. E. Yu: (all unrelated COI in the last 3 years):Consulting: Abbvie, Advanced Accelerator Applications, Bayer, Clovis, Exelixis, Janssen, Merck, Sanofi, Research Funding to Institution: Bayer, Blue Earth, Daiichi-Sankyo, Dendreon, Lantheus, Merck, Seagen, Taiho Dr. B. Montgomery: (all unrelated COI in the last 3 years):Consulting (uncompensated): Propella, Strandsmart, Research Funding to Institution: Astellas, AstraZeneca, Beigene, ESSA, Janssen, Clovis