Effect of longitudinal changes of cachexia on the efficacy and toxicity of immune checkpoint inhibitors in esophageal squamous cell cancer (ESCC) patients

IF 3 3区医学 Q2 NUTRITION & DIETETICS Nutrition Pub Date : 2024-04-05 DOI:10.1016/j.nut.2024.112462

Haoqian Li , Butuo Li , Xiaoqing Wang , Huan Zhang , Chunni Wang , Bingjie Fan , Linlin Wang

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Abstract

Purpose

Immune checkpoint inhibitors (ICIs) have enhanced survival in advanced esophageal squamous cell cancer (ESCC) patients, but their efficacy varies. Cachexia, characterized by muscle loss and significant weight loss, might influence ICI response. This study examines the relationship between cachexia's longitudinal changes and ICI outcomes in ESCC patients.

Methods

ESCC patients undergoing at least two ICI cycles from 2017 to 2021 were studied. Cachexia's baseline and evolving patterns during ICI treatment were observed. Kaplan-Meier and Cox regression analyses were used to assess cachexia's effect on ICI efficacy. Chi-square tests were used to determine cachexia's link to immune-related adverse effects (irAEs).

Results

Two hundred seventy-eight ICI-treated patients had a median progression-free survival (PFS) of 5.78 months and overall survival (OS) of 8.3 months. Pretreatment cachexia led to worse outcomes: PFS 7.87 versus 5.3 months, time to progression (TTP) 10.9 versus 6.1 months, and OS 14.3 versus 9.2 months. Irreversible cachexia showed the poorest results. Cachexia's changes weren't associated with irAEs.

Conclusion

Baseline and evolving cachexia significantly impact ICI efficacy in ESCC patients. Continuous cachexia monitoring during ICI therapy is crucial for optimal ESCC management.

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食管鳞状细胞癌（ESCC）患者恶病质的纵向变化对免疫检查点抑制剂疗效和毒性的影响

目的免疫检查点抑制剂（ICIs）可提高晚期食管鳞状细胞癌（ESCC）患者的生存率，但其疗效各不相同。以肌肉减少和体重显著下降为特征的恶病质可能会影响 ICI 的反应。本研究探讨了ESCC患者恶病质纵向变化与ICI疗效之间的关系。方法研究了2017年至2021年接受至少两个ICI周期治疗的ESCC患者。观察了恶病质的基线和 ICI 治疗期间的演变模式。采用 Kaplan-Meier 和 Cox 回归分析评估恶病质对 ICI 疗效的影响。结果 278 名接受 ICI 治疗的患者的中位无进展生存期（PFS）为 5.78 个月，总生存期（OS）为 8.3 个月。治疗前的恶病质会导致更差的结果：无进展生存期（PFS）为 7.87 个月对 5.3 个月，进展时间（TTP）为 10.9 个月对 6.1 个月，总生存期（OS）为 14.3 个月对 9.2 个月。不可逆恶病质的结果最差。结论基线恶病质和恶病质的变化对ESCC患者的ICI疗效有显著影响。在 ICI 治疗期间持续监测恶病质对 ESCC 的最佳治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.