Frequency of weight and body composition increases in advanced non-small cell lung cancer patients during first line therapy.

IF 8.9 1区 医学 Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2024-09-17 DOI:10.1002/jcsm.13534
Philip Bonomi,Hita Moudgalya,Sandra L Gomez,Palmi Shah,Sanjib Basu,Marta Batus,Levi B Martinka,Ahmed Abdelkader,Iphigenia Tzameli,Sonia Cobain,Susie Collins,Edmund J Keliher,Danna M Breen,Roberto A Calle,Mary Jo Fidler,Jeffrey A Borgia
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Abstract

BACKGROUND The primary objective of this study was to assess the frequency of body composition increases and their relationships to changes in body weight in two cohorts of real world, treatment-naïve, advanced non-small cell lung cancer (NSCLC) patients. One cohort received the current standard of care (CSOC), which consisted of immunotherapy and newer chemotherapy regimens, and the other cohort was treated with the former standard of care (FSOC), consisting only of older platinum-containing regimens. METHODS CSOC (n = 106) and FSOC (n = 88) cohorts of advanced NSCLC patients were included in this study. Weights were collected at each clinical visit, and body composition analysis from routine chest computed tomography via automated segmentation software assessed at baseline and at 6 and 12 weeks. Standard statistical methods were used to calculate relationships between changes in weight and in body composition. RESULTS The CSOC cohort contained 106 stage IV NSCLC patients treated between 16/12/2014 and 22/10/2020 while the FSOC cohort contained 88 stage III/IV NSCLC patients treated between 16/6/2006 and 18/11/2014. While each cohort exhibited decreases in median weight, body mass index (BMI), mean skeletal muscle index (SMI) and subcutaneous adipose tissue index (SATI) at the 6 and 12 week time points, a subset of patients experienced increases in these parameters. Using a threshold of ≥2.5% increase for weight, BMI, SMI, and SATI at the 12 week time point, both cohorts showed similar (20.5% and 27.3%) increases in these parameters. With a cut point of ≥5% increase at 12 weeks follow-up, 8.0% to 25.0% of the patients gained ≥5% in weight, BMI, SMI and SATI. Comparing these results in each cohort showed no significant differences. Pearson coefficients for weight change related to changes in SMI and SATI at 6 and 12 weeks ranged from 0.31 to 0.58 with all P values <0.02. Pearson coefficients for weight change at 12 weeks related to changes in VATI and IMATI ranged from 0.26 to 0.47 with all P values <0.05. Comparison of Pearson coefficients for each cohort showed no significant differences. CONCLUSIONS Although decreases in median weight, BMI, SMI and SATI were observed in both cohorts, similar percentage of patients in each cohort experienced increases in these parameters. These findings, plus the positive correlations between longitudinal measurements of weight, muscle mass and adipose tissue, indicate that weight gain in these patients involves increases in both muscle mass and adipose tissue. Upon validation, these findings could have implications for clinical trial design and for translational research in cancer cachexia.
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晚期非小细胞肺癌患者在一线治疗期间体重和身体成分增加的频率。
背景本研究的主要目的是评估现实世界中两组未经治疗的晚期非小细胞肺癌(NSCLC)患者身体成分增加的频率及其与体重变化的关系。其中一组患者接受了当前的标准疗法(CSOC),包括免疫疗法和较新的化疗方案;另一组患者接受了以前的标准疗法(FSOC),仅包括较旧的含铂方案。在每次临床就诊时收集体重,并在基线、6 周和 12 周时通过自动分割软件对常规胸部计算机断层扫描进行身体成分分析评估。结果CSOC队列中有106名在2014年12月16日至2020年10月22日期间接受治疗的IV期NSCLC患者,而FSOC队列中有88名在2006年6月16日至2014年11月18日期间接受治疗的III/IV期NSCLC患者。虽然每个队列在 6 周和 12 周时间点的中位体重、体重指数 (BMI)、平均骨骼肌指数 (SMI) 和皮下脂肪组织指数 (SATI) 都有所下降,但仍有一部分患者的这些参数有所上升。以体重、BMI、SMI 和 SATI 在 12 周时间点的增幅≥2.5% 为临界点,两组患者的这些参数增幅相似(20.5% 和 27.3%)。以随访 12 周时增加≥5% 为切点,8.0% 到 25.0% 的患者体重、BMI、SMI 和 SATI 增加≥5%。比较每个队列中的这些结果,未发现明显差异。体重变化与 6 周和 12 周 SMI 和 SATI 变化的皮尔逊系数介于 0.31 和 0.58 之间,所有 P 值均小于 0.02。12 周时体重变化与 VATI 和 IMATI 变化的皮尔逊系数介于 0.26 和 0.47 之间,所有 P 值均小于 0.05。结论虽然在两个队列中都观察到了中位体重、BMI、SMI 和 SATI 的下降,但每个队列中都有类似比例的患者经历了这些参数的上升。这些发现以及体重、肌肉质量和脂肪组织纵向测量值之间的正相关性表明,这些患者的体重增加涉及肌肉质量和脂肪组织的增加。这些发现一经验证,将对癌症恶病质的临床试验设计和转化研究产生影响。
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
Journal of Cachexia, Sarcopenia and Muscle
Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine
自引率
12.40%
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期刊介绍: The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.
期刊最新文献
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