Prognostic Value of Baseline Skeletal Muscle Index in Colorectal Cancer Patients Treated with Fruquintinib: A multi-center real world analysis.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-11-20 DOI:10.1007/s00384-024-04747-z

Wanfen Tang, Fakai Li, Hongjuan Zheng, Jinglei Zhao, Hangping Wei, Xuerong Xiong, Hailang Chen, Cui Zhang, Weili Xie, Penghai Zhang, Guangrong Gong, Mingliang Ying, Qiusheng Guo, Qinghua Wang, Jianfei Fu

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Abstract

Background: The Skeletal Muscle Index (SMI) serves as an objective metric for assessing nutritional status in patients with malignant tumors. Research has found baseline nutritional status can influence both the efficacy and prognosis of targeted anti-tumor therapies, with growth factor tyrosine kinase inhibitors frequently inducing drug-related sarcopenia. Fruquintinib has received approval for the treatment of metastatic colorectal cancer. This study examines the prognostic significance of baseline SMI in patients with metastatic colorectal cancer undergoing treatment with fruquintinib. Additionally, the study investigates the incidence of SMI reduction following fruquintinib therapy to assess its impact on patient prognosis.

Methods: A retrospective multicenter study was conducted to analyze patients with metastatic colorectal cancer who received fruquintinib treatment across eight medical centers in Eastern China. The muscle area at the third lumbar vertebra was assessed, and both baseline and post-treatment SMI values were calculated independently. The relationship between SMI and patient survival was subsequently examined.

Results: The median progression-free survival (PFS) for the cohort of 105 patients was 4.2 months (95% CI, 3.7 to 4.9 months), while the median overall survival (OS) was 10.2 months (95% CI, 9.0 to 12.7 months). Notably, the baseline SMI prior to the initiation of fruquintinib therapy exhibited a significant correlation with OS (P = 0.0077). Multivariate analysis indicated that baseline SMI serves as an independent prognostic factor for OS (P = 0.005). Furthermore, after Propensity Score Matching (PSM) analysis, there was still a significant correlation between baseline SMI and OS. Among the patients, 28.87% developed sarcopenia following oral administration of fruquintinib. However, no statistically significant difference in OS was observed between the group with reduced SMI and the group without SMI reduction after treatment with fruquintinib.

Conclusion: The baseline SMI was identified as an independent prognostic factor for OS and may influence the survival outcomes of patients with metastatic colorectal cancer undergoing treatment with fruquintinib. Despite the potential of fruquintinib to induce sarcopenia, no significant correlation was observed between changes in SMI following treatment and patient survival.

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接受氟康替尼治疗的结直肠癌患者基线骨骼肌指数的预后价值：多中心真实世界分析

背景：骨骼肌指数（SMI骨骼肌指数（SMI）是评估恶性肿瘤患者营养状况的客观指标。研究发现，基线营养状况会影响抗肿瘤靶向疗法的疗效和预后，生长因子酪氨酸激酶抑制剂经常会诱发与药物相关的肌少症。Fruquintinib已获准用于治疗转移性结直肠癌。本研究探讨了接受福仑替尼治疗的转移性结直肠癌患者基线 SMI 的预后意义。此外，该研究还调查了福仑替尼治疗后 SMI 降低的发生率，以评估其对患者预后的影响：方法：本研究是一项回顾性多中心研究，分析了华东地区8家医疗中心接受福仑替尼治疗的转移性结直肠癌患者。该研究评估了第三腰椎处的肌肉面积，并独立计算了基线和治疗后的SMI值。随后研究了SMI与患者生存期之间的关系：105例患者的中位无进展生存期（PFS）为4.2个月（95% CI，3.7至4.9个月），中位总生存期（OS）为10.2个月（95% CI，9.0至12.7个月）。值得注意的是，开始接受福罗替尼治疗前的基线SMI与OS有显著相关性（P = 0.0077）。多变量分析表明，基线SMI是OS的独立预后因素（P = 0.005）。此外，经过倾向得分匹配（PSM）分析，基线 SMI 与 OS 之间仍存在显著相关性。口服福罗替尼后，28.87%的患者出现了肌少症。然而，在使用弗仑替尼治疗后，SMI降低组与SMI未降低组的OS差异无统计学意义：结论：基线SMI被认为是OS的独立预后因素，可能会影响接受fruquintinib治疗的转移性结直肠癌患者的生存结果。尽管福仑替尼有可能诱发肌肉疏松症，但治疗后SMI的变化与患者生存率之间并无显著相关性。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.