OBJECTIVE: The association between cancer-induced weight-loss (CIWL) and poor clinical outcomes in patients treated with immunotherapy is scarcely understood. We evaluated the use of a cachexia-grading system in IO-treated non-small cell lung cancer (NSCLC) patients in order to predict clinical outcomes. MATERIALS: 300 patients with NSCLC, who received immunotherapy during any line of therapy, were included. All patients were graded according to a previously validated cachexia scale, which takes into consideration body mass index (BMI) and weight loss, stratifying patients into five risk categories (0 [pre-cachexia] - 4 [refractory cachexia]). Primary endpoint was overall survival (OS). RESULTS: Ninety-one (30.3%) patients were classified in the low risk category, 176 (58.6%) were classified in the intermediate risk category and 33 (11%) were in the high risk category. Patients classified as low-risk had a significantly longer OS compared with those with intermediate or high risk (22.4 mo, [95%CI: 16.6-NR] vs. 17.1 [95%CI: 13.5-22.4] vs. 8.0 [3.9-18.4]; p < 0.001). In the multivariate analysis, after adjusting for age, hemoglobin and ORR, hazard of death increased as per the cachexia risk scale (Hazard ratio: 1.62 [1.22-2.16]; p = 0.001). CONCLUSION: Cachexia is independently associated with worse OS in NSCLC patients who receive immunotherapy, highlighting the role for nutritional assessment.
OBJECTIVE: The association between cancer-induced weight-loss (CIWL) and poor clinical outcomes in patients treated with immunotherapy is scarcely understood. We evaluated the use of a cachexia-grading system in IO-treated non-small cell lung cancer (NSCLC) patients in order to predict clinical outcomes. MATERIALS: 300 patients with NSCLC, who received immunotherapy during any line of therapy, were included. All patients were graded according to a previously validated cachexia scale, which takes into consideration body mass index (BMI) and weight loss, stratifying patients into five risk categories (0 [pre-cachexia] - 4 [refractory cachexia]). Primary endpoint was overall survival (OS). RESULTS: Ninety-one (30.3%) patients were classified in the low risk category, 176 (58.6%) were classified in the intermediate risk category and 33 (11%) were in the high risk category. Patients classified as low-risk had a significantly longer OS compared with those with intermediate or high risk (22.4 mo, [95%CI: 16.6-NR] vs. 17.1 [95%CI: 13.5-22.4] vs. 8.0 [3.9-18.4]; p < 0.001). In the multivariate analysis, after adjusting for age, hemoglobin and ORR, hazard of death increased as per the cachexia risk scale (Hazard ratio: 1.62 [1.22-2.16]; p = 0.001). CONCLUSION:Cachexia is independently associated with worse OS in NSCLCpatients who receive immunotherapy, highlighting the role for nutritional assessment.
Authors: Yizhen Guo; Lai Wei; Sandip H Patel; Gabrielle Lopez; Madison Grogan; Mingjia Li; Tyler Haddad; Andrew Johns; Latha P Ganesan; Yiping Yang; Daniel J Spakowicz; Peter G Shields; Kai He; Erin M Bertino; Gregory A Otterson; David P Carbone; Carolyn Presley; Samuel K Kulp; Thomas A Mace; Christopher C Coss; Mitch A Phelps; Dwight H Owen Journal: Clin Lung Cancer Date: 2022-01-08 Impact factor: 4.840
Authors: Oscar Arrieta; Andrés F Cardona; Luis Lara-Mejía; David Heredia; Feliciano Barrón; Zyanya Lucia Zatarain-Barrón; Francisco Lozano; Vladmir Cordeiro de Lima; Federico Maldonado; Francisco Corona-Cruz; Maritza Ramos; Luis Cabrera; Claudio Martin; Luis Corrales; Mauricio Cuello; Marisol Arroyo-Hernández; Enrique Aman; Ludwing Bacon; Renata Baez; Sergio Benitez; Antonio Botero; Mauricio Burotto; Christian Caglevic; Gustavo Ferraris; Helano Freitas; Diego Lucas Kaen; Sebastián Lamot; Gustavo Lyons; Luis Mas; Andrea Mata; Clarissa Mathias; Alvaro Muñoz; Ana Karina Patane; George Oblitas; Luis Pino; Luis E Raez; Jordi Remon; Leonardo Rojas; Christian Rolfo; Alejandro Ruiz-Patiño; Suraj Samtani; Lucia Viola; Santiago Viteri; Rafael Rosell Journal: Crit Rev Oncol Hematol Date: 2020-06-20 Impact factor: 6.312