Body composition derangements in lung cancer patients treated with first‐line pembrolizumab: A multicentre observational study

作者：Ilaria Trestini, Lorenzo Belluomini, Alessandra Dodi, Marco Sposito, Alberto Caldart, Dzenete Kadrija, Luca Pasqualin, Silvia Teresa Riva, Ilaria Mariangela Scaglione, Daniela Tregnago, Alice Avancini, Jessica Insolda, Linda Confortini, Miriam Casali, Jessica Menis, Emanuele Vita, Marco Cintoni, Marco Todesco, Gianluca Milanese, Isabella Sperduti, Mirko D’Onofrio, Marco Infante, Marcello Tiseo, Maria Cristina Mele, Giampaolo Tortora, Michèle Milella, Emilio Bria, Sara Pilotto · 发表于：Journal of Cachexia Sarcopenia and Muscle · 年份：2024 · DOI：10.1002/jcsm.13568 · 被引用次数：28 · 研究领域：Cancer Immunotherapy and Biomarkers、Inflammatory Biomarkers in Disease Prognosis、Nutrition and Health in Aging

BACKGROUND: While immune checkpoint inhibitors (ICIs) are increasingly reshaping the therapeutic landscape of non-small-cell lung cancer (NSCLC), only a limited proportion of patients achieve a relevant and long-lasting benefit with these treatments, calling for the identification of clinical and, ideally modifiable, predictors of efficacy. Body composition phenotypes may reflect aspects of patients' immunology and thereby their ability to respond to ICIs. This study aims to explore the possible association between pre-treatment body composition phenotypes, tumour response, and clinical outcomes in patients receiving first-line pembrolizumab monotherapy for advanced NSCLC. METHODS: A retrospective review of consecutive patients with treatment-naïve NSCLC and PD-L1 expression ≥50% undergoing pembrolizumab at three academic institutions was performed. Pre-treatment body composition parameters were measured at the third lumbar vertebra level by computed tomography, defined using pre-established cut-offs. Primary endpoint was objective response rate (ORR), secondary endpoints progression-free survival and overall survival (PFS and OS), compared through the log-rank test and the Cox proportional hazards model. RESULTS: . Overall, 59.0% and 51.5% of patients met established radiographic criteria for evidence of sarcopenia and myosteatosis, respectively, which occur across the BMI spectrum. Multivariate regression analysis, adjusted for co-morbidities, revealed that sarcopenia (aOR ...