Abstract
Purpose
The aim of this study was to elucidate the clinical impact of skeletal muscle area (SMA) in patients with non-small cell lung cancer (NSCLC) treated with anti-programmed cell death-1 (PD-1) inhibitors.
Methods
Univariate and multivariate analyses were performed on data of 103 patients with advanced or recurrent NSCLC treated with anti-PD-1 inhibitors. The SMA was measured at the level of the third lumbar vertebral (L3) on computed tomography images using OsiriX software (32-bit, version 5.8; OsiriX, Geneva, Switzerland). The L3 muscle index (cm2/m2) was defined as the SMA (cm2) at the L3 level divided by the height (m) squared.
Results
L3 muscle index Low was an independent predictor of both progression-free (P = 0.0399) and overall survival (P = 0.0155). Moreover, the disease control rate was significantly lower in the L3 muscle index Low group (49.0% [25/51]) than in the L3 muscle index High group (73.1% [38/52]; P = 0.0117). However, there was no significant difference between the response rates of the L3 muscle index Low group (21.6% [11/51]) and L3 muscle index High group (32.7% [17/52]; P = 0.2031).
Conclusions
L3 muscle index Low is an independent predictor of worse outcomes in NSCLC patients treated with anti-PD-1 inhibitors.
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Acknowledgements
We thank Dr. Trish Reynolds, MBBS, FRACP, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
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432_2020_3146_MOESM1_ESM.tif
Supplementary file1 (TIF 10272 kb) Association between L3 muscle index and BMI in patients with non-small cell lung cancer treated with anti-PD-1 inhibitors. BMI, body mass index; L3, third lumbar vertebra; PD-1, programmed cell death-1
432_2020_3146_MOESM2_ESM.tif
Supplementary file2 (TIF 10272 kb) Kaplan–Meier curves showing survival of patients with non-small cell lung cancer treated with anti-PD-1 inhibitors according to BMI status. (a) Progression-free survival and (b) overall survival. BMI, body mass index; PD-1, programmed cell death-1
432_2020_3146_MOESM3_ESM.tif
Supplementary file3 (TIF 10272 kb) Association between BMI status and treatment response in patients with non-small cell lung cancer treated with anti-PD-1 inhibitors. (a) Response rate and (b) disease control rate. Responses were determined according to the Response Evaluation Criteria in Solid Tumors. BMI, body mass index; CR, complete response; PD, progressive disease; PD-1, programmed cell death-1; PR, partial response; SD, stable disease
432_2020_3146_MOESM5_ESM.tif
Supplementary file5 (TIF 10272 kb) Association between PD-L1 tumor expression status and treatment response in patients with non-small cell lung cancer treated with anti-PD-1 inhibitors. (a) Response rate and (b) disease control rate. Responses were determined according to the Response Evaluation Criteria in Solid Tumors. CR, complete response; PD, progressive disease; PD-1, programmed cell death-1; PD-L1, programmed cell death-ligand 1; PR, partial response; SD, stable disease; TPS, tumor proportion score
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Takada, K., Yoneshima, Y., Tanaka, K. et al. Clinical impact of skeletal muscle area in patients with non-small cell lung cancer treated with anti-PD-1 inhibitors. J Cancer Res Clin Oncol 146, 1217–1225 (2020). https://doi.org/10.1007/s00432-020-03146-5
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DOI: https://doi.org/10.1007/s00432-020-03146-5