The Role of a Cachexia Grading System in Patients with Non-Small Cell Lung Cancer Treated with Immunotherapy: Implications for Survival. (10th March 2021)

• Record Type: Journal Article
• Authors: Turcott, Jenny G.; Martinez-Samano, Julio E.; Cardona, Andrés F.; Bassarmal, Suraj Samtani; Ramírez-Tirado, Laura Alejandra; Zatarain-Barrón, Zyanya Lucia; Barrón, Feliciano; Corrales, Luis; Martín, Claudio; Barragán-Castillo, Pablo Alan; Ruiz-Patiño, Alejandro; Flores-Estrada, Diana; Arrieta, Oscar
• Is Part Of: Nutrition and cancer. Volume 73:Number 5(2021)
• Page Start: 794
• Page End: 801
• Publication Date: 2021-03-10
• Subjects: Cancer -- Periodicals; Nutrition -- Periodicals; Cancer; Nutrition; Periodicals; 616.9940654
• DOI: 10.1080/01635581.2020.1769691
• Languages: English
• ISSNs: 0163-5581

Abstract

Abstract: 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.