PMID- 33951292
OWN - NLM
STAT- MEDLINE
DCOM- 20220104
LR  - 20220104
IS  - 1759-7714 (Electronic)
IS  - 1759-7706 (Print)
IS  - 1759-7706 (Linking)
VI  - 12
IP  - 12
DP  - 2021 Jun
TI  - Sarcopenia as a predictor of initial administration dose of afatinib in patients 
      with advanced non-small cell lung cancer.
PG  - 1824-1830
LID - 10.1111/1759-7714.13934 [doi]
AB  - BACKGROUND: Sarcopenia has recently emerged as a new condition with increasing 
      importance in lung cancer patients. The aim of this study was to investigate the 
      influence of sarcopenia on tolerance and efficacy of afatinib. METHODS: We 
      retrospectively evaluated 35 patients with epidermal growth factor receptor 
      (EGFR) mutant advanced non-small cell lung cancer (NSCLC) treated with first-line 
      afatinib. Skeletal muscle area (SMA) was measured at the third lumbar vertebra 
      using routine conducted computed tomography (CT) images for evaluation of disease 
      burden. Sarcopenia was defined as skeletal muscle index (SMI = SMA/height(2) ) 
      </=38.5 cm(2) /m(2) for women and </=52.4 cm(2) /m(2) for men based on previous 
      criteria. Fisher's exact tests, Kaplan-Meier method, and logistic regression 
      modeling were used. RESULTS: The median age at diagnosis was 65 years 
      (range,39-84 years). A total of 24 (68.6%) patients were diagnosed with 
      sarcopenia. The most frequent adverse events (AEs) related to afatinib were 
      diarrhea (94.3%) followed by rash (77.1%) and paronychia (60%). Overall, 19 
      (54.3%) patients had dose reduction. Sarcopenic patients had a significantly 
      higher rate of grade >/= 2 diarrhea (75.0 vs. 27.3%, p = 0.011) and 
      toxicity-related dose reduction (75.0 vs. 9.1%, p = 0.001). Multivariate analysis 
      also showed that sarcopenia (odds ratio [OR] 51.7, 95% confidence interval [CI]: 
      2.4-1081.3, p = 0.01) was an independent risk factor for dose reduction of 
      afatinib. The median progression-free survival (PFS) for afatinib was 12.0 months 
      (95% CI: 10.6-13.4). Both dose reduction and sarcopenia did not affect 
      therapeutic efficacy. CONCLUSIONS: Toxicity-related dose reduction is common with 
      initiation of afatinib 40 mg/day. Sarcopenic patients might begin treatment with 
      a low dose of afatinib according to tolerance.
CI  - (c) 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and 
      John Wiley & Sons Australia, Ltd.
FAU - Nie, Xin
AU  - Nie X
AUID- ORCID: 0000-0003-2759-2950
AD  - Palliative Care Center & Daycare Center, Key Laboratory of Carcinogenesis and 
      Translational Research (Ministry of Education/Beijing), Peking University Cancer 
      Hospital & Institute, Beijing, China.
FAU - Zhang, Ping
AU  - Zhang P
AD  - Department of Medical Oncology, Beijing Hospital, National Center of Gerontology; 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Gao, Jia-Yin
AU  - Gao JY
AD  - Department of Radiology, Beijing Hospital, National Center of Gerontology; 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Cheng, Gang
AU  - Cheng G
AD  - Department of Medical Oncology, Beijing Hospital, National Center of Gerontology; 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Liu, Wei
AU  - Liu W
AD  - Palliative Care Center & Daycare Center, Key Laboratory of Carcinogenesis and 
      Translational Research (Ministry of Education/Beijing), Peking University Cancer 
      Hospital & Institute, Beijing, China.
FAU - Li, Lin
AU  - Li L
AUID- ORCID: 0000-0003-2934-650X
AD  - Department of Medical Oncology, Beijing Hospital, National Center of Gerontology; 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210505
PL  - Singapore
TA  - Thorac Cancer
JT  - Thoracic cancer
JID - 101531441
RN  - 0 (Protein Kinase Inhibitors)
RN  - 41UD74L59M (Afatinib)
SB  - IM
MH  - Adult
MH  - Afatinib/*adverse effects
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Non-Small-Cell Lung/complications/*drug therapy
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/complications/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Protein Kinase Inhibitors/*adverse effects
MH  - Sarcopenia/*chemically induced
PMC - PMC8201527
OTO - NOTNLM
OT  - afatinib
OT  - non-small cell lung cancer
OT  - sarcopenia
COIS- No authors report any conflict of interest.
EDAT- 2021/05/06 06:00
MHDA- 2022/01/05 06:00
PMCR- 2021/06/01
CRDT- 2021/05/05 18:01
PHST- 2021/02/28 00:00 [revised]
PHST- 2021/02/04 00:00 [received]
PHST- 2021/02/28 00:00 [accepted]
PHST- 2021/05/06 06:00 [pubmed]
PHST- 2022/01/05 06:00 [medline]
PHST- 2021/05/05 18:01 [entrez]
PHST- 2021/06/01 00:00 [pmc-release]
AID - TCA13934 [pii]
AID - 10.1111/1759-7714.13934 [doi]
PST - ppublish
SO  - Thorac Cancer. 2021 Jun;12(12):1824-1830. doi: 10.1111/1759-7714.13934. Epub 2021 
      May 5.