PMID- 36969820 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230328 IS - 2296-861X (Print) IS - 2296-861X (Electronic) IS - 2296-861X (Linking) VI - 10 DP - 2023 TI - Prognostic value of sarcopenia in patients with lung cancer treated with epidermal growth factor receptor tyrosine kinase inhibitors or immune checkpoint inhibitors. PG - 1113875 LID - 10.3389/fnut.2023.1113875 [doi] LID - 1113875 AB - OBJECTIVES: It remains controversial whether sarcopenia has any significant impact on the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) or immune checkpoint inhibitors (ICIs) in patients with advanced non-small cell lung cancer (NSCLC). Therefore, in this study, we aimed to assess the association between sarcopenia and clinical outcomes in patients with advanced NSCLC receiving EGFR-TKIs or ICIs as a first-line therapy. METHODS: We retrospectively enrolled 131 patients with advanced NSCLC treated with first-line EGFR-TKIs or ICIs between 1 March 2019 and 31 March 2021. To estimate sarcopenia, we calculated skeletal muscle index (SMI) as the ratio of skeletal muscle area (cm(2)) to height squared (m(2)). Associations between sarcopenia and overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method and log-rank tests, respectively. A Cox proportional hazards regression model was used to assess the factors associated with OS and PFS. The Student's t-test or Mann-Whitney U test was used to compare the SMI between patients with or without objective response and disease control. The chi-squared test was used to compare adverse events (AEs) between patients with and without sarcopenia. RESULTS: Among the 131 patients, 35 (26.7%) were diagnosed with sarcopenia. Sarcopenia was an independent predictor of poor OS and PFS (p < 0.05) overall and in the EGFR-TKI- and ICI-treated cohorts. Among all patients, those with sarcopenia showed significantly shorter OS and PFS than those without sarcopenia (median OS and PFS: 13.0 vs. 26.0 months and 6.4 vs. 15.1 months; both p < 0.001). These associations were consistent across the subtypes of most clinical characteristics. Statistically significant differences between the objective response (OR) and non-OR groups were also observed in the mean SMI (OR group, 43.89 +/- 7.55 vs. non-OR group, 38.84 +/- 7.11 cm(2)/m(2); p < 0.001). In addition, we observed similar results with disease control (DC) and non-DC groups (DC group, 42.46 +/- 7.64 vs. non-DCR group, 33.74 +/- 4.31 cm(2)/m(2); p < 0.001). The AEs did not differ significantly between the sarcopenia and non-sarcopenia groups. CONCLUSION: Sarcopenia before treatment might be a significant predictor of poor clinical outcomes (shorter OS and PFS, fewer ORs, less DC) in patients with advanced NSCLC treated with EGFR-TKIs or ICIs as the first-line therapy. CI - Copyright (c) 2023 Lyu, Yang, Xiao, Nie, Xiong, Liu, Zhang, Zhang, Tang, Pan, Liang, Bai, Li, Kuang and Li. FAU - Lyu, Jiahua AU - Lyu J AD - School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Yang, Ningjing AU - Yang N AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Xiao, Ling AU - Xiao L AD - School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Nie, Xinyu AU - Nie X AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Xiong, Jing AU - Xiong J AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Liu, Yudi AU - Liu Y AD - School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Zhang, Min AU - Zhang M AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Zhang, Hangyue AU - Zhang H AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Tang, Cunhan AU - Tang C AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Pan, Shiyi AU - Pan S AD - School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Liang, Long AU - Liang L AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Bai, Hansong AU - Bai H AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Li, Churong AU - Li C AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Kuang, Hao AU - Kuang H AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. FAU - Li, Tao AU - Li T AD - School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. AD - Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. LA - eng PT - Journal Article DEP - 20230308 PL - Switzerland TA - Front Nutr JT - Frontiers in nutrition JID - 101642264 PMC - PMC10031770 OTO - NOTNLM OT - EGFR-TKIs OT - immune-checkpoint inhibitors OT - lung cancer OT - prognosis OT - sarcopenia COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/03/28 06:00 MHDA- 2023/03/28 06:01 PMCR- 2023/01/01 CRDT- 2023/03/27 03:43 PHST- 2022/12/01 00:00 [received] PHST- 2023/02/21 00:00 [accepted] PHST- 2023/03/27 03:43 [entrez] PHST- 2023/03/28 06:00 [pubmed] PHST- 2023/03/28 06:01 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fnut.2023.1113875 [doi] PST - epublish SO - Front Nutr. 2023 Mar 8;10:1113875. doi: 10.3389/fnut.2023.1113875. eCollection 2023.