NSCLC: sarcopenia tied to poorer PFS with PD-1 inhibitors

  • Shiroyama T & al.
  • Sci Rep
  • 21 Feb 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with advanced NSCLC and sarcopenia at baseline had worse PFS and response rates after treatment with programmed death (PD)-1 inhibitors.

Why this matters

  • Skeletal muscle loss from sarcopenia may be a useful predictor of outcomes with PD-1 inhibitors.

Study design

  • 42 patients with previously treated advanced NSCLC.
  • Funding: None.

Key results

  • 52.4% of patients had sarcopenia at baseline.
  • Sarcopenia was associated with significantly worse PFS (2.1 vs 6.8 months; P=.004) and response rate (9.1% vs 40.0%; P=.025)
  • In patients with good performance status (PS), sarcopenia was significantly associated with worse PFS compared with no sarcopenia (2.3 vs 7.6 months; P=.004), even though overall, good PS was associated with better PFS compared with bad PS (3.8 vs 1.4 months; P=.030).
  • There was no significant association between sarcopenia and worse PFS in patients with poor PS.
  • No significant difference in PFS based on BMI.
  • Lower 1-year PFS in patients with sarcopenia (10.1% vs 38.1%).
  • Long-term response (>12 months of tumor remission) was greater in patients without sarcopenia (30.0% vs 4.5%; P=.041).

Limitations

  • Retrospective study with small sample size.