FIT: Functional and imaging testing for patients with metastatic cancer

Area of Science:

• Oncology
• Clinical Research
• Body Composition Analysis

Background:

• Selecting appropriate study endpoints for cancer cachexia trials is challenging.
• Understanding the relationship between body composition, functional outcomes, and patient-reported outcomes (PROs) is crucial for effective trial design in metastatic cancer patients.

Purpose of the Study:

• To evaluate the associations between changes in weight, body composition, functional outcomes, and PROs in patients with metastatic cancer.
• To inform the selection of optimal study endpoints for future cancer cachexia clinical trials.

Main Methods:

• A 2-year observational study involving 57 metastatic solid cancer patients (ECOG 0-2) receiving cancer-directed therapy.
• Longitudinal assessments of weight, body composition (skeletal muscle, adipose tissue), functional status (6-Min Walk Test, Timed Up and Go, Short Physical Performance Battery), and PROs were conducted at baseline and 3 months.
• Statistical analyses included paired t tests and linear regression models, adjusting for age and sex.

Main Results:

• 38 patients completed 3-month assessments; mean age 61.8 years, 47% female.
• No significant changes in weight or skeletal muscle mass were observed over 3 months, but total adipose tissue increased.
• Weight changes showed no association with functional outcomes or PROs. However, greater skeletal muscle loss correlated with significant declines in physical function (p < 0.01).

Conclusions:

• Body weight may not change significantly in metastatic cancer patients undergoing therapy.
• Skeletal muscle loss is a key indicator of declining physical function in this population.
• Prospective cancer cachexia studies should prioritize changes in body composition, rather than weight, as primary endpoints.