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Published on: May 10, 2024
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From Symptom to Outcome: Defining Clinically Meaningful Patient-Reported Appetite Loss in Non-Small-Cell Lung Cancer.
Jiawei Zhou1,2, Benyam Muluneh1,2, Quefeng Li3
1Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Journal of Cachexia, Sarcopenia and Muscle
|December 3, 2025
Summary
Appetite loss in non-small-cell lung cancer (NSCLC) significantly impacts weight and survival. This study identified key appetite loss thresholds linked to adverse outcomes, advocating for better symptom management in cancer care.
Area of Science:
- Oncology
- Clinical Nutrition
- Biostatistics
Background:
- Appetite loss is a prevalent and severe symptom in non-small-cell lung cancer (NSCLC) patients, exacerbated by cancer progression and treatment.
- This symptom frequently leads to unintended weight loss and cancer cachexia, diminishing patient quality of life and prognosis.
- Currently, appetite loss is under-recognized in oncology, lacking standardized assessment tools and management strategies.
Purpose of the Study:
- To develop a predictive model for identifying clinically significant appetite loss thresholds in NSCLC patients.
- To correlate these thresholds with substantial weight reduction and decreased overall survival.
- To emphasize the clinical impact of appetite loss and promote patient-centered care strategies.
Main Methods:
- Utilized longitudinal data from 476 NSCLC patients (recovering cohort) and 380 NSCLC patients (chemotherapy cohort) on appetite scores (LCSS) and body weight.
- Employed a mechanism-based population modeling approach to predict appetite's impact on body weight.
- Validated the model and determined clinically meaningful appetite loss thresholds associated with 3.5-kg weight loss and reduced survival (HR > 1, p < 0.05).
Main Results:
- A 23-mm decline in appetite correlated with a 3.5-kg weight loss in the chemotherapy cohort.
- Appetite loss trajectories showed significant associations with overall survival (p < 0.001).
- Identified clinically meaningful appetite loss thresholds: 4 mm at 1 month and 11 mm at 3 months, both linked to reduced OS in docetaxel-treated patients (p < 0.05).
Conclusions:
- A population predictive model was successfully developed to quantify the relationship between appetite and body weight in NSCLC.
- Clinically meaningful thresholds for appetite loss were identified, highlighting its prognostic significance.
- This research underscores the necessity of managing appetite loss in oncology and supports its use as a quantitative endpoint.
