Sarcopenia Predicts Outcome After Chemoimmunotherapy, Not Chemotherapy, in Advanced Lung Cancer: Single-Centre...

Area of Science:

• Oncology
• Cancer Research
• Clinical Medicine

Background:

• Sarcopenia, the loss of skeletal muscle mass, is common in non-small cell lung cancer (NSCLC) patients.
• Its predictive value in advanced NSCLC treated with first-line immunotherapy plus chemotherapy (CITx) is not well understood.

Purpose of the Study:

• To investigate the predictive role of sarcopenia in advanced NSCLC patients receiving first-line CITx versus chemotherapy alone (CTx).

Main Methods:

• Retrospective analysis of advanced NSCLC patients treated with CITx (n=552) or CTx (n=622).
• Sarcopenia assessed using CT-derived skeletal muscle index.
• Progression-free survival (PFS) and overall survival (OS) were evaluated.

Main Results:

• Sarcopenia was present in 49.5% of patients and associated with worse overall survival.
• In the CITx group, sarcopenia predicted higher risk of progression (aHR 1.23) and death (aHR 1.42).
• No significant association between sarcopenia and outcomes was found in the CTx group; interaction was significant for PFS (p=0.041) and OS (p=0.022).

Conclusions:

• Sarcopenia is a predictive biomarker for poorer outcomes in advanced NSCLC patients treated with CITx, but not CTx.
• Skeletal muscle mass evaluation can identify NSCLC patients at risk for suboptimal response to CITx.
• Further research into interventions targeting sarcopenia and cachexia is warranted.