Sarcopenia in Patients With Cancer and Its Association With Chemotherapy-Induced Peripheral Neurotoxicity

Area of Science:

• Oncology
• Neurology
• Radiology

Background:

• Chemotherapy-induced peripheral neurotoxicity (CIPN) is a frequent neurologic complication of cancer therapy.
• Sarcopenia, the loss of muscle mass, is linked to treatment toxicity, but its specific association with CIPN is not well understood.

Purpose of the Study:

• To investigate the association between sarcopenia detected before chemotherapy and the subsequent development of CIPN.
• To identify potential risk factors for CIPN in cancer patients undergoing specific chemotherapies.

Main Methods:

• A prospective observational study involving 105 cancer patients scheduled for brentuximab vedotin, oxaliplatin, or paclitaxel.
• Pretreatment CT or PET-CT scans were used to assess sarcopenia via skeletal muscle index.
• Patients were evaluated for CIPN using Total Neuropathy Score-clinical version (TNSc) and CTCAE grading before and after treatment.

Main Results:

• Nearly half of the patients (47.6%) presented with sarcopenia before treatment.
• Sarcopenia was significantly more prevalent in patients who developed clinically relevant CIPN (CR-CIPN).
• Multivariate analysis confirmed sarcopenia as an independent risk factor for CR-CIPN (OR 2.5), while paclitaxel and brentuximab vedotin were associated with lower odds of CR-CIPN compared to oxaliplatin.

Conclusions:

• Pretreatment sarcopenia is a significant predictor, associated with a 2.5-fold increased likelihood of developing moderate-to-severe CIPN.
• Routine prechemotherapy imaging for sarcopenia assessment can aid in identifying patients at high risk for CR-CIPN.