Early host adaptation defined by nutritional and inflammatory dynamics predicts disease progression in solid tumours

Area of Science:

• Oncology
• Clinical Nutrition
• Biochemistry

Background:

• Inflammatory and nutritional markers' early shifts during cancer treatment are not well understood.
• Predictive value of these early changes for patient outcomes requires investigation.

Purpose of the Study:

• To track changes in inflammatory and nutritional parameters from treatment initiation to 3 months in adults with newly diagnosed solid tumors.
• To determine if these early shifts predict progression-free and overall survival.

Main Methods:

• Single-center prospective study of 100 adult solid tumor patients starting systemic therapy.
• Assessed anthropometrics, body composition (BIA), MNA-SF, handgrip, gait speed, and blood samples at baseline and 3 months.
• Utilized Wilcoxon signed-rank test, Spearman correlation, ROC curves, and logistic regression for analysis.

Main Results:

• Sarcopenia was rare (1% at 3 months); body fat decreased significantly, but muscle mass remained stable.
• Third-month C-reactive protein (CRP) was the sole independent predictor of progression and survival (AUC 0.672).
• Elevated CRP (≥4.74 mg/L) increased progression risk 3.63-fold; albumin correlated with skeletal muscle index (SMI).

Conclusions:

• Early sarcopenia is uncommon, but inflammation is prevalent during initial cancer treatment.
• Third-month CRP independently predicts outcomes, even with stable nutritional and muscle indices, suggesting inflammation precedes compositional decline.
• Routine CRP and albumin monitoring may identify patients needing closer follow-up and intervention.