1392P - Characterization of cachectic patients with non-small cell lung cancer (NSCLC) according to their modified Glasgow Prognostic Score (mGPS)

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cancer in Adolescents
Palliative Care
Lung and other Thoracic Tumours
Palliative and Supportive Care
Presenter Barry Laird
Citation Annals of Oncology (2017) 28 (suppl_5): v497-v501. 10.1093/annonc/mdx382
Authors B. Laird1, D. McMillan2, S. Kaasa3, M. Fallon4, R. Skipworth5, D. Currow6, R. Giorgino7
  • 1Institute Of Genetics And Molecular Medicine, University of Edinburgh, EH4 2XR - Edinburgh/GB
  • 2Academic Unit Of Surgery, New Lister Building, Glasgow Royal Infirmary, University of Glasgow, Glasgow/GB
  • 3Department Of Oncology, Oslo University Hospital and University of Oslo, Oslo/NO
  • 4Institute Of Genetics And Molecular Medicine, University of Edinburgh, Edinburgh/GB
  • 5Clinical Surgery, University of Edinburgh, Edinburgh/GB
  • 6Impacct – Improving Palliative Aged And Chronic Care Through Clinical Research And Translation, Faculty Of Health, University of Technology Sydney, 2007 - Sydney/AU
  • 7Research And Development Innovation And Strategy Department, Helsinn Healthcare, Lugano/CH

Abstract

Background

Patients with advanced NSCLC often develop anorexia/cachexia, a comorbidity characterized by decreased body weight or low body mass index (BMI), which negatively impacts quality of life and life expectancy. Weight loss and BMI were suggested to have independent prognostic value (Martin L et al, JCO 2015). The mGPS (0–2) has independent prognostic value, where patients with mGPS 2 (C-reactive protein levels >10mg/L and albumin levels

Methods

Patients with unresectable stage III/IV NSCLC and cachexia (BMI

Results

At baseline, 36% patients had mGPS 0 (n = 296), 49% mGPS 1 (n = 396) and 15% mGPS 2 (n = 123). Patients who lost 10% body weight, a higher percentage had mGPS 2. Patients with mGPS 2 had on average substantially lower values of body weight, body composition parameters, handgrip strength and anorexia/cachexia and fatigue scores than the other mGPS subgroups (Table).Table:

1392P

Baseline characteristics based on mGPS score
mGPS 0 (n = 296)mGPS 1 (n = 396)mGPS 2 (n = 123)
Body weight loss, n (%) ≤ 10% > 10%205 (43.0) 92 (27.1)218 (45.7) 178 (52.5)54 (11.3) 69 (20.4)
Mean body weight, kg (SD)66.9 (13.66)67.4 (12.73)63.0 (13.77)
Mean lean body mass, kg (SD)44.9 (8.64)46.2 (7.78)44.5 (8.54)
Mean appendicular lean body mass, kg (SD)19.3 (4.59)19.7 (3.95)18.4 (4.25)
Mean fat mass, kg (SD)19.4 (8.06)19.0 (7.80)16.3 (8.01)
Mean handgrip strength, kg (SD)32.2 (11.74)32.7 (10.92)27.2 (9.91)
Mean FAACT Anorexia/Cachexia subscale score (SD)31.6 (7.92)29.5 (8.16)25.5 (8.77)
Mean fatigue subscale score (SD)32.4 (9.74)30.6 (10.21)25.4 (10.95)

FAACT, Functional Assessment of Anorexia/Cachexia Therapy; mGPS, modified Glasgow prognostic score; SD, standard deviation.

Conclusions

While patients with cachexia present mGPS scores that vary from 0–2, a higher percentage of patients with mGPS 2 was observed among those with >10% body weight loss. The baseline characteristics observed in patients with mGPS 2 are worse than in the other mGPS subgroups, suggesting that mGPS may be helpful in identifying patients with more-advanced cachexia.

Clinical trial identification

ROMANA 1: NCT01387269 ROMANA 2: NCT01387282

Legal entity responsible for the study

Helsinn

Funding

Helsinn

Disclosure

B. Laird: Advisory board membership: Chugai Pharma. S. Kaasa: Stock ownership: Eir solutions AS. R. Skipworth: Corporate-sponsored research: Research grant/agreement with Novartis. D. Currow: Unpaid advisory board member for Helsinn. Paid consultant and receive payment for intellectual property with Mayne Pharma and am a consultant with Specialist Therapeutics Australia Pty. Ltd. R. Giorgino: Helsinn Healthcare employee. All other authors have declared no conflicts of interest.