800P - Impact of body composition on treatment toxicities in patients with metastatic prostate cancer treated with docetaxel

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Supportive Care
Prostate Cancer
Presenter Samantha Cushen
Citation Annals of Oncology (2014) 25 (suppl_4): iv255-iv279. 10.1093/annonc/mdu336
Authors S. Cushen1, A.M. Ryan2, M. Lim3, R. McDermott3, D.G. Power4
  • 1Food & Nutritional Sciences, University College Cork, 0000 - Cork/IE
  • 2Food & Nutritional Sciences, University College Cork, Cork/IE
  • 3Dept. Of Medical Oncology, Adelaide & Meath Hospital incorporating National Children's Hospital, Dublin/IE
  • 4Medical Oncology, Mercy University Hospital, Cork/IE

Abstract

Aim

Body composition is an important prognostic factor in cancer patients (pts) and evidence for a strong link between low skeletal muscle mass (sarcopenia) and chemotherapy toxicity is increasing. Docetaxel is standard first line treatment for castrate resistant prostate cancer (CRPC). The aim of this study was to correlate body composition (by computed tomography) with toxicity to docetaxel in CRPC.

Methods

Pts with CRPC who received docetaxel between 2008 - 2013 were included. Correlations between pt characteristics, body composition and toxicity to chemotherapy were analyzed. Sarcopenia was defined using published cut offs. Toxicity was assessed using Common Terminology Criteria for Adverse Effects v4.0.

Results

62 pts, mean age 69y (SD 7), were included. In total 73% of pts were overweight or obese (BMI > 25kg/m2). Sarcopenia was present in 68% (n = 42) and of these 28 (66.6%) were both sarcopenic and overweight or obese. Sarcopenic pts were older (71 vs. 65y, p < 0.001) and had a lower BMI (26.6 vs. 30.9kg/m2, p < 0.001) compared to non-sarcopenic pts. Grade 3-4 toxicity was seen in 23% (n = 14) of pts during the first 3 cycles of treatment, the most common being fatigue (48%), pain (23%) and anaemia (19%). There was no effect of sarcopenia, defined using published cutoffs on toxicity, however, pts with a skeletal muscle index (SMI) < 25th centile (45cm2/m2) received less treatment compared to pts with a SMI > 75th centile (89 days vs 159 days, p = 0.056). When we analysed the drug dose according to SMI (cm2/m2), 31% of pts receiving a drug dose >75th centile (1.98mg/SMI) experienced neutropenia in the first 3 cycles vs 0% receiving a dose <25th centile (1.347mg/SMI;p = 0.048). A high BMI was associated with better survival, BMI >25kg/m2:722 days vs 327 days for BMI <25kg/m2. CRP was also prognostically significant, with values >75th centile (133mg/dl) having a shorter survival compared to pts with CRP < 75th centile (150 vs. 661 days; p= 0.01).

Conclusions

Sarcopenia is highly prevalent in pts with CRPC receiving docetaxel but is masked by excessive adiposity. Very low skeletal muscle mass is associated with less treatment days and poor tolerance to chemotherapy. High BMI is associated with longer survival.

Disclosure

All authors have declared no conflicts of interest.