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Weight Loss over Time in Non-Small Cell Lung Cancer: Results from a Landmark Analysis of 800+ Prospectively-Treated Patients

Date

28 Sep 2019

Session

Poster Display session 1

Presenters

Jennifer Le-rademacher

Citation

Annals of Oncology (2019) 30 (suppl_5): v718-v746. 10.1093/annonc/mdz265

Authors

J. Le-rademacher1, C. Lopez1, E. Wolfe1, A. Jatoi2

Author affiliations

  • 1 Health Sciences Research, Mayo Clinic, 55905 - Rochester/US
  • 2 Medical Oncology, Mayo Clinic, 55905 - Rochester/US
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Resources

Abstract 1504

Background

Weight loss prior to cancer treatment carry a negative impact on clinical outcomes. However, few studies have addressed whether weight assessment over time is plagued by high dropout rates and whether weight change carries a prognostic association in the same manner as it does at baseline.

Methods

A pooled analysis of individual patient data was undertaken among non-small cell lung cancer patients who participated in prospective cancer treatment trials from the Alliance for Clinical Trials in Oncology from 1998-2008. This study examined 1) rates of missing weight data over time and 2) the prognostic association of weight beyond baseline assessment.

Results

822 chemotherapy-treated patients were examined. 659 (80%) were still on treatment at the beginning of cycle 2. Weight was available for 656 (80%) patients. However, by cycles 3 and 4, weight was available for only 448 (55%) and 384 (47%) patients, respectively. From baseline to immediately prior to cycle 2, 224 patients (34% of 656) lost more than 2% baseline weight, and 226 (34%) lost between 0 and 2%. With respect to prognostic associations, the median survival time from the beginning of cycle 2 was 6.9, 10.9, and 13.0 months for patients with weight loss of 2% or more, loss of < 2%, and those with weight gain, respectively. In multivariate analyses, after adjustment for age, gender, performance score, type of treatment, and body mass index, weight loss of 2% or more was associated with poor survival compared to weight loss of < 2% (hazard ratio (HR) = 1.57; 95% CI [1.27 to 1.95]; P <.001). Although weight gain was not associated with improved overall survival, it was associated with better progression-free survival outcomes (HR = 0.81; 95% CI [0.66 to 0.99]; P=.04).

Conclusions

Weight is a clinically useful endpoint and should be integrated into cancer cachexia trials because of its ease of frequent measurement and sustained prognostic association.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Fred C and Katherine B Andersen Foundation and the United States National Cancer Institute.

Disclosure

All authors have declared no conflicts of interest.

Resources from the same session

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