Abstract 4159
Background
Weight loss and lean body mass wasting are highly prevalent in NSCLC pts, but frequently underestimated. This study aimed to assess the prevalence of malnutrition and its correlation with outcome in A-NSCLC pts.
Methods
A-NSCLC pts treated at AOUI of Verona (2016-2018) received nutritional counselling by a qualified dietitian. Nutritional Risk Screening (NRS) 2002 was used to estimate the nutritional risk. Bilateral psoas major muscles were measured at L3 vertebrae level with routine staging-computed tomography (CT). Changes in psoas muscles were evaluated using Wilcoxon signed-rank test. Data were correlated to progression-free/overall survival (PFS/OS) and response rate (ORR) using a Cox and logistic regression model. Kaplan-Meier curves were compared with Log-Rank.
Results
Data from 38 pts (20 males [52.6%], 18 females [47.4%]) were gathered, with a median follow-up of 21 months (range 1-197). At baseline, 18.4% were underweight, 18.4% normal weight, 34.2% overweight and 31.6% obese. The majority (65.8%) were at risk of malnutrition (NRS≥3). At multivariate analysis, stage (HR 4.99, 95% CI 1.05-27.74, p = 0.04), performance status (HR 4.99, 95% CI 1.55-16.03, p = 0.007) and NRS (HR 7.61, 95% CI 1.52-38.11, p = 0.01), were significant independent predictors for PFS. Pts with baseline NRS≤3 had significantly longer 1-year PFS (58.6% vs 16.7%, p = 0.04) and 2-year OS (90.6% vs 68.3%, p = 0.03) and a better ORR than those with NRS > 3 (66.7% vs 21.4%). A significant loss in psoas muscle mass was detected in pts treated with both immunotherapy and other therapies (p = 0.01 and p = 0.002, respectively). Of interest, in immunotherapy-treated pts (n = 16) loss in psoas muscle mass correlated with worse ORR, PFS and OS, although differences did not reach a statistical significance.
Conclusions
Malnutrition was common in A-NSCLC pts and associated with poor ORR, PFS and OS. Particularly, in pts treated with immunotherapy, muscle mass wasting seems to impact on efficacy outcome, suggesting a potential interaction between immunological and nutritional parameters. The introduction in clinical routine of a comprehensive nutritional profiling and monitoring is highly recommended in A-NSCLC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
E. Bria: Honoraria (self): MSD, Astra-Zeneca, Celgene, Pfizer, Helsinn, Eli-Lilly, BMS, Novartis, and Roche; Research grant / Funding (self): AIRC-IG 20583. M. Milella: Honoraria (self): Pfizer, EUSA Pharma, AstraZeneca. S. Pilotto: Honoraria (self): Astra-Zeneca, Eli-Lilly, BMS, Boehringer Ingelheim, Roche, MSD and Istituto Gentili; Research grant / Funding (self): AIRC-IG 20583. All other authors have declared no conflicts of interest.
Resources from the same session
1757 - Development of chimeric antigenic receptor (CAR) against VEGFR2 for solid tumor treatment
Presenter: Li-Shuang Ai
Session: Poster Display session 1
Resources:
Abstract
4156 - Triple blockade of EGFR, MEK and PD-L1 as effective antitumor treatment in PD-L1 overexpressing, MEK inhibitor resistant colon cancer cells.
Presenter: Nunzia Matrone
Session: Poster Display session 1
Resources:
Abstract
2949 - EGFR-mediated PD-L1 upregulation in HER2+ breast cancer (BC) cell line models
Presenter: Nicola Gaynor
Session: Poster Display session 1
Resources:
Abstract
4270 - The impact of cortisol on immune cells and its effect on cancer-immune cells co-culture in a 3D spheroid of ovarian cancer
Presenter: Maysa Al-natsheh
Session: Poster Display session 1
Resources:
Abstract
1568 - Application of sonoporation to increase anticancer drug efficacy in 2D and 3D NSCLC cell cultures
Presenter: Vilma Petrikaite
Session: Poster Display session 1
Resources:
Abstract
5400 - Tr1-like cells in human peripheral blood are part of the T effector memory pool and are preferentially stimulated via CD55
Presenter: Iniobong Charles
Session: Poster Display session 1
Resources:
Abstract
5817 - Functional analysis of tumor infiltrating lymphocytes in triple negative breast cancer focusing on granzyme B
Presenter: Hitomi Kawaji
Session: Poster Display session 1
Resources:
Abstract
2287 - Aberrant glycolysis associates with inflammatory tumor microenvironment and promotes metastasis in triple-negative breast cancer
Presenter: Chengwei Lin
Session: Poster Display session 1
Resources:
Abstract
735 - Anti-cancer effects of differentiation-inducing factor-1 in triple negative breast cancer.
Presenter: Fumi Tetsuo
Session: Poster Display session 1
Resources:
Abstract
2105 - The Inhibitory Effect in Oral Squamous Cell Carcinoma Cells by Knocking down Matrix Metalloproteinase 9
Presenter: Xinyan Zhang
Session: Poster Display session 1
Resources:
Abstract