Malnutrition is frequent, but usually under-recognised in aNSCLC. Pre-treatment nutritional status is an important prognostic factor in aNSCLC patients (pts). However, its value is not yet clarified in those receiving targeted therapies, including tyrosine kinase inhibitors (TKIs). The aim of the present study was to define an algorithm for early identification of malnourished pts with oncogene-addicted aNSCLC.
In 49 aNSCLC oncogene-addicted pts (EGFR mutated or other as ALK, ROS1, BRAF mut), a nutritional screening was performed before starting TKIs therapy. Body mass index (BMI; kg/m2), handgrip strength (kg), previous 6-months weight changes (%), albumin levels (g/dl) and Prognostic Nutritional Index-PNI (10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3) were collected). Correlations between the nutritional parameters and the clinicopathological characteristics were analysed using Student’s t-test.
Patients’ characteristics were as follows: median age (range) 67 y (35-84); male/female 12/37; EGFR/ALK/ROS1/BRAF addiction 32/8/6/3; BMI ≤18.5/18.5-24.9/>25 3/32/14. Focusing only patients with normal BMI (18.5-24.9, G1) vs those with high BMI (>25, G2), mean (SD) handgrip strength was 22.8 kg (6.8) vs 28.2 kg (11.1) (p=0.05); mean 6-month weight change was -4.1 kg (6.5) vs +7.2 kg (12.1) (p<0.001); mean albumin levels were 3.5 (0.5) vs 3.2 g/dl (0.4) (p=0.05); mean Prognostic Nutritional Index (PNI) score was 34.9 (5.3) vs 31.7 (3.6) (p=0.05). Grouping pts according to tumor mutation (EGFR vs other), mean BMI was 22.3 (4.1) vs 25.4 (6.3) (p=0.04); mean 6-months weight change was -3.5 kg (9.5) vs +3.4 kg (10.2) (p=0.02). Pts with mutation other than EGFR presented more frequently BMI >25: 9/15 (60%) vs 5/31 (16.1%) (p=0.01). Pts with BMI>25 presented higher functional index (handgrip), higher 6-month weight gain and were less frequently EGFR mutated. Furthermore, they had lower albumin levels and PNI scores.
According to our preliminary data, aNSCLC oncogene-addicted pts with BMI>25, despite having higher functional indexes, had worse nutritional parameters and may benefit from full nutritional assessment and counselling to prevent sarcopenic obesity.
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Has not received any funding.
E. Capelletto: Non-Financial Interests, Institutional, Advisory Board: Boehringer Ingelheim; Non-Financial Interests, Institutional, Advisory Board: AstraZeneca; Non-Financial Interests, Institutional, Advisory Board: MSD. M.L. Reale: Other, Institutional, Advisory Board: Eli Lilly; Other, Institutional, Advisory Board: Boehringer Ingelheim. M. Tampellini: Other, Speaker’s Bureau: Merck; Other, Advisory Board: Amgen; Other, Speaker’s Bureau: Sanofi; Other, Advisory Board: MSD; Other, Speaker’s Bureau: Servier. S. Novello: Other, Advisory Board: AstraZeneca; Other, Advisory Board: Boehringer Ingelheim; Other, Advisory Board: BeiGene; Other, Advisory Board: Eli Lilli; Other, Speaker’s Bureau: Takeda; Other, Expert Testimony: Pfizer; Other, Expert Testimony: Roche; Other, Speaker’s Bureau: Amgen; Other, Speaker’s Bureau: Sanofi; Other, Speaker’s Bureau: BMS; Other, Expert Testimony: MSD. All other authors have declared no conflicts of interest.