Abstract 72P
Background
Chemotherapy-induced toxicities commonly occur in non-small cell lung cancer (NSCLC) patients treated with platinum-based chemotherapy. In several cancer types, low skeletal muscle mass (SMM) has been associated with a higher incidence of dose-limiting toxicities (DLT). Aim of this study was to evaluate the association between both low SMM and low skeletal muscle density (SMD) and chemotherapy-induced toxicity in NSCLC patients.
Methods
A multicentre prospective follow-up study (PGxLUNG study) was conducted. NSCLC patients (stage II-IV) treated with first-line platinum-based chemotherapy with pre-treatment imaging being available, were included. Skeletal muscle mass area (SMA) segmentation was performed on abdominal imaging at the level of L3 and corrected for squared height to yield the lumbar skeletal muscle mass index (LSMI). SMD was calculated as the mean Hounsfield Unit (HU) of the segmented SMA. SMM and SMD were categorized as low, intermediate and high, based on LSMI and HU tertiles. Toxicity was defined as haematological toxicity, non-haematological toxicity and DLT. The relationship between SMM, SMD and toxicity was assessed with logistic regression modelling.
Results
In total, 297 patients were included of which 84.8% developed any haematological toxicity, 63.3% any non-haematological toxicity, and 55.6% any DLT. Low SMM (ORadj 2.86, 95%CI 1.13-7.24), low SMD (ORadj 2.88, 95%CI 1.06-7.80) and age at diagnosis >65 years (ORadj 3.26, 95%CI 1.58-6.71) were statistically significantly associated with chemotherapy-induced overall haematological toxicity. Low SMM (ORadj 2.23, 95%CI 1.23-4.04) and high SMD (ORadj 0.41, 95%CI 0.23-0.74) were statistically significantly associated with a higher respectively lower risk of DLT.
Conclusions
NSCLC patients with pretreatment low SMM or low SMD are at significant higher risk for chemotherapy-induced haematological toxicities and DLT. Further studies should be aimed to investigate whether platinum dosing based on SMM and/or improvement of pre-treatment SMM could reduce the risk of toxicity without compromising efficacy.
Clinical trial identification
NTR: NL5373610015.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.