Abstract 1618P
Background
Body composition phenotypes may reflect aspects of patients (pts)’ immunology and thereby their ability to respond to immunotherapies. Therefore, our study aimed to describe the pre-treatment body composition profile of pts and explore the possible associations between these parameters and clinical outcomes in non-small-cell lung cancer (NSCLC) pts receiving first-line Pembrolizumab monotherapy.
Methods
A retrospective review of consecutive advanced NSCLC pts treated with Pembrolizumab as first-line therapy at two academic medical institutions from August 2017 to October 2021 was performed. The estimation of skeletal muscle and adipose tissue were performed using pre-treatment computed tomography scans at the level of the third lumbar vertebra, obtaining Skeletal Muscle Area (SMA), Intermuscular Adipose Tissue (IMAT, Subcutaneous Adipose Tissue (SAT), and Visceral Adipose Tissue (VAT). Data were correlated to progression-free/overall survival (PFS/OS) using a Cox and logistic regression model. Log-Rank analysis was used for Kaplan-Meier curves comparison.
Results
Data from 102 pts (median age: 68 years [range 36-85]; median follow-up: 12 months [range 1-131]) were collected. Overall, 52% and 58.8% of pts met established radiographic criteria for evidence of sarcopenia and myosteatosis, respectively, which occur across the BMI spectrum. Median OS was 17.2 months; higher SAT (HR 1.01, 95% CI 1.00-1.02; p=0.017) and higher VAT/SMA ratio (HR 1.48, 95% CI 1.07-2.05; p=0.016) were significantly associated to OS. A ROC curve was constructed to obtain a VAT/SMA ratio cut-off for OS.
Conclusions
Our findings showed that pre-treatment skeletal muscle wasting was often reported in NSCLC patients undergoing Pembrolizumab, across all BMI categories. Besides, our preliminary results support the hypothesis that BC may affect these patients’ survival, suggesting a potential interaction between BC and the immune system. Further analyses are ongoing in this patients’ cohort, to augment knowledge in this field combining biological and clinical features with analytic and preclinical studies.
Clinical trial identification
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.