Abstract 1616P
Background
Cancer-associated cachexia is a multifactorial wasting disorder that includes anorexia, involuntary weight loss (WL) and decreased skeletal muscle mass, and is an indicator of poor prognosis. As such, international consensus (IC) diagnostic criteria for cancer cachexia have been proposed (Fearon et al., Lancet Oncol 2011;12:489–95). This systematic literature review (SLR) examined the relationship between cachexia and survival in patients with non-small-cell lung cancer (NSCLC).
Methods
The SLR was conducted following PRISMA guidelines. Embase® and PubMed were searched to identify articles published in English between 1 Jan 2016 and 10 Oct 2021 reporting survival in adults with cancer and cachexia or at risk of cachexia, as defined by IC criteria or a broader definition of any WL. Included publications were of randomized/non-randomized clinical trials and retrospective/prospective observational studies in ≥100 patients with NSCLC.
Results
Forty-two publications in patients with NSCLC met eligibility criteria (41 observational studies; 1 pooled analysis of clinical trials). Included studies were primarily from Europe (40%), Asia (21%) or the United States (19%). Twelve studies (29%) reported cachexia using IC criteria and 30 studies reported either any WL or WL >5%. Four studies reported prevalence of cachexia, which ranged from 5.3% to 48.1%. Thirty-one studies reported prevalence of any WL; of these, 16 studies reported prevalence of WL ≥5% (prevalence range: 7.4%–58.9%). An association between survival and cachexia/WL was assessed across 41 studies that used multivariate (n=34) or univariate (n=7) analyses. Cachexia/WL was associated with a statistically significantly poorer survival in 30 of 34 studies (88.2%) that used multivariate analyses.
Conclusions
This SLR found that less than a third of studies used the IC criteria to identify cachexia in the context of NSCLC. Nonetheless, cachexia/WL was associated with significantly poorer survival in these patients. An awareness of cachexia in NSCLC would allow early implementation of disease management strategies that may improve prognosis in these patients.
Clinical trial identification
The protocol for this study is registered with the PROSPERO database: registration number CRD42022284170.
Editorial acknowledgement
Editorial support was provided by Shirley Smith, PhD, of Engage Scientific Solutions (Envision Pharma Group, Horsham, UK) and was funded by Pfizer. Assistance with database searches, reference screening, and data extraction was provided by Mohd Kashif Siddiqui, MPharm and Lauren Moubarak, MPharm, of Curo (Envision Pharma Group, Horsham, UK) and was funded by Pfizer.
Legal entity responsible for the study
The legal entity responsible for the study is Pfizer.
Funding
The study was sponsored by Pfizer.
Disclosure
P.D. Bonomi: Financial Interests, Personal, Honoraria: Pfizer, Merck, Roche Genentech. J. Crawford: Financial Interests, Personal, Advisory Role: Pfizer, Actimed, Aveo, Faraday. R. Dunne: Financial Interests, Personal, Advisory Board, Honoraria: Helsinn Healthcare, Exelixis. K.E. Smoyer: Financial Interests, Personal, Full or part-time Employment: Envision Pharma Group; Financial Interests, Personal, Stocks/Shares: Envision Pharma Group. T.D. McRae: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer. M.I. Rossulek: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer. J.H. Revkin: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer. L.C. Tarasenko: Financial Interests, Personal, Full or part-time Employment: Pfizer; Financial Interests, Personal, Stocks/Shares: Pfizer.