Abstract 418P
Background
Skeletal muscle wasting potentially represents intriguing predictive markers of treatment response and survival outcomes in lung cancer patients receiving immunotherapy. This study aimed to identify reliable factors could serve as proxies for muscle wasting.
Methods
We retrospectively analyzed a cohort of consecutive advanced non-small cell lung cancer (NSCLC) patients treated with first-line pembrolizumab between June 2018 and September 2021, recruited from three Italian oncology centers (University of Verona, Gemelli University Hospital in Rome, and Parma University Hospital). Data on computed tomography-based body composition, clinical-radiological parameters (e.g., age, sex, BMI, performance status (PS), smoking history, comorbidities, disease stage), and thyroid hormones (fT3 and fT4) were available. A multivariate logistic regression model was developed and used to identify the predictive of outcome.
Results
For the study, 31 patients with NSCLC treated with upfront pembrolizumab were evaluable. The prevalence of muscle wasting was 58.1%. Regression model showed a statistically significant association between muscle wasting and PS (p=0.005) as well as the fT3/fT4 ratio (p=0.0296). Adjusting for PS as a confounder, the fT3/fT4 ratio showed a trend towards significance (p=0.091). ROC analysis identified 2.84 as the optimal cut point that most accurately classifies the fT3/fT4 ratio as low or high risk for muscle atrophy. Among sarcopenic patients, 77.3% had a low ratio vs 14.3% had a high ratio (p=0.006). No significant association in progression-free survival (PFS) was observed for fT3/T4 ratio (p=0.567); however, a significant correlation with overall survival (OS) was found (p=0.032).
Conclusions
The fT3/fT4 ratio, albeit in a small sample, emerged as a potential easy-assessable proxy for muscle wasting linked to poorer response and survival outcomes in NSCLC patients.
Clinical trial identification
Protocol 2193CESC, 2022.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.