Introduction: Muscle wasting has detrimental effects, including increased mortality. Identifying patients at risk can guide treatment efforts. Methods: POWER 1 and 2 were randomized, double‐blind, placebo‐controlled, multinational phase III trials that studied 600 patients with lung cancer at the start of chemotherapy; the studies' aim was to assess the efficacy of enobosarm on prevention and treatment of muscle loss. We performed a secondary analysis restricted to the control group, using a cumulative logit model for ordinal outcome to determine which baseline characteristics predicted physical and functional loss during chemotherapy. Results: In all, 53% of patients had loss of lean body mass and 49% had loss of stair climb power (SCP) at day 84 of treatment. Of the 322 patients who received placebo, 232 with observable outcome and baseline covariates were included for lean body mass analysis and 236 for SCP analysis. More advanced disease predicted a higher probability of greater physical loss (OR = 1.96; 95% confidence interval [CI]: 1.14–3.36). Three factors predicted higher probability of SCP loss: taxane chemotherapy (OR = 1.73; 95% CI: 1.06–2.83), tobacco use before chemotherapy (OR = 2.15, 95% CI: 1.10–4.18), and SCP at baseline (OR = 1.01, 95% CI: 1.004–1.015). Higher body mass index was a protective factor for functional loss (OR = 0.85; 95% CI: 0.73–0.98). A higher Eastern Cooperative Oncology Group Performance Status trended toward being predictive of greater probability of both physical loss (0.767) and functional loss (0.070), but the results were not statistically significant. Conclusions: Approximately 50% of patients with advanced lung cancer who were undergoing chemotherapy had ongoing loss of muscle mass and muscle function. Advanced stage predicted physical loss. Tobacco use and taxane chemotherapy predicted functional loss. Body mass index was a protective factor for functional loss. We identified predictors of physical and functional loss that could be used as therapeutic targets or to guide treatment efforts.

中文翻译：

---

接受铂类化疗的晚期肺癌患者身体和功能丧失的预测因素

简介：肌肉萎缩具有不利影响，包括死亡率增加。识别有风险的患者可以指导治疗工作。方法：POWER 1 和 2 是随机、双盲、安慰剂对照、多国 III 期试验，研究了 600 名化疗开始时的肺癌患者；这些研究的目的是评估 enobosarm 在预防和治疗肌肉损失方面的功效。我们对对照组进行了二次分析，使用顺序结果的累积 logit 模型来确定哪些基线特征预测了化疗期间的身体和功能丧失。结果：总共有 53% 的患者在治疗的第 84 天失去了瘦体重，49% 的患者失去了爬楼梯能力 (SCP)。在接受安慰剂的 322 名患者中，232 个具有可观察结果和基线协变量的结果被包括用于瘦体重分析，236 个用于 SCP 分析。疾病越晚期，身体损失越大的可能性越大（OR = 1.96；95% 置信区间 [CI]：1.14–3.36）。三个因素预测 SCP 丢失的可能性更高：紫杉烷化疗（OR = 1.73；95% CI：1.06-2.83）、化疗前吸烟（OR = 2.15，95% CI：1.10-4.18）和基线时的 SCP（OR = 1.01，95% 置信区间：1.004–1.015）。较高的体重指数是功能丧失的保护因素（OR = 0.85；95% CI：0.73–0.98）。较高的东部肿瘤合作小组表现状态倾向于预测身体损失 (0.767) 和功能损失 (0.070) 的可能性更大，但结果没有统计学意义。结论：大约 50% 接受化疗的晚期肺癌患者的肌肉质量和肌肉功能持续丧失。高级阶段预测身体损失。烟草使用和紫杉烷化疗可预测功能丧失。体重指数是功能丧失的保护因素。我们确定了可用作治疗目标或指导治疗工作的身体和功能丧失的预测因素。