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Impact of weight loss on treatment with PD-1/PD-L1 inhibitors plus chemotherapy in advanced non-small-cell lung cancer.
Supportive Care in Cancer ( IF 3.1 ) Pub Date : 2021-09-22 , DOI: 10.1007/s00520-021-06572-4
Taichi Miyawaki 1, 2 , Tateaki Naito 1 , Michitoshi Yabe 1 , Hiroaki Kodama 1 , Naoya Nishioka 1 , Eriko Miyawaki 1 , Nobuaki Mamesaya 1 , Haruki Kobayashi 1 , Shota Omori 1 , Kazushige Wakuda 1 , Akira Ono 1 , Hirotsugu Kenmotsu 1 , Haruyasu Murakami 1 , Keita Mori 3 , Hideyuki Harada 4 , Kazuhisa Takahashi 2 , Toshiaki Takahashi 1
Affiliation  

PURPOSE Programmed cell death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors plus chemotherapy have become the standard first line of treatment in patients with advanced non-small-cell lung cancer (NSCLC). However, few studies have explicitly focused on the impact of weight loss on the efficacy of PD-1/PD-L1 inhibitors plus chemotherapy. Thus, we evaluated the clinical implications of weight loss on the survival outcomes in patients who received this treatment. METHODS We conducted a retrospective review of medical records of patients with advanced NSCLC who were treated with PD-1/PD-L1 inhibitors plus chemotherapy from December 2018 to December 2020. Significant weight loss was defined as an unintentional weight loss of 5% or more over 6 months. We evaluated the progression-free survival (PFS) and overall survival (OS) of patients with or without weight loss. RESULTS Among the 80 included patients, 37 (46%) had weight loss, and were associated with a lower objective response rate (30 vs 51%, P < 0.05), poorer PFS (2.3 vs 12.0 months, P < 0.05), and poorer OS (10.8 vs 23.9 months, P < 0.05) than those without weight loss. The Cox proportional-hazard ratios (95% confidence interval) of weight loss were 1.77 (1.01-3.10) for PFS and 2.90 (1.40-6.00) for OS, with adjustments for Eastern Cooperative Oncology Group performance status, PD-L1 tumour proportion score, histology, and central nervous system metastases. CONCLUSION Pre-treatment weight loss may reduce treatment efficacy and shorten survival time in patients receiving PD-1/PD-L1 inhibitors plus chemotherapy. Early evaluation and intervention for weight loss might improve oncological outcomes in patients with advanced NSCLC.

中文翻译:

体重减轻对 PD-1/PD-L1 抑制剂加化疗治疗晚期非小细胞肺癌的影响。

目的 程序性细胞死亡-1 (PD-1)/程序性死亡配体 1 (PD-L1) 抑制剂加化疗已成为晚期非小细胞肺癌 (NSCLC) 患者的标准一线治疗。然而,很少有研究明确关注体重减轻对 PD-1/PD-L1 抑制剂加化疗疗效的影响。因此,我们评估了体重减轻对接受这种治疗的患者生存结果的临床意义。方法 我们对 2018 年 12 月至 2020 年 12 月期间接受 PD-1/PD-L1 抑制剂联合化疗的晚期 NSCLC 患者的病历进行回顾性分析。显着体重减轻定义为非故意体重减轻 5% 或更多超过 6 个月。我们评估了体重减轻或不减轻患者的无进展生存期(PFS)和总生存期(OS)。结果 在纳入的 80 名患者中,37 名(46%)体重减轻,并与较低的客观缓解率(30 vs 51%,P < 0.05)、较差的 PFS(2.3 vs 12.0 个月,P < 0.05)和与没有体重减轻的人相比,OS 较差(10.8 个月 vs 23.9 个月,P < 0.05)。体重减轻的 Cox 比例风险比(95% 置信区间)PFS 为 1.77(1.01-3.10),OS 为 2.90(1.40-6.00),并根据东部肿瘤协作组的体能状态、PD-L1 肿瘤比例评分进行了调整、组织学和中枢神经系统转移。结论 接受PD-1/PD-L1抑制剂联合化疗的患者治疗前体重减轻可能会降低治疗效果并缩短生存时间。
更新日期:2021-09-22
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