Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A
ABSTRACT Background Cancer cachexia complicates advanced non‐small cell lung cancer (NSCLC); however, it remains unclear how often cachexia occurs and how it affects the course of chemotherapy in patients receiving first‐line systemic therapy. Methods We conducted a multicentre, prospective observat...
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| Language: | English |
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Wiley
2024-12-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
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| Online Access: | https://doi.org/10.1002/jcsm.13606 |
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| author | Keita Miura Takehito Shukuya Naoki Furuya Ryo Morita Akira Kisohara Atsuto Mouri Satoshi Watanabe Hisashi Tanaka Aya Hirata Taiki Hakozaki Kosuke Hamai Naoko Matsumoto Kana Watanabe Hironori Ashinuma Eisaku Miyauchi Koji Sugano Shinobu Hosokawa Koji Amano Satoshi Morita Kunihiko Kobayashi Makoto Maemonodo Kazuhisa Takahashi |
| author_facet | Keita Miura Takehito Shukuya Naoki Furuya Ryo Morita Akira Kisohara Atsuto Mouri Satoshi Watanabe Hisashi Tanaka Aya Hirata Taiki Hakozaki Kosuke Hamai Naoko Matsumoto Kana Watanabe Hironori Ashinuma Eisaku Miyauchi Koji Sugano Shinobu Hosokawa Koji Amano Satoshi Morita Kunihiko Kobayashi Makoto Maemonodo Kazuhisa Takahashi |
| author_sort | Keita Miura |
| collection | DOAJ |
| description | ABSTRACT Background Cancer cachexia complicates advanced non‐small cell lung cancer (NSCLC); however, it remains unclear how often cachexia occurs and how it affects the course of chemotherapy in patients receiving first‐line systemic therapy. Methods We conducted a multicentre, prospective observational study and enrolled previously untreated NSCLC patients with Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0–2 and cachexia between September 2020 and September 2021. The primary outcome measure was the trends in the Functional Assessment of Anorexia/Cachexia Treatment and Anorexia/Cachexia Subscale [FAACT (A/CS)] scores by cohort. Secondary outcome measures included the incidence of cachexia before the initiation of first‐line systemic therapy, quality of life (QOL) measures, body weight (BW) changes, and efficacy and safety of first‐line systemic therapy. Results A total of 887 consecutive patients with previously untreated advanced NSCLC and ECOG PS of 0–2 who were initiated on first‐line systemic therapy were evaluated. A total of 281 patients (31.7%) experienced BW loss consistent with the criteria of cachexia, and 186 were evaluated for QOL, BW and outcome measurements. Overall, 180/186 patients received first‐line systemic therapy. Cohort 1 (targeted therapy), cohort 2 [cytotoxic chemotherapy (CTx) ± immune checkpoint inhibitors (ICIs)] and cohort 3 (ICIs) included 42, 98 and 40 patients, respectively. There were significant variations in QOL trends by cohort, with chemotherapy‐associated emesis affecting early appetite‐related QOL. The change in the FAACT (A/CS) score at 1 week from baseline was worse in cohort 2 (the least square mean change ± standard error: −3.0 ± 0.9) than in cohorts 1 (1.6 ± 1.2, p = 0.003) and 3 (1.8 ± 1.0, p = 0.002); meanwhile, the change at 6 weeks was worse in cohort 1 (−1.5 ± 1.2) than in cohorts 2 (3.6 ± 0.9, p = 0.001) and 3 (3.5 ± 1.1, p = 0.004). BW reduction was observed in all cohorts within 6 weeks of therapy initiation. The targeted therapy cohort demonstrated superior progression‐free survival (PFS) and overall survival (OS) to CTx ± ICIs cohort or ICIs cohort (median PFS was 9.7 months, 6.3 months, 3.1 months, in cohort 1, 2, 3, respectively (cohort 1 vs. cohort 2: HR, 0.58, p = 0.018; cohort 1 vs. cohort 3: HR, 0.41, p = 0.001); median OS was not reached, 15.8 months, 9.9 months, respectively (cohort 1 vs. cohort 2: HR, 0.52, p = 0.033; cohort 1 vs. cohort 3: HR, 0.37, p = 0.003). Conclusions Approximately 1/3 patients with previously untreated advanced NSCLC have cachexia. Appetite‐related QOL trends vary based on the type of first‐line systemic therapy in cachectic NSCLC patients, and the PFS and OS of these patients seemed to be shorter. |
| format | Article |
| id | doaj-art-2bd96d96f73f40fa8b85b8d8ecdb6499 |
| institution | Kabale University |
| issn | 2190-5991 2190-6009 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj-art-2bd96d96f73f40fa8b85b8d8ecdb64992024-12-12T02:31:37ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092024-12-011562618262810.1002/jcsm.13606Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050AKeita Miura0Takehito Shukuya1Naoki Furuya2Ryo Morita3Akira Kisohara4Atsuto Mouri5Satoshi Watanabe6Hisashi Tanaka7Aya Hirata8Taiki Hakozaki9Kosuke Hamai10Naoko Matsumoto11Kana Watanabe12Hironori Ashinuma13Eisaku Miyauchi14Koji Sugano15Shinobu Hosokawa16Koji Amano17Satoshi Morita18Kunihiko Kobayashi19Makoto Maemonodo20Kazuhisa Takahashi21Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Internal Medicine, Division of Respiratory Medicine St Marianna University School of Medicine Kawasaki JapanDepartment of Respiratory Medicine Akita Kousei Medical Center Akita JapanDepartment of Respiratory Medicine Kasukabe Medical Center Saitama JapanDepartment of Respiratory Medicine, Comprehensive Cancer Center Saitama Medical University International Medical Center Hidaka JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine Hirosaki University Graduate School of Medicine Hirosaki JapanDepartment of Respiratory Medicine Kyorin University School of Medicine Tokyo JapanDepartment of Thoracic Oncology and Respiratory Medicine Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital Tokyo JapanDepartment of Respiratory Medicine Hiroshima Prefectural Hospital Hiroshima JapanDepartment of Respiratory Disease Hiroshima red Cross Hospital & Atomic‐Bomb Survivors Hospital Hiroshima JapanDepartment of Respiratory Medicine Miyagi Cancer Center Miyagi JapanDivision of Respiratory Medicine Chiba Cancer Center Chiba JapanDepartment of Respiratory Medicine Tohoku University Hospital Sendai JapanDivision of Respiratory Medicine Juntendo Tokyo Koto Geriatric Medical Center Tokyo JapanDepartment of Respiratory Medicine Japanese red Cross Okayama Hospital Okayama JapanDepartment of Supportive and Palliative Care Osaka International Cancer Institute Osaka JapanDepartment of Biomedical Statistics and Bioinformatics Kyoto University Graduate School of Medicine Kyoto JapanDepartment of Respiratory Medicine, Comprehensive Cancer Center Saitama Medical University International Medical Center Hidaka JapanDepartment of Medicine, Division of Pulmonary Medicine Jichi Medical University Tochigi JapanDepartment of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo JapanABSTRACT Background Cancer cachexia complicates advanced non‐small cell lung cancer (NSCLC); however, it remains unclear how often cachexia occurs and how it affects the course of chemotherapy in patients receiving first‐line systemic therapy. Methods We conducted a multicentre, prospective observational study and enrolled previously untreated NSCLC patients with Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0–2 and cachexia between September 2020 and September 2021. The primary outcome measure was the trends in the Functional Assessment of Anorexia/Cachexia Treatment and Anorexia/Cachexia Subscale [FAACT (A/CS)] scores by cohort. Secondary outcome measures included the incidence of cachexia before the initiation of first‐line systemic therapy, quality of life (QOL) measures, body weight (BW) changes, and efficacy and safety of first‐line systemic therapy. Results A total of 887 consecutive patients with previously untreated advanced NSCLC and ECOG PS of 0–2 who were initiated on first‐line systemic therapy were evaluated. A total of 281 patients (31.7%) experienced BW loss consistent with the criteria of cachexia, and 186 were evaluated for QOL, BW and outcome measurements. Overall, 180/186 patients received first‐line systemic therapy. Cohort 1 (targeted therapy), cohort 2 [cytotoxic chemotherapy (CTx) ± immune checkpoint inhibitors (ICIs)] and cohort 3 (ICIs) included 42, 98 and 40 patients, respectively. There were significant variations in QOL trends by cohort, with chemotherapy‐associated emesis affecting early appetite‐related QOL. The change in the FAACT (A/CS) score at 1 week from baseline was worse in cohort 2 (the least square mean change ± standard error: −3.0 ± 0.9) than in cohorts 1 (1.6 ± 1.2, p = 0.003) and 3 (1.8 ± 1.0, p = 0.002); meanwhile, the change at 6 weeks was worse in cohort 1 (−1.5 ± 1.2) than in cohorts 2 (3.6 ± 0.9, p = 0.001) and 3 (3.5 ± 1.1, p = 0.004). BW reduction was observed in all cohorts within 6 weeks of therapy initiation. The targeted therapy cohort demonstrated superior progression‐free survival (PFS) and overall survival (OS) to CTx ± ICIs cohort or ICIs cohort (median PFS was 9.7 months, 6.3 months, 3.1 months, in cohort 1, 2, 3, respectively (cohort 1 vs. cohort 2: HR, 0.58, p = 0.018; cohort 1 vs. cohort 3: HR, 0.41, p = 0.001); median OS was not reached, 15.8 months, 9.9 months, respectively (cohort 1 vs. cohort 2: HR, 0.52, p = 0.033; cohort 1 vs. cohort 3: HR, 0.37, p = 0.003). Conclusions Approximately 1/3 patients with previously untreated advanced NSCLC have cachexia. Appetite‐related QOL trends vary based on the type of first‐line systemic therapy in cachectic NSCLC patients, and the PFS and OS of these patients seemed to be shorter.https://doi.org/10.1002/jcsm.13606anorexiacancer cachexianon‐small cell lung cancerquality of life |
| spellingShingle | Keita Miura Takehito Shukuya Naoki Furuya Ryo Morita Akira Kisohara Atsuto Mouri Satoshi Watanabe Hisashi Tanaka Aya Hirata Taiki Hakozaki Kosuke Hamai Naoko Matsumoto Kana Watanabe Hironori Ashinuma Eisaku Miyauchi Koji Sugano Shinobu Hosokawa Koji Amano Satoshi Morita Kunihiko Kobayashi Makoto Maemonodo Kazuhisa Takahashi Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A Journal of Cachexia, Sarcopenia and Muscle anorexia cancer cachexia non‐small cell lung cancer quality of life |
| title | Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A |
| title_full | Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A |
| title_fullStr | Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A |
| title_full_unstemmed | Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A |
| title_short | Impact of Cachexia and First‐Line Systemic Therapy for Previously Untreated Advanced Non‐Small Cell Lung Cancer: NEJ050A |
| title_sort | impact of cachexia and first line systemic therapy for previously untreated advanced non small cell lung cancer nej050a |
| topic | anorexia cancer cachexia non‐small cell lung cancer quality of life |
| url | https://doi.org/10.1002/jcsm.13606 |
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