Body composition and checkpoint inhibitor treatment outcomes in advanced melanoma: a multicenter cohort study
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Le résumé fourni par la source
Abstract Introduction The association of body composition with checkpoint inhibitor outcomes in melanoma is a matter of ongoing debate. In this study, we aim to add to previous evidence by investigating body mass index (BMI) alongside CT derived body composition metrics in the largest cohort to date. Method Patients treated with first-line anti-PD1 ± anti-CTLA4 for advanced melanoma were retrospectively identified from 11 melanoma reference centers in The Netherlands. Age, sex, Eastern Cooperative Oncology Group performance status, serum lactate dehydrogenase, presence of brain and liver metastases, number of affected organs and BMI at baseline were extracted from electronic patient files. From baseline CT scans, five body composition metrics were automatically extracted: skeletal muscle index, skeletal muscle density, skeletal muscle gauge, subcutaneous adipose tissue index and visceral adipose tissue index. All predictors were correlated in uni- and multivariable analysis to progression-free, overall and melanoma-specific survival (PFS, OS and MSS) using Cox proportional hazards models. Results A total of 1471 eligible patients were included. Median PFS and OS were 8.8 and 34.8 months, respectively. A significantly worse PFS was observed in underweight patients (multivariable HR=1.87, 95% CI 1.14–3.07). Furthermore, better OS was observed in patients with higher skeletal muscle density (multivariable HR=0.91, 95% CI 0.83-0.99) and gauge (multivariable HR=0.88, 95% CI 0.84-0.996), and a worse OS with higher visceral adipose tissue index (multivariable HR=1.13, 95% CI 1.04-1.22). No association with survival outcomes was found for overweightness or obesity and survival outcomes, or for subcutaneous adipose tissue. Discussion Our findings suggest that underweight BMI is associated with worse PFS, whereas higher skeletal muscle density and lower visceral adipose tissue index were associated with better OS. These associations were independent of previously identified predictors, including sex, age, performance status and extent of disease. No significant association between higher BMI and survival outcomes was observed.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Body composition and checkpoint inhibitor treatment outcomes in advanced melanoma: a multicenter cohort study
- Date Crossref
- 02/03/2024
- Éditeur
- openRxiv
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Utrecht University pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Utrecht Image Sciences Institute pays non établi dans la noticeÉtablissement de santé
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The Netherlands Cancer Institute Department of Medical Oncology pays non établi dans la noticeÉtablissement de santé
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Zuyderland Medisch Centrum pays non établi dans la noticeÉtablissement de santé
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Radboud University Nijmegen Department of Medical Oncology pays non établi dans la noticeUniversité ou école supérieure
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Radboud University Medical Center pays non établi dans la noticeOrganisme public
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Isala pays non établi dans la noticeÉtablissement de santé
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Leiden University Medical Center Department of Medical Oncology pays non établi dans la noticeOrganisme public
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Cancer Institute (WIA) pays non établi dans la noticeÉtablissement de santé
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Centre Hospitalier Universitaire Vaudois pays non établi dans la noticeÉtablissement de santé
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University Medical Center Groningen pays non établi dans la noticeÉtablissement de santé
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University of Groningen pays non établi dans la noticeUniversité ou école supérieure
Utrecht University, Image Sciences Institute — University Medical Center Utrecht et Department of Medical Oncology — The Netherlands Cancer Institute, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.