Affiliation:
1. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine Kurume University School of Medicine Fukuoka Japan
2. Biostatistics Center Kurume University School of Medicine Fukuoka Japan
3. Department of Diagnostic Pathology Kurume University Hospital Fukuoka Japan
4. Cancer Vaccine and Immunotherapy Center and Division of Cancer Immunotherapy Kanagawa Cancer Center Research Institute Kanagawa Japan
Abstract
AbstractBackgroundThe presence of cachexia negatively impacts the prognosis of patients with cancer. However, the mechanisms behind the development of cachexia and its prognostic impact on immunotherapy efficacy are not fully understood.Materials and MethodsWe retrospectively screened patients with advanced or recurrent non‐small cell lung cancer (NSCLC) who received PD‐1/PD‐L1 inhibitor monotherapy. Among 183 patients, pre‐treatment plasma samples were available from 100 patients. We defined cancer cachexia as weight loss of at least 5% during the past 6 months or weight loss of at least 2% and BMI <20. We analyzed 75 soluble immune mediators in pre‐treatment plasma samples to explore the possible mechanisms behind the development of cancer cachexia. We also investigated whether cancer cachexia affects prognosis.ResultsAmong 100 patients, 35 had cancer cachexia. Logistic regression analysis identified ghrelin, c‐reactive protein (CRP), pentraxin‐3 (PTX‐3), and osteopontin (OPN) as factors associated with cachexia. Patients with cachexia had worse progression‐free survival (PFS) and overall survival (OS), although we did not detect statistically significant differences. Analyzing the soluble immune mediators associated with cachexia, the combination of cachexia and PTX‐3 or OPN expression levels was predictive for PFS and the combination of cachexia and CRP or OPN expression levels was predictive for OS.ConclusionsPre‐treatment ghrelin, CRP, PTX‐3, and OPN may be associated with cachexia. Among patients with NSCLC who received PD‐1/L1 inhibitor monotherapy, those with cachexia had worse survival than those without cachexia. Larger studies will be required to confirm our data and better understand the mechanisms behind the development of cachexia.
Funder
Japan Agency for Medical Research and Development
Subject
Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology