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替西罗莫司与人体成分的初步研究。

A pilot study of temsirolimus and body composition.

机构信息

Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,

出版信息

J Cachexia Sarcopenia Muscle. 2013 Dec;4(4):259-65. doi: 10.1007/s13539-013-0113-y. Epub 2013 Jul 27.

Abstract

PURPOSE

Body weight and composition play a role in cancer etiology, prognosis, and treatment response. Therefore, we analyzed the weight, body composition changes, and outcome in patients treated with temsirolimus, an mTor inhibitor that has weight loss as one of its side effects.

PATIENTS AND METHODS

Sixteen patients with advanced solid tumors treated with temsirolimus were studied; body composition was evaluated utilizing computerized tomography images. Sarcopenia was defined as skeletal muscle index lower than 38.5 cm(2)/m(2) for women and 52.4 cm(2)/m(2) for men.

RESULTS

Five of 16 patients (31 %) were men; median age, 60 years. Forty-four percent (7/16) of patients were sarcopenic. Fatigue, anemia, hyperglycemia, and hyperlipidemia were common. Baseline sarcopenia and body composition did not correlate with worse toxicity or treatment outcome. However, there was a trend for greater loss of adipose area (p = 0.07), fat mass (p = 0.09), and adipose index (p = 0.07) for patients with grade 3 or 4 toxicities versus those with grade 1 and 2 side effects.

CONCLUSION

Patients with higher grade toxicities tended to lose more body fat, suggesting a possible end-organ metabolic effect of temsirolimus. These observations merit exploration in a larger cohort of patients.

摘要

目的

体重和身体成分在癌症的病因学、预后和治疗反应中起作用。因此,我们分析了接受雷帕霉素(mTOR 抑制剂)治疗的患者的体重、身体成分变化和结局,该药的副作用之一是体重减轻。

方法

对 16 例接受雷帕霉素治疗的晚期实体瘤患者进行了研究;利用计算机断层扫描图像评估身体成分。定义骨骼肌指数低于女性 38.5 cm(2)/m(2)和男性 52.4 cm(2)/m(2)为肌肉减少症。

结果

16 例患者中 5 例(31%)为男性;中位年龄为 60 岁。44%(7/16)的患者存在肌肉减少症。疲劳、贫血、高血糖和高血脂很常见。基线肌肉减少症和身体成分与更严重的毒性或治疗结局无关。然而,与不良反应 1 级和 2 级相比,3 级或 4 级毒性患者的脂肪面积(p=0.07)、脂肪量(p=0.09)和脂肪指数(p=0.07)丢失趋势更大。

结论

毒性较高的患者往往会失去更多的体脂肪,这表明雷帕霉素可能对终末器官代谢有影响。这些观察结果值得在更大的患者队列中进一步探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1306/3830004/212c3ec24f1d/13539_2013_113_Fig1_HTML.jpg

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