Medical Oncology, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Thorac Cancer. 2019 Feb;10(2):347-351. doi: 10.1111/1759-7714.12965. Epub 2019 Jan 2.
Sarcopenia represents one of the hallmarks of all chronic disease, including non-small cell lung cancer (NSCLC). A computed tomography scan is an easy modality to estimate the skeletal muscle mass through cross-sectional image analysis at the level of the third lumbar vertebra (L3). Baseline skeletal muscle mass (SMM) was evaluated using gender-specific cutoffs for skeletal muscle index in NSCLC patients administered immunotherapy with nivolumab to evaluate its possible correlations with clinical outcomes. From April 2015 to August 2018, 23 stage IV NSCLC patients were eligible for image analysis. Nine patients (39.1%) had low SMM. Among patients with baseline low and non-low SMM, median progression free survival was 3.1 and 3.8 months, respectively (P = 0.0560), while median overall survival was 4.1 and 13 months, respectively (P = 0.2866). This hypothesis-generating preliminary report offers the opportunity to speculate about the negative influence of sarcopenia on immune response. In our opinion, nutritional status could affect the clinical outcomes of immunotherapy, even if we cannot make definitive conclusions here. Further studies on the topic are required.
肌肉减少症是所有慢性疾病（包括非小细胞肺癌）的特征之一。计算机断层扫描是一种通过第三腰椎（L3）的横断面图像分析来估计骨骼肌质量的简单方法。在接受纳武利尤单抗免疫治疗的非小细胞肺癌患者中，使用骨骼肌指数的性别特异性截止值来评估基线骨骼肌质量（SMM），以评估其与临床结局的可能相关性。从 2015 年 4 月至 2018 年 8 月，23 名 IV 期非小细胞肺癌患者符合图像分析条件。9 名患者（39.1%）存在低 SMM。在基线低 SMM 和非低 SMM 的患者中，无进展生存期中位数分别为 3.1 和 3.8 个月（P=0.0560），而总生存期中位数分别为 4.1 和 13 个月（P=0.2866）。这项生成假设的初步报告提供了推测肌肉减少症对免疫反应的负面影响的机会。我们认为，营养状况可能会影响免疫治疗的临床结局，尽管我们不能在此处得出明确的结论。需要进一步研究这一课题。
