Department of Nephrology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China.
Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China.
Aging (Albany NY). 2024 Mar 11;16(6):5354-5369. doi: 10.18632/aging.205652.
Cachexia, a multifactorial syndrome, is frequently noticed in cancer patients. A recent study has shown inconsistent findings about the relationship between cachexia and the efficiency of immune checkpoint inhibitors (ICIs). To analyze this disparity, we did a meta-analysis.
From the beginning of each database to July 2023, literature describing the association between cachexia and prognosis of ICI-treated patients with solid malignancies was systematically searched in three online databases. Estimates were pooled, and 95% confidence intervals (CIs) were generated.
We analyzed a total of 12 articles, which included data from 1407 patients. The combined results of our analysis showed that cancer patients with cachexia had significantly worse overall survival (HR = 1.88, 95% CI: 1.59-2.22, < 0.001), progression-free survival (HR = 1.84, 95% CI: 1.59-2.12, < 0.001), and time to treatment failure (HR = 2.15, 95% CI: 1.32-3.50, = 0.002). These findings were consistent in both univariate and multivariate analyses. Additionally, while not statistically significant, we observed a trend towards a lower objective response rate in cancer patients with cachexia compared to those without cachexia (OR = 0.59, 95% CI: 0.32-1.09, = 0.093).
Poor survival in cachexia patients suggests a negative relationship between cachexia and ICI efficacy. In clinical practice, the existence of cachexia should be estimated to choose individuals who may benefit from ICIs.
恶病质是一种多因素综合征，常发生于癌症患者中。最近的一项研究表明，恶病质与免疫检查点抑制剂（ICI）疗效之间的关系存在不一致的发现。为了分析这种差异，我们进行了荟萃分析。
从每个数据库的开始到 2023 年 7 月，系统地在三个在线数据库中搜索描述恶病质与接受固体恶性肿瘤 ICI 治疗患者预后之间关系的文献。对估计值进行汇总，并生成 95%置信区间（CI）。
我们分析了总共 12 篇文章，其中包括 1407 名患者的数据。我们分析的综合结果表明，患有恶病质的癌症患者的总生存期明显更差（HR=1.88，95%CI：1.59-2.22，<0.001），无进展生存期（HR=1.84，95%CI：1.59-2.12，<0.001）和治疗失败时间（HR=2.15，95%CI：1.32-3.50，=0.002）。这些发现无论是在单变量还是多变量分析中都是一致的。此外，尽管没有统计学意义，但我们观察到患有恶病质的癌症患者的客观缓解率低于没有恶病质的患者（OR=0.59，95%CI：0.32-1.09，=0.093）。
恶病质患者的生存较差表明恶病质与 ICI 疗效之间存在负相关。在临床实践中，应该估计恶病质的存在，以选择可能从 ICI 中受益的个体。
