Xue Dinglong, Li Ning, Yang Jiaxin, Men Kaiya, Li Lijun, Jiang Hao, Zhao Xu, Zhang Shuai
Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
Front Oncol. 2024 Sep 23;14:1450020. doi: 10.3389/fonc.2024.1450020. eCollection 2024.
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of a number of patients with advanced cancer, and while this has resulted in increased survival times, it has also led to the emergence of novel immune-related adverse events (irAEs). In individuals with advanced cancer, sarcopenia is a significant symptom of cachexia and is linked to poor nutritional status and increased mortality. The present study aimed to evaluate sarcopenia and other risk variables that can affect the emergence of irAEs in patients with lung cancer.
A single-center retrospective analysis of 129 patients with advanced lung cancer treated with programmed cell death protein-1 (PD-1)/programmed cell death ligand-1 (PD-L1) checkpoint inhibitors was conducted from August 2020 to August 2022. Data on baseline characteristics and adverse events of participants were collected. Computed tomography was used to determine the skeletal muscle index at the third lumbar vertebra (L3-SMI) and whether sarcopenia is present.
The median age of all participants was 60 years old (range, 52-66 years), with men accounting for 68.9% of the total patient cohort. The present study showed that 44 (34%) participants presented with any degree of irAEs, and 79 (61.2%) patients presented with sarcopenia. There were no statistically significant differences in baseline characteristics, such as age and sex, between patients who presented with irAEs and those without irAEs. Using logistic regression analysis, individuals with sarcopenia were 2.635-times more likely to experience any grade of irAEs than those without sarcopenia.
irAEs are prevalent side effects of PD-1/PD-L1 inhibitor therapy for patients with cancer. By diagnosing and treating sarcopenia early, it is possible to lower the potential risk of irAEs in patients with advanced cancer. Furthermore, sarcopenia can be utilized as a predictor of irAEs.
免疫检查点抑制剂（ICIs）彻底改变了许多晚期癌症患者的治疗方式，虽然这使得生存时间延长，但也导致了新型免疫相关不良事件（irAEs）的出现。在晚期癌症患者中，肌肉减少症是恶病质的一个重要症状，与营养状况不佳和死亡率增加有关。本研究旨在评估肌肉减少症以及其他可能影响肺癌患者发生irAEs的风险变量。
对2020年8月至2022年8月期间接受程序性细胞死亡蛋白1（PD-1）/程序性细胞死亡配体1（PD-L1）检查点抑制剂治疗的129例晚期肺癌患者进行单中心回顾性分析。收集参与者的基线特征和不良事件数据。使用计算机断层扫描确定第三腰椎的骨骼肌指数（L3-SMI）以及是否存在肌肉减少症。
所有参与者的中位年龄为60岁（范围52-66岁），男性占患者总数的68.9%。本研究表明，44例（34%）参与者出现任何程度的irAEs，79例（61.2%）患者存在肌肉减少症。出现irAEs的患者与未出现irAEs的患者在年龄和性别等基线特征方面无统计学显著差异。使用逻辑回归分析，存在肌肉减少症的个体发生任何等级irAEs的可能性是没有肌肉减少症个体的2.635倍。
irAEs是癌症患者接受PD-1/PD-L1抑制剂治疗的常见副作用。通过早期诊断和治疗肌肉减少症，有可能降低晚期癌症患者发生irAEs的潜在风险。此外，肌肉减少症可用作irAEs的预测指标。
