Taoka Masataka, Ichihara Eiki, Yokoyama Toshihide, Inoue Koji, Tamura Tomoki, Sato Akiko, Oda Naohiro, Kano Hirohisa, Nakamura Kayo, Kawai Haruyuki, Inoue Masaaki, Ochi Nobuaki, Fujimoto Nobukazu, Ichikawa Hirohisa, Ando Chihiro, Oze Isao, Kiura Katsuyuki, Maeda Yoshinobu, Hotta Katsuyuki
Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Center for Clinical Oncology, Okayama University Hospital, Okayama 700-8558, Japan.
Cancers (Basel). 2024 Dec 6;16(23):4089. doi: 10.3390/cancers16234089.
Limited data are available on the frequency and significance of body weight loss during cancer therapy. This study investigated the frequency of patients who experienced body weight loss during immune checkpoint inhibitor (ICI) plus chemotherapy for advanced non-small cell lung cancer (NSCLC) and the impact of weight loss on treatment outcomes. Using the clinical data of 370 patients with NSCLC who received a combination of ICI and chemotherapy at 13 institutions, this study investigated the frequency of body weight loss > 5% during treatment and determined the impact of body weight loss on patient outcomes. Of the 370 included patients, 141 (38.1%) lost more than 5% of their body weight during ICI plus chemotherapy (WL group). The 2-month landmark analysis showed that patients who experienced body weight loss of >5% during treatment had worse overall survival (OS) and progression-free survival (PFS) than those who did not (OS 14.0 and 31.1 months in the WL non-WL groups, respectively, < 0.001; PFS 6.8 and 10.9 months in the WL non-WL groups, respectively, = 0.002). Furthermore, a negative impact of body weight loss on survival was observed even in those who had obesity (body mass index [BMI] ≥ 25.0) at the start of therapy (OS 12.8 and 25.4 months in the WL non-WL groups, respectively, < 0.001; PFS 5.7 and 10.7 months in the WL non-WL groups, respectively, = 0.038). In conclusion, weight loss of >5% during ICI plus chemotherapy negatively influenced patient outcomes. Further and broader studies should investigate the role of nutritional status, specifically weight change and nutritional support, in responsiveness to ICI plus chemotherapy.
关于癌症治疗期间体重减轻的频率及意义，现有数据有限。本研究调查了晚期非小细胞肺癌（NSCLC）患者在接受免疫检查点抑制剂（ICI）联合化疗期间体重减轻的频率，以及体重减轻对治疗结果的影响。本研究利用13家机构中370例接受ICI与化疗联合治疗的NSCLC患者的临床数据，调查了治疗期间体重减轻>5%的频率，并确定了体重减轻对患者预后的影响。在纳入的370例患者中，141例（38.1%）在ICI联合化疗期间体重减轻超过5%（体重减轻组）。2个月的标志性分析显示，治疗期间体重减轻>5%的患者的总生存期（OS）和无进展生存期（PFS）比未减轻体重的患者更差（体重减轻组和非体重减轻组的OS分别为14.0个月和31.1个月，<0.001；体重减轻组和非体重减轻组的PFS分别为6.8个月和10.9个月，=0.002）。此外，即使在治疗开始时患有肥胖症（体重指数[BMI]≥25.0）的患者中，也观察到体重减轻对生存有负面影响（体重减轻组和非体重减轻组的OS分别为12.8个月和25.4个月，<0.001；体重减轻组和非体重减轻组的PFS分别为5.7个月和10.7个月，=0.038）。总之，ICI联合化疗期间体重减轻>5%对患者预后有负面影响。应开展进一步的更广泛研究，调查营养状况，特别是体重变化和营养支持，在对ICI联合化疗的反应中的作用。
