Author of

• 18973

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  P2.01 - Advanced NSCLC (ID 618)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)

  • 23171

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    P2.01-048 - Early Changes in Body Composition in Metastatic Non-Small Cell Lung Cancer (NSCLC) Are Predictive for Poor Overall Survival (ID 10236)

    09:00 - 16:00  |  Author(s): J.H.R.J. Degens
    • Abstract

    Background:
    Weight loss adversely affects prognosis in metastatic NSCLC. However, the pattern of changes in muscle mass and adipose tissue during first cycle of chemotherapy and their relation to survival is unclear. Therefore, we analyzed changes in muscle cross-sectional area (CSA), inter- and intramuscular adipose tissue (IMAT), subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) on CT-images after three weeks of chemotherapy in patients with metastatic NSCLC and their influence on overall survival (OS).
    
    Method:
    In this post-hoc analysis of a subset of the randomized controlled NVALT12 trial (NCT01171170 [1]), body composition was characterized by CSA and distribution of both muscle and adipose tissue at the third lumbar level on CT-images obtained at baseline and three weeks after start of chemotherapy. Changes in body composition parameters were related to OS with Kaplan Meier and log-rank test. Cox multivariate analysis was performed to assess the relative contribution of muscle and adipose tissue CSA and distribution to OS.
    
    Result:
    Data were available of 103 patients. Cox regression analysis showed that loss of muscle CSA and IMAT independently affected survival while change in SAT and VAT did not. 74 patients (72%) exhibited muscle loss (group 1) versus 29 patients (28%) who had stable or gain of muscle CSA (group 2). Groups were comparable regarding age, WHO PS, TNM status, and Charlson comorbidity index. Median OS (95% CI) was 10.0 (7.9-12.2) months in group 1 and 15.3 (11.1-19.5) months in group 2 (p=0.004). Among muscle losing patients two sub-groups were distinguished based on IMAT change. Loss of muscle mass combined with loss of IMAT (group 1a, n=33) also showed significant loss of SAT and lower survival rates compared to loss of muscle mass with preserved IMAT (group 1b, n=40). Median OS (95% CI) was 7.3 (5.0-9.5) months in group 1a compared to 12.9 (9.2-16.6) months (p<0.001) in group 1b.
    
    Conclusion:
    Early changes in body composition patterns during the first cycle of chemotherapy in metastatic NSCLC are predictive for OS and might be useful for more personalised supportive intervention during follow-up treatment. Reference 1. Dingemans AM, Groen HJ, Herder GJ et al. A randomized phase II study comparing paclitaxel-carboplatin-bevacizumab with or without nitroglycerin patches in patients with stage IV nonsquamous nonsmall-cell lung cancer: NVALT12 (NCT01171170)dagger. Ann Oncol 2015; 26: 2286-2293.