Association of Pre-treatment Sarcopenia with Side Effects and Prognosis in Non-small Cell Lung Cancer Patients Receiving Erlotinib

OpenAlex İngilizce

We investigated the relationship of baseline sarcopenia with toxicities, treatment response, and survival in patients who had non-small cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation and received erlotinib. METHODSComputed tomography images from PET/CT scans before erlotinib treatment were retrospectively assessed.Skeletal muscle index, calculated as skeletal muscle area at third lumbar vertebra level/square of height, was used to define sarcopenia with <52.4 cm 2 /m 2 for males and <38.5 cm 2 /m 2 for females.Cox hazard models were conducted to determine predictors of survival. RESULTSThe study included 30 patients, and 11 (36.7%) were sarcopenic.All-grade and Grade 3 toxicities were more frequent in sarcopenic group, although it was statistically insignificant (81.8% vs. 63.2%,p=0.282 for all-grade, and 18.2% vs. 10.5%, p=0.552 for grade 3).Response rates were 63.6% in sarcopenic and 68.4% in non-sarcopenic patients (p=0.789).Median progression-free survival was 7.9 and 9.2 months in sarcopenic and non-sarcopenic cases, respectively (p=0.561).However, median overall survival (OS) of sarcopenic patients was significantly shorter than non-sarcopenic ones (11.8 vs. 30.2months, p=0.023), and sarcopenia predicted OS independently in multivariate analysis (Hazard ratio=2.63,p=0.029). CONCLUSIONEarly recognition, treatment, and prevention of sarcopenia may improve long-term survival in EGFRmutant NSCLC patients treated with first-line erlotinib.