Prognostic Role of Pre-Treatment Body Composition Parameters in Patients Undergoing First-Line Immunotherapy for Metastatic Renal Cell Carcinoma.

IF 2.5 4区医学 Q3 ONCOLOGY

Cancer Management and Research Pub Date : 2024-08-28 eCollection Date: 2024-01-01 DOI:10.2147/CMAR.S476150

Sangmin Lee, Jae-Hun Kim, Wan Song, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Se Hoon Park, Ji Hyun Lee, Jiwoong Yu, Minyong Kang

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Abstract

Purpose: We investigated the relationship between body mass index (BMI), radiological body composition, and survival outcomes in patients with metastatic renal cell carcinoma (mRCC) underwent first-line immune checkpoint inhibitor (ICI)-based therapy.

Methods: Analyzing data from 102 patients treated between November 2019 and March 2023, pre-treatment computed tomography (CT) scans assessed fat and muscle areas. BMI and body composition indices were examined, including skeletal muscle index, subcutaneous fat index (SFI), visceral fat index, and total fat index. Kaplan-Meier curves and Log rank tests compared progression-free survival (PFS) and overall survival (OS), while multivariable Cox proportional regression analysis was performed to identify the variables significantly associated with survival outcomes.

Results: 54 patients (52.9%) experienced disease progression, and 26 (25.5%) died during a median follow-up of 17.4 months. High SFI was significantly associated with improved OS (p = 0.018) but not PFS (p = 0.090). Multivariable analysis confirmed the positive impact of high SFI on OS (adjusted HR: 0.37, p = 0.029) and suggested a trend towards improved PFS (adjusted HR: 0.61, p = 0.088). Notably, in the ipilimumab + nivolumab subgroup, high SFI significantly correlated with both PFS and OS (p = 0.047 and p = 0.012, respectively).

Conclusion: High SFI predicts favorable OS in patients with mRCC receiving first-line ICI-based therapy, especially patients treated with ipilimumab + nivolumab displayed a significant association between high SFI and favorable PFS and OS.

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接受一线免疫疗法治疗转移性肾细胞癌患者治疗前身体成分参数的预后作用

目的：我们研究了接受一线免疫检查点抑制剂（ICI）治疗的转移性肾细胞癌（mRCC）患者的体重指数（BMI）、放射学身体成分和生存结果之间的关系：分析2019年11月至2023年3月期间接受治疗的102名患者的数据，治疗前计算机断层扫描（CT）评估脂肪和肌肉面积。检查了体重指数和身体成分指数，包括骨骼肌指数、皮下脂肪指数（SFI）、内脏脂肪指数和总脂肪指数。卡普兰-梅耶曲线和对数秩检验比较了无进展生存期（PFS）和总生存期（OS），同时进行了多变量考克斯比例回归分析，以确定与生存结果显著相关的变量：结果：在中位 17.4 个月的随访期间，54 名患者（52.9%）出现疾病进展，26 名患者（25.5%）死亡。高SFI与OS改善（p = 0.018）明显相关，但与PFS（p = 0.090）无关。多变量分析证实了高 SFI 对 OS 的积极影响（调整后 HR：0.37，p = 0.029），并表明 PFS 有改善的趋势（调整后 HR：0.61，p = 0.088）。值得注意的是，在ipilimumab + nivolumab亚组中，高SFI与PFS和OS均有显著相关性（分别为p = 0.047和p = 0.012）：结论：高SFI可预测接受一线ICI治疗的mRCC患者的良好OS，尤其是接受伊匹单抗+nivolumab治疗的患者，高SFI与良好的PFS和OS之间存在显著关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.