The influence of cachexia on the immunotherapy efficacy of Sintilimab for non-small cell lung cancer
10.3760/cma.j.cn112152-20200916-00828
- VernacularTitle:恶病质对信迪利单抗免疫治疗非小细胞肺癌疗效的影响
- Author:
Xiqing LI
1
;
Zunlan ZHAO
;
Menglin HOU
;
Yongxia CUI
;
Shuangyin HAN
;
Fangfang FU
Author Information
1. 河南省人民医院肿瘤中心，郑州 450003
- Keywords:
Lung neoplasms;
Immunotherapy;
Immunocheck inhibitors;
Anti-procedural death receptor (PD-L1) antibody;
Cachexia;
Psoas major muscle area
- From:
Chinese Journal of Oncology
2021;43(12):1292-1297
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate whether cachexia affects the treatment effect of immune checkpoint inhibitors for non-small cell lung cancer (NSCLC).Methods:The prognosis of 62 patients with advanced NSCLC who received anti-programmed cell death-1 (PD-1) in Henan Provincial People′s Hospital from 2019 to 2021 were retrospectively analyzed. The cachexia was evaluated before and after the second course of immunotherapy. Kaplan-Meier and Log rank methods were used for survival analysis, Cox regression model was used for multivariate analysis, and Spearman′s correlation analysis was used for correlation analysis.Results:After the second course of immunotherapy, psoas major muscle area (PMMA) values of the cachexia group and the control group were (14.10±4.09) and (11.66±3.22) cm 2 respectively, with statistics significance ( P=0.001). The level of Prealbumin and body weight were correlated with cachexia ( P<0.05). The 6-month and 1-year survival rates of 62 cases in the whole group were 58.6% and 42.5%, respectively. The progression-free survival (PFS) in the control group (7.6 months) was higher than that in the cachexia group (3.8 months, P=0.006). The PFS in patients with high expression of PD-L1 (7.1 months) was longer than that of patients with low expression (3.8 months, P=0.009). The overall survival (OS) in the cachexia group (6.3 months) was lower than that in the control group (18.2 months, P=0.006). The OS in patients with high expression of PD-L1 (14.5 months) was longer than that of patients with low expression (1 months, P=0.038). The level of Prealbumin, the level of PD-L1 expression and the change rate of PMMA were related to the OS of the patients ( P<0.05). The level of Prealbumin and the change rate of PMMA were the independent influencing factors of the OS ( P<0.05). The PMMA and the level of Prealbumin were negatively correlated ( r=-0.003 8, P<0.05). Conclusion:Cachexia has a negative impact on the outcomes of patients who received anti-PD-1 immune checkpoint inhibitor therapy.
