Clinical impact of cancer cachexia on the outcome of patients with non-small cell lung cancer with PD-L1 tumor proportion scores of ≥50% receiving pembrolizumab monotherapy versus immune checkpoint inhibitor with chemotherapy

• Published in: Oncoimmunology 2025-12, Vol.14 (1), p.2442116
• Main Authors: Kawachi, Hayato, Yamada, Tadaaki, Tamiya, Motohiro, Negi, Yoshiki, Kijima, Takashi, Goto, Yasuhiro, Nakao, Akira, Shiotsu, Shinsuke, Tanimura, Keiko, Takeda, Takayuki, Okada, Asuka, Harada, Taishi, Date, Koji, Chihara, Yusuke, Hasegawa, Isao, Tamiya, Nobuyo, Katayama, Yuki, Nishioka, Naoya, Morimoto, Kenji, Iwasaku, Masahiro, Tokuda, Shinsaku, Shimose, Takayuki, Takayama, Koichi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; B7-H1 Antigen - antagonists & inhibitors; B7-H1 Antigen - metabolism; Cachexia - etiology; Cancer cachexia; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; combination therapy; Female; Humans; immune checkpoint inhibitor; Immune Checkpoint Inhibitors - administration & dosage; Immune Checkpoint Inhibitors - adverse effects; Immune Checkpoint Inhibitors - therapeutic use; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Middle Aged; non-small cell lung cancer; Original Research; Prognosis; Retrospective Studies; Treatment Outcome
• ISSN: 2162-402X; 2162-4011; 2162-402X
• DOI: 10.1080/2162402X.2024.2442116

This retrospective, multicenter cohort study aimed to determine whether cancer cachexia serves as a biomarker for determining the most effective treatment for patients having non-small-cell lung cancer (NSCLC) with high programmed death ligand 1 (PD-L1) expression treated with immune checkpoint inhibitors (ICIs) alone or combined with chemotherapy (ICI/chemotherapy). We included 411 patients with advanced NSCLC with a PD-L1 tumor proportion score of ≥50%. The patients were treated with pembrolizumab monotherapy or ICI/chemotherapy. Cancer cachexia was defined as a weight loss of >5% of the total body weight or a body mass index of 2% within 6 months before starting treatment. Eighty-five (21%) patients met the cancer cachexia criteria. Overall survival (OS) was significantly shorter in patients with cachexia than in those without cachexia in both the pembrolizumab monotherapy group (17.2 vs. 35.8 months,