Prognostic significance of CT-determined sarcopenia in older patients with advanced squamous cell lung cancer treated with programmed death-1 inhibitors

• Published in: Scientific reports 2024-05, Vol.14 (1), p.12025-12025, Article 12025
• Main Authors: Ying, Lin, Xu, Liqian, Yang, Ji, Zhang, Qin
• Format: Article
• Language: English
• Subjects: 631/67; 692/308; Aged; Aged, 80 and over; Apoptosis; Body mass index; Cancer therapies; Carcinoma, Squamous Cell - complications; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - drug therapy; Female; Humanities and Social Sciences; Humans; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - adverse effects; Immune Checkpoint Inhibitors - therapeutic use; Immunotherapy; Inhibitors; Kaplan-Meier Estimate; Lung cancer; Lung carcinoma; Lung Neoplasms - complications; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Medical prognosis; multidisciplinary; Older people; Patients; PD-1 protein; Prognosis; Programmed death-1 inhibitors; Retrospective Studies; Sarcopenia; Sarcopenia - diagnostic imaging; Sarcopenia - etiology; Science; Science (multidisciplinary); Skeletal muscle; Squamous cell carcinoma; Squamous cell lung cancer; Survival; Tomography, X-Ray Computed - methods; Toxicity
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-62825-2

Sarcopenia has been associated with higher toxicity induced by anti-cancer treatments and shorter survival in patients with squamous cell lung carcinoma (SqCLC). Over the past few decades, immune checkpoint inhibitors (ICIs) significantly improves the prognosis. However, few clinical studies explored the effectiveness of immunotherapy in the elderly population. Here, we performed a retrospective analysis to determine the prognostic role of sarcopenia in older patients with SqCLC receiving ICIs. We retrospectively assessed SqCLC patients who were treated with PD-1 inhibitors and all patients were at least 70 years old. Pre-treatment sarcopenic status was determined by analyzing L3 skeletal muscle index (SMI) with chest CT. Progression-free survival (PFS), disease-specific survival (DSS) and overall survival (OS) were estimated using the Kaplan–Meier method, and the differences in survival were compared using the log-rank test. Among 130 male SqCLC patients, 93 had sarcopenia. Patients with sarcopenia were older and had a lower body mass index (BMI). Over an average follow-up of 20.8 months, 92 patients died. For all 130 patients, the mean OS was 13.3 months. Patients with sarcopenia had a significantly shorter OS and PFS than those without sarcopenia (OS, 12.4 ± 5.2 months vs. 15.5 ± 10.5 months, P = 0.028; PFS, 6.4 ± 2.9 months vs. 7.7 ± 4.2 months; P = 0.035). Multivariable analysis showed that sarcopenia was an independent prognostic factor for shorter OS and PFS. CT-determined sarcopenia is an independent prognostic factor for older patients with SqCLC receiving ICIs.