Effect of body tissue composition on the outcome of patients with metastatic non-small cell lung cancer treated with PD-1/PD-L1 inhibitors

• Published in: PloS one 2023-02, Vol.18 (2), p.e0277708-e0277708
• Main Authors: Makrakis, Dimitrios, Rounis, Konstantinos, Tsigkas, Alexandros-Pantelis, Georgiou, Alexandra, Galanakis, Nikolaos, Tsakonas, George, Ekman, Simon, Papadaki, Chara, Monastirioti, Alexia, Kontogianni, Meropi, Gioulbasanis, Ioannis, Mavroudis, Dimitris, Agelaki, Sofia
• Format: Article
• Language: English
• Subjects: Analysis; Biology and Life Sciences; Biomarkers; Body fat; Body mass index; Brain cancer; Carcinoma, Non-Small-Cell Lung - pathology; Care and treatment; Complications and side effects; Composition; Computed tomography; Data collection; Diagnosis; Disease control; Female; Gender; Histology; Humans; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - pharmacology; Immune Checkpoint Inhibitors - therapeutic use; Immunotherapy; Inhibitors; Ipilimumab; Lung cancer; Lung cancer, Non-small cell; Lung cancer, Small cell; Lung diseases; Lung Neoplasms - pathology; Male; Measuring instruments; Medicine and Health Sciences; Melanoma; Metastases; Metastasis; Muscles; Musculoskeletal system; Non-small cell lung carcinoma; Obesity; Patient outcomes; PD-1 protein; PD-L1 protein; Prognosis; Programmed Cell Death 1 Receptor; Prospective Studies; Regression analysis; Retrospective Studies; Sarcopenia; Skeletal muscle; Small cell lung carcinoma; Statistical significance; Tissues; Values; Vertebrae
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0277708

Obesity and sarcopenia have been reported to affect outcomes in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). We analyzed prospective data from 52 patients with non-oncogene driven metastatic NSCLC treated with ICIs. Body tissue composition was calculated by measuring the fat and muscle densities at the level of 3rd lumbar vertebra in each patient computed tomography scan before ICI initiation using sliceOmatic tomovision. We converted the densities to indices [Intramuscular Fat Index (IMFI), Visceral Fat Index (VFI), Subcutaneous Fat Index (SFI), Lumbar Skeletal Muscle Index (LSMI)] by dividing them by height in meters squared. Patients were dichotomized based on their baseline IMFI, VFI and SFI according to their gender-specific median value. The cut-offs that were set for LMSI values were 55 cm2/m2 for males and 39 cm2/m2 for females. SFI distribution was significantly higher (p = 0.040) in responders compared to non-responders. None of the other variables affected response rates. Low LSMI HR: 2.90 (95% CI: 1.261-6.667, p = 0.012) and low SFI: 2.20 (95% CI: 1.114-4.333, p = 0.023) values predicted for inferior OS. VFI and IMFI values did not affect survival. Subcutaneous adipose and skeletal muscle tissue composition significantly affected immunotherapy outcomes in our cohort.