The effect of sarcopenia on erlotinib therapy in patients with metastatic lung adenocarcinoma
Open Access
- 14 May 2022
- journal article
- research article
- Published by Association of Basic Medical Sciences of FBIH in Bosnian Journal of Basic Medical Sciences
- Vol. 22 (6), 982-991
- https://doi.org/10.17305/bjbms.2022.7147
Abstract
Erlotinib, a tyrosine kinase inhibitor, has been shown to improve the survival of patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer. Sarcopenia is a status with increasing importance in lung cancer, and it may predict a poor prognosis. We aimed to evaluate the impact of sarcopenia on erlotinib therapy and prognosis in patients with EGFR-mutated (exon 19 or 21 L858R) metastatic lung adenocarcinoma. Sarcopenia was defined as skeletal muscle index ≤39 cm2/m2 for women and ≤55 cm2/m2 for men. The patient characteristics, inflammation parameters, clinical and survival outcomes of the erlotinib therapy were examined according to sarcopenia status. We also analyzed the erlotinib treatment-related toxicity. Seventy-two patients were included in our retrospective study, and the mean age of the patients was 63.7 years. A total of 39 (54.2%) patients were diagnosed with sarcopenia. Patients with sarcopenia had a poor prognosis and had a shorter median progression-free survival (PFS) than patients without sarcopenia (10.5 months vs. 21.8 months, p=0.002). Sarcopenia (HR 2.08) and C-reactive protein > 6.5 mg/L (HR 2.57) were determined as independent poor prognostic factors for PFS of erlotinib therapy. Treatment-related toxicity occurred in 34.7% of patients treated with erlotinib, and sarcopenia did not significantly affect treatment-related toxicity. We also found that sarcopenia significantly affected the response to erlotinib. The expected survival outcomes may be low when erlotinib therapy is used in patients with sarcopenia and metastatic lung adenocarcinoma. This study showed that survival and clinical outcomes could be better predicted by detecting sarcopenia in patients with lung cancer using erlotinib.Keywords
This publication has 40 references indexed in Scilit:
- Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancerSupportive Care in Cancer, 2014
- Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trialThe Lancet Oncology, 2012
- Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 studyThe Lancet Oncology, 2011
- Definition and classification of cancer cachexia: an international consensusThe Lancet Oncology, 2011
- Sarcopenia: European consensus on definition and diagnosisAge and Ageing, 2010
- Oxidative Stress, Molecular Inflammation and SarcopeniaInternational Journal of Molecular Sciences, 2010
- Clinical Significance of Pretreatment C-Reactive Protein in Patients with Advanced Nonsquamous, Non-Small Cell Lung Cancer Who Received GefitinibOncology, 2010
- Prognostic Significance of C-Reactive Protein and Smoking in Patients with Advanced Non-small Cell Lung Cancer Treated with First-Line Palliative ChemotherapyJournal of Thoracic Oncology, 2009
- Correlation of C-Reactive Protein with Survival and Radiographic Response to First-Line Platinum-Based Chemotherapy in Advanced Non-Small Cell Lung CancerOncology Research and Treatment, 2008
- A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine careApplied Physiology, Nutrition, and Metabolism, 2008