Background: Finding the most effective tailored 1L tp in mRCC is a challenge and biomarkers for choice are limited. Sarcopenia, loss of muscle mass and strength, may impact on clinical outcomes in mRCC pts. We evaluate correlation between BC-related markers and prognosis in mRCC pts treated with 1L tp. Patients and Methods: We conducted a multicentric retrospective analysis of 76 mRCC pts with intermediate (int) and high risk according to the international mRCC Database Consortium (IMDC) score who underwent 1L tp with tyrosine kinase inhibitor (TKI)(25pts)(A), immunotherapy (IT)( 28)(B), TKI+IT (23)(C) between 2019 and 2023. General characteristics, BC and inflammatory parameters were recorded at baseline (BL) and at 1st revaluation (1R). BC parameters were calculated from CT scan quantifying: total, visceral and subcutaneous fat (TF, VF and SF), skeletal muscle area (SMA), skeletal muscle density (SMD), skeletal muscle index (SMI) and adjusted SMI (aSMI) at 3L vertebral level. We used Kaplan-Meier method to estimate survival and Spearman’s test to correlate variables. Results: We had 17% female, 71% mRCC at diagnosis, 81,6% clear cell. At diagnosis, median (m) BMI was 24,4, m age 64 years (range 25-81). Sarcopenic pts defined with Fearon et al 2011 were 56,57 % at BL. Among the nonsarcopenic pts, 30,3% became sarcopenic at the 1R, of them 90% were int IMDC, 100% had disease progression. Among parameters, BMI correlates (p<0,05) with NLR, SII (Systemic immune inflammation index), SMI, aSMI, TF, VF, SF; age with VF and aSMI; SII with SF and SMI; TF, VF and SF with SMI. At BL, predictors of better OS were better ECOG (p=0,006), int IMDC (p=0,043), tp with B or C vs A (p=0,002), low NLR (p<0,0001) and low SII (p=0,017). Higher muscle mass (SMI codified with Fearon or Martin and aSMI codified with m) showed better OS (p=0,015, p=0,011 and p=0,022, respectively). Among subgroups, in B high aSMI showed better OS (p=0,018). At 1R, low NLR, high SMD, SMI, aSMI and loss of SF, SMD and SMI predicted better OS (p= 0,004, p=0,006, p=0,002, p=0,006, p=0,009, p=0,02). In C, we had significant impact of aSMI (p=0,037), SMI with m (p=0,013) and TF (p=0,043). Conclusions: Sarcopenia seems to be a prognostic factor in mRCC in 1L tp despite our limited series. Jointly with scores already used in clinical practice, it can contribute to a better selection of treatments.
Correlation between body composition (BC) and outcomes in mRCC patients (pts) in first line therapy (1L tp) / Tchawa Tchamake, J. C.; Baldessari, C.; Farioli, F.; Agresti, G.; Maruzzo, M.; Basso, U.; Buti, S.; Favaretto, A.; D’Agostino, E.; Bacchelli, F.; Oltrecolli, M.; Pirola, M.; Roccabruna, S.; Caffari, E.; Pugliese, G.; Pipitone, S.; Vitale, M. G.; Fiocchi, F.; Dominici, M.; Sabbatini, R.. - In: TUMORI. - ISSN 0300-8916. - 110:2_suppl(2024), pp. D26.120-D26.120. [10.1177/03008916241277279]
Correlation between body composition (BC) and outcomes in mRCC patients (pts) in first line therapy (1L tp)
Buti S.Investigation
;
2024-01-01
Abstract
Background: Finding the most effective tailored 1L tp in mRCC is a challenge and biomarkers for choice are limited. Sarcopenia, loss of muscle mass and strength, may impact on clinical outcomes in mRCC pts. We evaluate correlation between BC-related markers and prognosis in mRCC pts treated with 1L tp. Patients and Methods: We conducted a multicentric retrospective analysis of 76 mRCC pts with intermediate (int) and high risk according to the international mRCC Database Consortium (IMDC) score who underwent 1L tp with tyrosine kinase inhibitor (TKI)(25pts)(A), immunotherapy (IT)( 28)(B), TKI+IT (23)(C) between 2019 and 2023. General characteristics, BC and inflammatory parameters were recorded at baseline (BL) and at 1st revaluation (1R). BC parameters were calculated from CT scan quantifying: total, visceral and subcutaneous fat (TF, VF and SF), skeletal muscle area (SMA), skeletal muscle density (SMD), skeletal muscle index (SMI) and adjusted SMI (aSMI) at 3L vertebral level. We used Kaplan-Meier method to estimate survival and Spearman’s test to correlate variables. Results: We had 17% female, 71% mRCC at diagnosis, 81,6% clear cell. At diagnosis, median (m) BMI was 24,4, m age 64 years (range 25-81). Sarcopenic pts defined with Fearon et al 2011 were 56,57 % at BL. Among the nonsarcopenic pts, 30,3% became sarcopenic at the 1R, of them 90% were int IMDC, 100% had disease progression. Among parameters, BMI correlates (p<0,05) with NLR, SII (Systemic immune inflammation index), SMI, aSMI, TF, VF, SF; age with VF and aSMI; SII with SF and SMI; TF, VF and SF with SMI. At BL, predictors of better OS were better ECOG (p=0,006), int IMDC (p=0,043), tp with B or C vs A (p=0,002), low NLR (p<0,0001) and low SII (p=0,017). Higher muscle mass (SMI codified with Fearon or Martin and aSMI codified with m) showed better OS (p=0,015, p=0,011 and p=0,022, respectively). Among subgroups, in B high aSMI showed better OS (p=0,018). At 1R, low NLR, high SMD, SMI, aSMI and loss of SF, SMD and SMI predicted better OS (p= 0,004, p=0,006, p=0,002, p=0,006, p=0,009, p=0,02). In C, we had significant impact of aSMI (p=0,037), SMI with m (p=0,013) and TF (p=0,043). Conclusions: Sarcopenia seems to be a prognostic factor in mRCC in 1L tp despite our limited series. Jointly with scores already used in clinical practice, it can contribute to a better selection of treatments.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
