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Comprehensive assessment of pretreatment sarcopenia impacts on patients with EGFR‐mutated NSCLC treated with afatinib

Authors :
Chen‐Te Wu
Ping‐Chih Hsu
John Wen‐Cheng Chang
Ching‐Fu Chang
Chen‐Yang Huang
Cheng‐Ta Yang
Chih‐Hsi Scott Kuo
Yueh‐Fu Fang
Chiao‐En Wu
Source :
Thoracic Cancer, Vol 14, Iss 25, Pp 2548-2557 (2023)
Publication Year :
2023
Publisher :
Wiley, 2023.

Abstract

Abstract Background This study aimed to comprehensively evaluate the efficacy and toxicity of afatinib in patients with sarcopenia, an important prognostic factor for treatment efficacy and toxicity in patients with cancer. Methods The clinical features of patients with advanced NSCLC treated with frontline afatinib between 2014 and 2018 at a medical center in Taiwan were retrospectively reviewed. Sarcopenia was evaluated based on the total cross‐sectional area of skeletal muscles assessed by computed tomography (CT) imaging at the L3 level. Baseline characteristics, response rates, survival rates, and adverse events (AEs) were compared between sarcopenic and nonsarcopenic patients. Results A total of 176 patients evaluated for sarcopenia by CT and treated with afatinib were enrolled in the current study. Sarcopenia was significantly associated with good performance status, low body mass index (BMI), low body surface area (BSA), and low total mass area (TMA). Sarcopenia did not influence the response rate (69.2% vs. 72.0%, p = 0.299), progression‐free survival (median 15.9 vs. 14.9 months, p = 0.791), or overall survival (median 26.5 vs. 27.2 months, p = 0.441). However, BSA ≤ 1.7 and the 40 mg afatinib dose were associated with dose reduction. TMA was the only independent factor for afatinib discontinuation due to AEs. Conclusion Sarcopenia was not associated with treatment efficacy or toxicity among patients with NSCLC harboring common mutations treated with afatinib, indicating sarcopenic patients should not be excluded from afatinib treatment. Other factors, such as BSA and TMA, were associated with dose reduction and afatinib discontinuation, respectively, which may require additional evaluations in future studies.

Details

Language :
English
ISSN :
17597714 and 17597706
Volume :
14
Issue :
25
Database :
Directory of Open Access Journals
Journal :
Thoracic Cancer
Publication Type :
Academic Journal
Accession number :
edsdoj.fc07701970254cbbb9979c7ef0d94271
Document Type :
article
Full Text :
https://doi.org/10.1111/1759-7714.15017