Sarcopenic overweight is associated with early acute limiting toxicity of anti-PD1 checkpoint inhibitors in melanoma patients
Sarcopenic overweight is associated with early acute limiting toxicity of anti-PD1 checkpoint inhibitors in melanoma patients
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DOI：
10.1007/s10637-017-0464-x
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发表时间：
2017-08-01
影响因子：
3.4
通讯作者：
Aractingi, Selim
中科院分区：
文献类型：
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作者：
Heidelberger, Valentine;Goldwasser, Francois;Aractingi, Selim
关于预测抗PD 1检查点抑制剂毒性的因素知之甚少。肌萎缩性肥胖与细胞毒性药物和靶向治疗的急性毒性增加有关。我们探讨了身体成分是否也影响黑色素瘤患者抗PD 1的早期急性限制性毒性（ALT）的发生。这是一项单中心、回顾性研究，分析了接受纳武单抗或派姆单抗治疗的连续黑色素瘤患者的毒性结局。已经分析了与患者或疾病状态相关的各种参数。在治疗开始前，使用CT测量体重指数（BMI; kg/m2）和肌肉质量。分类变量和连续变量的比较分别采用卡方检验和Mann-Whitney检验。在68例接受抗PD 1治疗的黑色素瘤患者（47例pembrolizumab，21例nivolumab）中，38例（56%）患者的BMI = 25 kg/m（2），11例（16%）患者的BMI = 30，而13例（19%）患者同时患有肌肉减少症和BMI = 25 kg/m（2）。对于11例（16%）发生早期ALT的患者，平均BMI较高（27.9 vs 24.7 kg/m2; p = 0.04）。在32名女性患者中，肌肉减少超重患者的ALT风险增加6.5倍（50 vs 7.7%; p = 0.01）。黑色素瘤患者中肌松性超重与抗PD 1的早期ALT相关。
Little is known on factors predicting toxicity of anti-PD1 checkpoint inhibitors. Sarcopenic obesity is associated with increased acute toxicity of cytotoxic agents and targeted therapies. We explored whether body composition also influenced the occurrence of early acute limiting toxicity (ALT) of anti-PD1 in melanoma patients. This is a monocentric, retrospective study analyzing toxicity outcome in consecutive melanoma patients treated with nivolumab or pembrolizumab. Various parameters linked to the patient or the disease status have been analysed. Body mass index (BMI; kg/m(2)) and muscle mass using CT were measured prior to treatment initiation. Chi-squared test and Mann-Whitney's tests were used for the comparison of categorical and continuous variables respectively. Among 68 melanoma patients treated with anti-PD1 (47 pembrolizumab, 21 nivolumab), 38 (56%) patients had a BMI = 25 kg/m(2) and 11 (16%) a BMI = 30, while 13 (19%) had both sarcopenia and a BMI = 25 kg/m(2). For the 11 (16%) patients who experienced early ALT, the mean BMI was higher (27.9 versus 24.7 kg/m(2); p = 0.04). Among the 32 female patients, sarcopenic overweight patients had a 6.5-fold increased risk of ALT (50 versus 7.7%; p = 0.01). Sarcopenic overweight is associated with more early ALT of anti-PD1 in melanoma patients.