Impact of sarcopenia on the efficacy of pembrolizumab in patients with advanced urothelial carcinoma: a preliminary report
Impact of sarcopenia on the efficacy of pembrolizumab in patients with advanced urothelial carcinoma: a preliminary report
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DOI：
10.1097/cad.0000000000000982
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发表时间：
2020-09-01
影响因子：
2.3
通讯作者：
Fujii, Yasuhisa
中科院分区：
文献类型：
--
作者：
Fukushima, Hiroshi;Fukuda, Shohei;Fujii, Yasuhisa
骨骼肌减少症是骨骼肌质量的退行性和系统性损失，是一种多因素综合征，反映虚弱、一般健康状况不佳以及可能存在癌症恶病质。在这里，我们的目的是研究肌肉减少症对派姆单抗治疗晚期尿路上皮癌（aUC）患者疗效的影响。这项回顾性研究纳入了28例接受派姆单抗作为二线或二线治疗的aUC患者。肌肉减少症是根据计算机断层扫描图像确定的。评估肌肉减少症与客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）的关系。总共有19例（68%）患者患有肌肉减少症。肌肉减少症患者的ORR为21%，而非肌肉减少症患者的ORR显著高于前者（67%,P = 0.019）。肌少症患者的PFS明显短于无肌少症患者（中位数，3个月vs 15个月，P = 0.038）。虽然没有达到统计学意义，但骨骼肌减少症患者的生存期比未达到的患者短（中位数为7个月vs.未达到，P = 0.086）。我们的初步结果显示，接受派姆单抗治疗的aUC患者中，超过一半的患者出现了肌肉减少症，这与治疗效果差显著相关。这表明肌少症与派姆单抗治疗aUC患者的临床相关性。
Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, is a multifactorial syndrome reflecting frailty, poor general health status, and the possible presence of cancer cachexia. Here, we aimed to investigate the effect of sarcopenia on the efficacy of pembrolizumab in patients with advanced urothelial carcinoma (aUC). This retrospective study included 28 patients with aUC treated with pembrolizumab as a second or later-line therapy. Sarcopenia was determined based on computed tomography images. Associations of sarcopenia with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. In total, 19 (68%) patients had sarcopenia. ORR was 21% in the patients with sarcopenia, while those without sarcopenia showed significantly higher ORR (67%,P = 0.019). PFS was significantly shorter in patients with sarcopenia than in those without (median, 3 vs. 15 months,P = 0.038). Although the statistical significance was not reached, OS was shorter in patients with sarcopenia than in those without (median, 7 months vs. not reached;P = 0.086). Our preliminary results demonstrated that more than half of patients with aUC who received pembrolizumab had sarcopenia, which was significantly associated with poor therapeutic efficacy. This indicates the clinical relevance of sarcopenia in pembrolizumab therapy for patients with aUC.