Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer

Immune checkpoint inhibitor (ICI)-based immunotherapy has significantly improved the survival of patients with advanced non-small cell lung cancer (NSCLC); however, a significant percentage of patients do not benefit from this approach, and predictive biomarkers are needed. Increasing evidence demon...

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Autores: Madeddu, Clelia, Busquets Rius, Sílvia, Donisi, Clelia, Lai, Eleonora, Pretta, Andrea, López-Soriano, Francisco J., Argilés Huguet, Josep Ma., Scartozzi, Mario, Macciò, Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/219214
Acceso en línea:https://hdl.handle.net/2445/219214
Access Level:acceso abierto
Palabra clave:Immunoteràpia
Càncer de pulmó
Caquèxia
Inflamació
Immunotheraphy
Lung cancer
Cachexia
Inflammation
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spelling Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancerMadeddu, CleliaBusquets Rius, SílviaDonisi, CleliaLai, EleonoraPretta, AndreaLópez-Soriano, Francisco J.Argilés Huguet, Josep Ma.Scartozzi, MarioMacciò, AntonioImmunoteràpiaCàncer de pulmóCaquèxiaInflamacióImmunotheraphyLung cancerCachexiaInflammationImmune checkpoint inhibitor (ICI)-based immunotherapy has significantly improved the survival of patients with advanced non-small cell lung cancer (NSCLC); however, a significant percentage of patients do not benefit from this approach, and predictive biomarkers are needed. Increasing evidence demonstrates that cachexia, a complex syndrome driven by cancer-related chronic inflammation often encountered in patients with NSCLC, may impair the immune response and ICI efficacy. Herein, we carried out a prospective study aimed at evaluating the prognostic and predictive role of cachexia with the related changes in nutritional, metabolic, and inflammatory parameters (assessed by the multidimensional miniCASCO tool) on the survival and clinical response (i.e., disease control rate) to ICI-based immunotherapy in patients with advanced NSCLC. We included 74 consecutive patients. Upon multivariate regression analysis, we found a negative association between IL-6 levels (odds ratio (OR) = 0.9036; 95%CI = 0.8408–0.9711; p = 0.0025) and the miniCASCO score (OR = 0.9768; 95%CI = 0.9102–0.9999; p = 0.0310) with the clinical response. As for survival outcomes, multivariate COX regression analysis found that IL-6 levels and miniCASCO-based cachexia severity significantly affected PFS (hazard ratio (HR) = 1.0388; 95%CI = 1.0230–1.0548; p < 0.001 and HR = 1.2587; 95%CI = 1.0850–1.4602; p = 0.0024, respectively) and OS (HR = 1.0404; 95%CI = 1.0221–1.0589; p < 0.0001 and HR = 2.3834; 95%CI = 1.1504–4.9378; p = 0.0194, respectively). A comparison of the survival curves by Kaplan–Meier analysis showed a significantly lower OS in patients with cachexia versus those without cachexia (p = 0.0323), as well as higher miniCASCO-based cachexia severity (p = 0.0428), an mGPS of 2 versus those with a lower mGPS (p = 0.0074), and higher IL-6 levels (>6 ng/mL) versus those with lower IL-6 levels (≤6 ng/mL) (p = 0.0120). In conclusion, our study supports the evidence that cachexia, with its related changes in inflammatory, body composition, and nutritional parameters, is a key prognostic and predictive factor for ICIs. Further larger studies are needed to confirm these findings and to explore the potential benefit of counteracting cachexia to improve immunotherapy efficacy.MDPI2025202520232025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion22 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/219214Articles publicats en revistes (Bioquímica i Biomedicina Molecular)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/cancers15041076Cancers, 2023, vol. 15, num.4, p. 1-22https://doi.org/10.3390/cancers15041076cc-by (c) Madeddu, C. et al., 2023http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2192142026-05-29T05:05:01Z
dc.title.none.fl_str_mv Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
title Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
spellingShingle Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
Madeddu, Clelia
Immunoteràpia
Càncer de pulmó
Caquèxia
Inflamació
Immunotheraphy
Lung cancer
Cachexia
Inflammation
title_short Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
title_full Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
title_fullStr Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
title_full_unstemmed Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
title_sort Effect of cancer-related cachexia and related changes in nutritional status, inflammatory status, and muscle mass on immunotherapy efficacy and survival in patients with advanced non-small cell lung cancer
dc.creator.none.fl_str_mv Madeddu, Clelia
Busquets Rius, Sílvia
Donisi, Clelia
Lai, Eleonora
Pretta, Andrea
López-Soriano, Francisco J.
Argilés Huguet, Josep Ma.
Scartozzi, Mario
Macciò, Antonio
author Madeddu, Clelia
author_facet Madeddu, Clelia
Busquets Rius, Sílvia
Donisi, Clelia
Lai, Eleonora
Pretta, Andrea
López-Soriano, Francisco J.
Argilés Huguet, Josep Ma.
Scartozzi, Mario
Macciò, Antonio
author_role author
author2 Busquets Rius, Sílvia
Donisi, Clelia
Lai, Eleonora
Pretta, Andrea
López-Soriano, Francisco J.
Argilés Huguet, Josep Ma.
Scartozzi, Mario
Macciò, Antonio
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Immunoteràpia
Càncer de pulmó
Caquèxia
Inflamació
Immunotheraphy
Lung cancer
Cachexia
Inflammation
topic Immunoteràpia
Càncer de pulmó
Caquèxia
Inflamació
Immunotheraphy
Lung cancer
Cachexia
Inflammation
description Immune checkpoint inhibitor (ICI)-based immunotherapy has significantly improved the survival of patients with advanced non-small cell lung cancer (NSCLC); however, a significant percentage of patients do not benefit from this approach, and predictive biomarkers are needed. Increasing evidence demonstrates that cachexia, a complex syndrome driven by cancer-related chronic inflammation often encountered in patients with NSCLC, may impair the immune response and ICI efficacy. Herein, we carried out a prospective study aimed at evaluating the prognostic and predictive role of cachexia with the related changes in nutritional, metabolic, and inflammatory parameters (assessed by the multidimensional miniCASCO tool) on the survival and clinical response (i.e., disease control rate) to ICI-based immunotherapy in patients with advanced NSCLC. We included 74 consecutive patients. Upon multivariate regression analysis, we found a negative association between IL-6 levels (odds ratio (OR) = 0.9036; 95%CI = 0.8408–0.9711; p = 0.0025) and the miniCASCO score (OR = 0.9768; 95%CI = 0.9102–0.9999; p = 0.0310) with the clinical response. As for survival outcomes, multivariate COX regression analysis found that IL-6 levels and miniCASCO-based cachexia severity significantly affected PFS (hazard ratio (HR) = 1.0388; 95%CI = 1.0230–1.0548; p < 0.001 and HR = 1.2587; 95%CI = 1.0850–1.4602; p = 0.0024, respectively) and OS (HR = 1.0404; 95%CI = 1.0221–1.0589; p < 0.0001 and HR = 2.3834; 95%CI = 1.1504–4.9378; p = 0.0194, respectively). A comparison of the survival curves by Kaplan–Meier analysis showed a significantly lower OS in patients with cachexia versus those without cachexia (p = 0.0323), as well as higher miniCASCO-based cachexia severity (p = 0.0428), an mGPS of 2 versus those with a lower mGPS (p = 0.0074), and higher IL-6 levels (>6 ng/mL) versus those with lower IL-6 levels (≤6 ng/mL) (p = 0.0120). In conclusion, our study supports the evidence that cachexia, with its related changes in inflammatory, body composition, and nutritional parameters, is a key prognostic and predictive factor for ICIs. Further larger studies are needed to confirm these findings and to explore the potential benefit of counteracting cachexia to improve immunotherapy efficacy.
publishDate 2023
dc.date.none.fl_str_mv 2023
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/219214
url https://hdl.handle.net/2445/219214
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/cancers15041076
Cancers, 2023, vol. 15, num.4, p. 1-22
https://doi.org/10.3390/cancers15041076
dc.rights.none.fl_str_mv cc-by (c) Madeddu, C. et al., 2023
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Madeddu, C. et al., 2023
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 22 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Articles publicats en revistes (Bioquímica i Biomedicina Molecular)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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