Relationship between Efficacy Outcomes and Weight Gain during Treatment of Advanced, Nonsquamous, Non-small Cell Lung Cancer Patients
Menée auprès de 421 patients atteints d'un cancer du poumon non à petites cellules cellules de stade avancé, cette étude rétrospective évalue l'association entre une prise de poids pendant les traitements et l'amélioration de la survie
Background : Unintentional weight loss occurs among advanced non-small cell lung cancer (NSCLC) patients and is associated with worse survival. Small studies have suggested that weight gain during treatment is associated with superior survival. Patients and Methods : A retrospective analysis analyzed data from three international phase III studies comprising 2301 advanced, nonsquamous NSCLC patients who received a platinum-based, first-line doublet, with or without bevacizumab and maintenance therapy. Body weight was recorded before and after treatment by each study's schedule. The relationship between weight gain and overall survival (OS) and progression-free survival (PFS) was assessed using log-rank test and adjusted Cox modeling. Logistic regression assessed the association between baseline covariates and post-baseline weight gain. Results : 421 (18.3%) patients had >5% weight gain after baseline. More than half of the weight gain cohort exhibited initial weight gain by 3 weeks. Median OS was 16.7 months versus 10.7 months for the >5% versus ≤5% weight gain subgroup (N=1880) (p<0.001). PFS was 6.9 versus 4.8 months, respectively (p<0.001). Differences in overall tumor response rate (50.8% versus 25.4%, respectively) and disease control rate (tumor response or stable disease) (91.5% versus 63.6%, respectively) were also significant (p<0.001). Cox modeling revealed the >5% subgroup had longer survival (HR=0.54, 95%CI=0.47-0.62; p<0.001) than the <5% subgroup after adjusting for baseline factors. Similar significant results were found for PFS (HR=0.59, 95%CI=0.52-0.67; p<0.001). Unadjusted logistic regression indicated a significant association between weight gain (>5% versus ≤5%) and age, and BMI. Conclusions : Weight gain during treatment may be an early indicator of clinical benefit. If confirmed in prospective studies, monitoring weight change may provide important information regarding survival outcomes in NSCLC and may provide ideas for new therapeutic strategies.