Sarcopenia assessed at a single time point is associated with the efficacy of immunotherapy, and we hypothesized that longitudinal changes in muscle mass may also be important. This retrospective study included patients with non-small cell lung cancer (NSCLC) who received durvalumab treatment after concurrent chemoradiotherapy (CCRT) between January 2017 and April 2023. Muscle loss and sarcopenia were assessed based on the lumbar skeletal muscle area. Patients with a decrease in muscle area of 10% or more during CCRT were categorized into the muscle loss group, while those with a decrease of less than 10% were categorized into the muscle maintenance group. We evaluated the relationship between muscle changes during CCRT and the efficacy of durvalumab treatment. Among the 98 patients, the muscle maintenance group had a significantly longer PFS of durvalumab treatment compared to the muscle loss group (29.2 months [95% confidence interval (CI): 17.2—not reached] versus 11.3 months [95% CI: 7.6–22.3];p= 0.008). The multivariable analysis confirmed that muscle change was a significant predictor of a superior PFS (HR: 0.47 [95% CI: 0.25–0.90]; thep-value was less than 0.05). In contrast, the OS between the groups did not differ significantly (not reached [95% CI: 21.8 months—not reached] and 36.6 months [95% CI: 26.9—not reached];p= 0.49). Longitudinal muscle changes during CCRT are a predictor of durvalumab’s efficacy in patients with NSCLC after CCRT.
单次评估的肌肉减少症与免疫治疗效果相关，我们假设肌肉质量的纵向变化可能同样重要。本研究回顾性纳入2017年1月至2023年4月期间接受同步放化疗（CCRT）后接受度伐利尤单抗治疗的非小细胞肺癌（NSCLC）患者。基于腰椎骨骼肌面积评估肌肉流失与肌肉减少症。将CCRT期间肌肉面积减少≥10%的患者归为肌肉流失组，减少<10%者归为肌肉维持组。我们评估了CCRT期间肌肉变化与度伐利尤单抗疗效的关系。在98例患者中，肌肉维持组的度伐利尤单抗治疗无进展生存期（PFS）显著长于肌肉流失组（29.2个月[95%置信区间(CI): 17.2—未达到] vs 11.3个月[95% CI: 7.6–22.3]；p=0.008）。多变量分析证实肌肉变化是PFS更优的显著预测因子（风险比：0.47[95% CI: 0.25–0.90]；p值<0.05）。相比之下，两组间的总生存期（OS）无显著差异（未达到[95% CI: 21.8个月—未达到] vs 36.6个月[95% CI: 26.9—未达到]；p=0.49）。CCRT期间的纵向肌肉变化可作为NSCLC患者CCRT后度伐利尤单抗疗效的预测指标。
肿瘤(癌症)患者之家