Background:Limited data are available on the frequency and significance of body weight loss during cancer therapy. This study investigated the frequency of patients who experienced body weight loss during immune checkpoint inhibitor (ICI) plus chemotherapy for advanced non-small cell lung cancer (NSCLC) and the impact of weight loss on treatment outcomes.Methods:Using the clinical data of 370 patients with NSCLC who received a combination of ICI and chemotherapy at 13 institutions, this study investigated the frequency of body weight loss > 5% during treatment and determined the impact of body weight loss on patient outcomes.Results:Of the 370 included patients, 141 (38.1%) lost more than 5% of their body weight during ICI plus chemotherapy (WL group). The 2-month landmark analysis showed that patients who experienced body weight loss of >5% during treatment had worse overall survival (OS) and progression-free survival (PFS) than those who did not (OS 14.0 and 31.1 months in the WL non-WL groups, respectively,p< 0.001; PFS 6.8 and 10.9 months in the WL non-WL groups, respectively,p= 0.002). Furthermore, a negative impact of body weight loss on survival was observed even in those who had obesity (body mass index [BMI] ≥ 25.0) at the start of therapy (OS 12.8 and 25.4 months in the WL non-WL groups, respectively,p< 0.001; PFS 5.7 and 10.7 months in the WL non-WL groups, respectively,p= 0.038).Conclusions:In conclusion, weight loss of >5% during ICI plus chemotherapy negatively influenced patient outcomes. Further and broader studies should investigate the role of nutritional status, specifically weight change and nutritional support, in responsiveness to ICI plus chemotherapy.
背景：关于癌症治疗期间体重减轻的发生频率及其临床意义，现有数据较为有限。本研究旨在探讨晚期非小细胞肺癌（NSCLC）患者在接受免疫检查点抑制剂（ICI）联合化疗期间发生体重减轻的频率，并分析体重减轻对治疗结局的影响。 方法：本研究基于13家医疗机构中370例接受ICI联合化疗的NSCLC患者的临床数据，分析治疗期间体重下降>5%的发生频率，并评估体重减轻对患者预后的影响。 结果：在纳入的370例患者中，141例（38.1%）在ICI联合化疗期间体重下降超过5%（体重减轻组）。以治疗2个月为界标进行分析显示，治疗期间体重下降>5%的患者总生存期（OS）和无进展生存期（PFS）均较未发生显著体重下降的患者更差（体重减轻组与非体重减轻组OS分别为14.0个月和31.1个月，p<0.001；PFS分别为6.8个月和10.9个月，p=0.002）。此外，即使在治疗开始时已存在肥胖（体重指数[BMI]≥25.0）的患者中，体重减轻仍对生存期产生负面影响（体重减轻组与非体重减轻组OS分别为12.8个月和25.4个月，p<0.001；PFS分别为5.7个月和10.7个月，p=0.038）。 结论：综上所述，ICI联合化疗期间体重下降>5%会对患者预后产生不利影响。未来需要开展更深入、更广泛的研究，以探讨营养状况（特别是体重变化与营养支持）对ICI联合化疗疗效的影响。
肿瘤(癌症)患者之家