Decreased Muscle Mass Predicts the Efficacy of Immunotherapy for Advanced Non-Small Cell Lung Cancer

Skeletal muscle mass loss may predict the therapeutic effects of immune checkpoint inhibitors in patients with advanced non-small cell lung cancer (NSCLC), according to a study published in Cancer Medicine.

In this retrospective study, researchers reviewed the medical records of 156 patients with NSCLC who had received PD-1/PD-L1 inhibitor monotherapy between March 2016 and February 2018. They then assessed muscle quality using lumbar computed tomography images, defined high muscle mass as a skeletal muscle density ≥41 and ≥33 Hounsfield units in patients with a body mass index (BMI) <25 kg/m2 and ≥25 kg/m2. The correlation of these muscle parameters was compared with overall response rate (ORR), progression-free survival (PFS), and overall survival (OS).

According to the results, patients with high muscle quality displayed both higher ORR (35.0% vs. 15.8 %; P<0.05) and longer PFS durations (median, 4.5 vs. 2.0 months; P<0.05) juxtaposed to those with low muscle quality. The researchers noted that there were no noted differences in the ORR or PFS between patients with high and those with low muscle quantities. They wrote, “On the contrary, regardless of muscle quality and quantity, there were no differences in OS between patients with high and those with low muscle status.”

“Lumbar skeletal muscle quality has the potential to predict the therapeutic effect of anti-PD-1/PD-L1 inhibitor monotherapy in patients with advanced NSCLC,” the researchers concluded.