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Master Thesis

Rôle de la sarcopénie chez des patients traités par inhibiteurs de check point immunitaire dans le cadre de cancers solides métastatiques

Abstract : Background: evidence suggests that sarcopenia is a significant predictor of worst outcomes and treatment toxicities in metastatic solid tumors patients. We investigated whether sarcopenia was associated with outcomes and severe toxicities (ST) in patients treated with check point inhibitors (CPI). Methods: all consecutive metastatic solid tumors patients treated with CPI from january 2013 to december 2017 in Bordeaux university hospital were retrospectively reviewed. Sarcopenia was evaluated using computed tomography (CT) obtained within 1 month before treatment initiation. Skeletal muscle mass index (SMI) were measured from axial L3 CT section. Clinical characteristics included Performance Status (PS) and anthropometric parameters. ST included grade III-IV according to NCI-CTC v4.0 and any grade of toxicity leading to treatment interruption. Results: among 261 pts included, 179 (69%) had metastatic lung cancer and 151 (58%) had previously received one line of treatment. Median age was 61 years old. PS status was 1 in 55% of pts. CPI treatment was: anti PD1, anti PD-L1, anti CTLA-4 and CPI combination in 192, 43, 3 and 20 pts, respectively. The prevalence of sarcopenia was 64%. Sarcopenia was associated with poor PS (p=0.002), anorexia (p<0.001), lower albumin and hemoglobin (p<0.001). Objective Response Rate (ORR) was 28% in sarcopenic (S) pts and 26% in non-sarcopenic (non-S) pts. Median progression free survival (PFS) was 6,9 and 7,6 months in S pts and non-S pts respectively (p=0.5). In multivariate analysis, sarcopenia was not associated with PFS or ORR. Median overall survival (mOS) was 10,2 months in lung cancer, without significant difference between S and non-S pts. In general population, ST occurred in 36 (14%) pts; among which 23 (64%) presented sarcopenia. In multivariate analysis, sarcopenia was not associated with ST. Conclusion: sarcopenia was not associated with outcomes or toxicities in metastatic solid tumors patients treated with CPI.
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https://dumas.ccsd.cnrs.fr/dumas-02418266
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Haya Laura Haik. Rôle de la sarcopénie chez des patients traités par inhibiteurs de check point immunitaire dans le cadre de cancers solides métastatiques. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02418266⟩

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