2Department of Nuclear Medicine, Marmara University Faculty of Medicine, İstanbul-Türkiye
3Department of Pathology, Marmara University Faculty of Medicine, İstanbul-Türkiye DOI : 10.5505/tjo.2022.3547 OBJECTIVE
We investigated the relationship of baseline sarcopenia with toxicities, treatment response, and survival in patients who had non-small cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation and received erlotinib.
METHODS
Computed tomography images from PET/CT scans before erlotinib treatment were retrospectively assessed.
Skeletal muscle index, calculated as skeletal muscle area at third lumbar vertebra level/square of
height, was used to define sarcopenia with <52.4 cm2/m2 for males and <38.5 cm2/m2 for females. Cox
hazard models were conducted to determine predictors of survival.
RESULTS
The study included 30 patients, and 11 (36.7%) were sarcopenic. All-grade and Grade 3 toxicities
were more frequent in sarcopenic group, although it was statistically insignificant (81.8% vs. 63.2%,
p=0.282 for all-grade, and 18.2% vs. 10.5%, p=0.552 for grade 3). Response rates were 63.6% in sarcopenic
and 68.4% in non-sarcopenic patients (p=0.789). Median progression-free survival was 7.9
and 9.2 months in sarcopenic and non-sarcopenic cases, respectively (p=0.561). However, median
overall survival (OS) of sarcopenic patients was significantly shorter than non-sarcopenic ones (11.8
vs. 30.2 months, p=0.023), and sarcopenia predicted OS independently in multivariate analysis
(Hazard ratio=2.63, p=0.029).
CONCLUSION
Early recognition, treatment, and prevention of sarcopenia may improve long-term survival in EGFRmutant
NSCLC patients treated with first-line erlotinib.