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Weighing the role of skeletal muscle mass and muscle density in cancer patients receiving PD-1/PD-L1 checkpoint inhibitors: a multicenter real-life study.

权衡骨骼肌质量和肌肉密度在接受PD-1/PD-L1 检查点抑制剂的癌症患者中的作用: 一项多中心现实生活研究。

  • 影响因子:4.29
  • DOI:10.1038/s41598-020-58498-2
  • 作者列表:"Cortellini A","Bozzetti F","Palumbo P","Brocco D","Di Marino P","Tinari N","De Tursi M","Agostinelli V","Patruno L","Valdesi C","Mereu M","Verna L","Lanfiuti Baldi P","Venditti O","Cannita K","Masciocchi C","Barile A","McQuade JL","Ficorella C","Porzio G
  • 发表时间:2020-01-29
Abstract

:Sarcopenia represents one of the hallmarks of all chronic diseases, including cancer, and was already investigated as a prognostic marker in the pre-immunotherapy era. Sarcopenia can be evaluated using cross-sectional image analysis of CT-scans, at the level of the third lumbar vertebra (L3), to estimate the skeletal muscle index (SMI), a surrogate of skeletal muscle mass, and to evaluate the skeletal muscle density (SMD). We performed a retrospective analysis of consecutive advanced cancer patient treated with PD-1/PD-L1 checkpoint inhibitors. Baseline SMI and SMD were evaluated and optimal cut-offs for survival, according to sex and BMI (+/-25) were computed. The evaluated clinical outcomes were: objective response rate (ORR), immune-related adverse events (irAEs), progression free survival (PFS) and overall survival (OS). From April 2015 to April 2019, 100 consecutive advanced cancer patients were evaluated. 50 (50%) patients had a baseline low SMI, while 51 (51%) had a baseline low SMD according to the established cut offs. We found a significant association between SMI and ECOG-PS (p = 0.0324), while no correlations were found regarding SMD and baseline clinical factors. The median follow-up was 20.3 months. Patients with low SMI had a significantly shorter PFS (HR = 1.66 [95% CI: 1.05-2.61]; p = 0.0291) at univariate analysis, but not at the multivariate analysis. They also had a significantly shorter OS (HR = 2.19 [95% CI: 1.31-3.64]; p = 0.0026). The multivariate analysis confirmed baseline SMI as an independent predictor for OS (HR = 2.19 [1.31-3.67]; p = 0.0027). We did not find significant relationships between baseline SMD and clinical outcomes, nor between ORR, irAEs and baseline SMI (data not shown). Low SMI is associated with shortened survival in advanced cancer patients treated with PD1/PDL1 checkpoint inhibitors. However, the lack of an association between SMI and clinical response suggests that sarcopenia may be generally prognostic in this setting rather than specifically predictive of response to immunotherapy.

摘要

: 肌肉减少症代表了包括癌症在内的所有慢性疾病的标志之一,并且已经作为免疫治疗前时代的预后标志物进行了研究。肌少症可以使用ct扫描的横截面图像分析来评估,在第三腰椎 (L3) 的水平,以估计骨骼肌指数 (SMI),替代骨骼肌质量,并评价骨骼肌密度 (SMD)。我们对接受PD-1/PD-L1 检查点抑制剂治疗的连续晚期癌症患者进行了回顾性分析。评估基线SMI和SMD,并根据性别和BMI (+/-25) 计算存活的最佳截止值。评估的临床结果为: 客观缓解率 (ORR) 、免疫相关不良事件 (irAEs) 、无进展生存期 (PFS) 和总生存期 (OS)。从 2015 年 4 月至 2019 年 4 月,连续评估了 100 例晚期癌症患者。根据建立的截止值,50 (50%) 例患者具有基线低SMI,而 51 (51%) 例患者具有基线低SMD。我们发现SMI和ECOG-PS之间存在显著相关性 (p   =   0.0324),而关于SMD和基线临床因素没有发现相关性。中位随访时间为 20.3 个月。在单因素分析中,低SMI患者的PFS显著缩短 (hr = 1.66 [95% CI: 1.05-2.61]; P = 0.0291),但在多因素分析中没有。他们的OS也显著较短 (hr = 2.19 [95% CI: 1.31-3.64]; P = 0.0026)。多变量分析证实基线SMI是OS的独立预测因子 (hr = 2.19 [1.31-3.67]; P = 0.0027)。我们没有发现基线SMD与临床结局之间的显著关系,也没有发现ORR、irAEs与基线SMI之间的显著关系 (数据未显示)。低SMI与用PD1/PDL1 检查点抑制剂治疗的晚期癌症患者的生存期缩短相关。然而,SMI与临床反应之间缺乏相关性表明,在这种情况下,肌肉减少症可能通常是预后的,而不是免疫治疗反应的特异性预测。

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METHODS::Pulmonary artery sling is a rare congenital anomaly of the origin and course of the left pulmonary artery. Patients with this condition typically present with respiratory failure in young infancy, and asymptomatic cases are uncommon. We describe the case of an adult patient with a lung adenocarcinoma of the right upper lobe, extending into the hilum and superior mediastinum, and with a previously unknown pulmonary artery sling anomaly. The local invasiveness of the tumor and the peculiar vascular anatomy contributed to a unique surgical scenario, wherein multiple reconstructive procedures were required.

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影响因子:6.93
发表时间:2020-01-15
DOI:10.1002/ijc.32532
作者列表:["Hata A","Nakajima T","Matsusaka K","Fukuyo M","Morimoto J","Yamamoto T","Sakairi Y","Rahmutulla B","Ota S","Wada H","Suzuki H","Matsubara H","Yoshino I","Kaneda A"]

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影响因子:6.93
发表时间:2020-01-01
DOI:10.1002/ijc.32530
作者列表:["Zhang L","Yang Y","Chai L","Bu H","Yang Y","Huang H","Ran J","Zhu Y","Li L","Chen F","Li W"]

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肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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