Can Changes in Skeletal Muscle Mass Predict Outcomes in Metastatic Kidney Cancer?
Posted: Monday, November 19, 2018
In work published in Targeted Oncology, decreased skeletal muscle mass occurring during first-line sunitinib therapy for metastatic renal cell carcinoma “was significantly associated with poor oncological outcomes. To the best of our knowledge, the present study is the first to indicate the significance of decreased skeletal muscle mass ” in this setting, wrote the authors, led by Hiroki Ishihara, MD, of Tokyo Women’s Medical University in Japan.
The team evaluated 69 patients retrospectively. Because decreased skeletal muscle mass during first-line sunitinib therapy was significantly associated with both progression-free and overall survival in patients with metastatic renal cell carcinoma, and because it had a prognostic effect for patients whether or not they were sarcopenic before treatment, Dr. Ishihara and colleagues concluded that decreased skeletal muscle mass in this setting “can be an effective marker of outcome prediction for [metastatic renal cell carcinoma].”
Each patient’s skeletal muscle index was calculated based on computed tomography images from before treatment initiation and from after two cycles of sunitinib treatment.
More than half of the patients (38) experienced a decrease in skeletal muscle mass. For them, progression-free and overall survival rates after sunitinib therapy initiation were significantly shorter than those in patients who had no such decrease (median progression-free survival: 9.53 vs. 28.4 months; P < .0001; overall survival: 19.8 vs. 52.6 months; P = .0001). Change in skeletal muscle index was an independent predictive factor for progression-free survival (P = .0002) and overall survival (P < .0001). Also objective response rate was significantly lower in patients with decreased skeletal muscle mass (P = .0164).