Association of computed tomography-based body composition with survival in metastatic renal cancer patient received immunotherapy: a multicenter, retrospective study

Wang, Jun; Dong, Pei; Qu, Yuanyuan; Xu, Wenhao; Zhou, Zhaohui; Kang, Ning; Peng, Yulu; Xiong, Longbin; Li, Zhen; Zou, Xiangpeng; Liu, Zhenhua; Li, Mingzhao; He, Zhisong; Luo, Junhang; Tian, Xi; Zhang, Ye; Guo, Shengjie; Han, Ho Jae; Zhou, Fangjian; Yin, Shaohan; Ye, Dingwei; Yu, Chunping; Zhang, Zhiling

doi:10.1007/s00330-022-09345-7

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…This lack of association was confirmed by Wang et al in metastatic renal cancer who received immunotherapy [33]. However, when using the SAT percentage - calculated as SAT/(visceral adipose tissue + total adipose tissue) – a significant association was observed between progression free survival and overall survival with adiposity [33]. Moreover, in this study the group with low SAT percentage had a higher percentage of T cell exclusion and a lower percentage of T cell infiltrate in the tumor microenvironment, supporting that adiposity may influence the response to immunotherapy [33].…”

Section: Clinical Impact Of Adipose Tissue Wasting In Cachexiamentioning

confidence: 69%

“…In fact, in patients with metastatic solid cancers, both SAT and visceral adipose tissue measured by CT-scan at lumbar 3 vertebra were not associated with overall survival [32]. This lack of association was confirmed by Wang et al in metastatic renal cancer who received immunotherapy [33]. However, when using the SAT percentage - calculated as SAT/(visceral adipose tissue + total adipose tissue) – a significant association was observed between progression free survival and overall survival with adiposity [33].…”

Section: Clinical Impact Of Adipose Tissue Wasting In Cachexiamentioning

confidence: 85%

“…However, when using the SAT percentage - calculated as SAT/(visceral adipose tissue + total adipose tissue) – a significant association was observed between progression free survival and overall survival with adiposity [33]. Moreover, in this study the group with low SAT percentage had a higher percentage of T cell exclusion and a lower percentage of T cell infiltrate in the tumor microenvironment, supporting that adiposity may influence the response to immunotherapy [33]. However, when the changes of adiposity were evaluated (by at least two measurements) the association between loss of adiposity and survival was more evident, also during a 1-month observation period [34 ▪ ].…”

Section: Clinical Impact Of Adipose Tissue Wasting In Cachexiamentioning

confidence: 97%

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Metabolic and histomorphological changes of adipose tissue in cachexia

Molfino

Imbimbo

Muscaritoli

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewTo describe the role of the main changes occurring in adipose tissue during cachexia and how these affects patient's outcomes, with a specific focus on cancer.Recent findingsIn cachexia, the changes within the adipose tissue have been recently described as the presence of inflammatory infiltration (T-lymphocytes and macrophages), enhanced fibrosis, and the occurrence of beige adipocytes (i.e., browning). The latter one is a process driving cachexia enhancing thermogenesis, primarily via modulation of uncoupling protein 1. Also, increased lipolysis of white adipose tissue, especially in cancer, via higher expression of hormone sensible and adipose tissue triglyceride lipases, was detected in experimental models and in human adipose tissue. Other systemic metabolic alterations occur in association with changes in adiposity, including insulin resistance and increased inflammation, all conditions associated with a worse outcome. Moreover, these profound metabolic alterations were shown to be implicated in several consequences, including extreme and progressive unvoluntary body weight loss.SummaryAlterations in adiposity occur early during cachexia. Adipose tissue atrophy, as well as metabolic changes of white adipose tissues were observed to be pivotal in cachexia, and to be implicated in several clinical complications and poor prognosis.Further research is necessary to clarify the mechanisms underlying the loss of adiposity and therefore to identify novel therapeutic options to counteract this phenomenon in cachexia.

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Section: Clinical Impact Of Adipose Tissue Wasting In Cachexiamentioning

confidence: 69%

Section: Clinical Impact Of Adipose Tissue Wasting In Cachexiamentioning

confidence: 85%

Section: Clinical Impact Of Adipose Tissue Wasting In Cachexiamentioning

confidence: 97%

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Metabolic and histomorphological changes of adipose tissue in cachexia

Molfino

Imbimbo

Muscaritoli

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…Three studies in total reported the relationship between body fat and ICI efficacy with conflicting results: two papers with larger sample sizes (n=251 and n=79) demonstrated a positive correlation with survival, while one study reported no significant correlation. Subcutaneous adipose tissue was measured in two papers ( 27 , 30 ) with diverse findings: SFI and SFA failed to show significant predictive value in these two studies, whereas SAT% was demonstrated as a positive prognostic factor for patients’ OS and PFS. One paper ( 27 ) investigated the predictive value of visceral adipose tissue using VFA but found no significant correlation with survival.TFI was showed in one study ( 32 ) to be significantly associated with OS and PFS, while the body composition risk score applied in the same study was a poor prognostic factor for OS, PFS and clinical benefit (CB).…”

Section: Resultsmentioning

confidence: 99%

Imaging-based adipose biomarkers for predicting clinical outcomes of cancer patients treated with immune checkpoint inhibitors: a systematic review

Pei,

Xie,

Liu

et al. 2023

Front. Oncol.

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BackgroundSince the application of Immune checkpoint inhibitors (ICI), the clinical outcome for metastatic cancer has been greatly improved. Nevertheless, treatment response varies in patients, making it urgent to identify patients who will receive clinical benefits after ICI therapy. Adipose body composition has proved to be associated with tumor response. In this systematic review, we aimed to summarize the current evidence on imaging adipose biomarkers that predict clinical outcomes in patients treated with ICI in various cancer types.MethodsEmbase and PubMed were searched from database inception to 1st February 2023. Articles included investigated the association between imaging-based adipose biomarkers and the clinical outcomes of patients treated with ICI. The methodological quality of included studies was evaluated through Newcastle- Ottawa Quality Assessment Scale and Radiomics Quality Score tools. ResultsTotally, 22 studies including 2256 patients were selected. Non-small cell lung cancer (NSCLC) had the most articles (6 studies), followed by melanoma (5 studies), renal cell carcinoma (RCC) (3 studies), urothelial carcinoma (UC) (2 studies), head and neck squamous cell carcinoma (HNSCC) (1 study), gastric cancer (1 study) and liver cancer (1 study). The remaining 3 studies investigated metastatic solid tumors including various types of cancers. Adipose biomarkers can be summarized into 5 categories, including total fat, visceral fat, subcutaneous fat, intramuscular fat and others, which exerted diverse correlations with patients’ prognosis after being treated with ICI in different cancers. Most biomarkers of body fat were positively associated with survival benefits. Nevertheless, more total fat was predictable of worse outcomes in NSCLC, while inter-muscular fat was associated with poor clinical benefits in UC. ConclusionThere is relatively well-supported evidence for imaging-based adipose biomarkers to predict the clinical outcome of ICI. In general, most of the studies show that adipose tissue is positively correlated with clinical outcomes. This review summarizes the significant biomarkers proven by researches for each cancer type. Further validation and large independent prospective cohorts are needed in the future. The protocol of this systematic review has been registered at the International Prospective Register of Systematic Reviews (http://www.crd.york.ac.uk/PROSPERO, registration no: CRD42023401986).

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“…In addition, the value of SMI in predicting the therapeutic effect of ICIs has also been confirmed. Wang et al ( 35 ) found that the survival period of melanoma patients with sarcopenia who received anti-PD-(L)1 treatment was shorter. Li et al ( 36 ) confirmed that the decrease of SMI was related to the shorter progression free survival and lower disease control rate of NSCLC receiving ICIs.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological characteristics correlated with programmed cell death-ligand 1 expression in advanced lung adenocarcinoma

Gao,

Zou,

Wang

et al. 2023

J Thorac Dis

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Background Recent studies have shown that immune checkpoint inhibitors (ICIs) targeting programmed cell death-ligand 1 (PD-L1) have potential benefits in patients with non-small cell lung cancer (NSCLC) subgroups, while the clinicopathological characteristics associated with PD-L1 expression have not been well established. The purpose of this study was to detect the expression level of PD-L1 in tumor tissues of patients with advanced lung adenocarcinoma (ADC) and analyze its possible relationship with clinicopathological characteristics, so as to identify the predictors of PD-L1 expression. Methods This retrospective study was conducted by analyzing the clinicopathological and imaging characteristics of hospitalized advanced lung ADC patients with PD-L1 available data and admitted to the respiratory department of our hospital. The expression level of PD-L1 in fresh-frozen tumor tissue samples of 136 advanced ADC patients was analyzed by immunohistochemistry. The patients were divided into positive and negative groups based on a cut-off of 1% PD-L1 expression level. Subsequently, the significant correlation between PD-L1 levels and clinicopathological features were evaluated. The predictive performance of clinicopathological characteristics on PD-L1 expression was evaluated and the optimal cut-off values were identified by plotting the receiver operating characteristic (ROC) curve. Results The expression level of PD-L1 was related to sex, clinical stage, serum carcinoembryonic antigen (CEA), neuron specific enolase (NSE), white blood cell (WBC), and tumor (T) and metastasis (M) stage. Multivariate logistic regression analysis showed the CEA, NSE, T stage, and WBC were independent predictors of PD-L1 positive expression in lung ADC patients. The ROC curve suggested the model combining CEA with NSE [area under the curve (AUC) =0.815] could better predict the expression levels of PD-L1. The optimal cut-off values for identifying advanced lung ADC patients with PD-L1 positive were CEA ≤13.38 ng/mL and NSE ≤42.35 ng/mL, with sensitivity and specificity of 85.4% and 55.6%, and 92.7% and 32.1%, respectively. Conclusions Some commonly used clinicopathological features are related to the histological expression of PD-L1. The serum CEA, NSE, T stage, and WBC values can be used as indicators to predict the expression level of PD-L1 in advanced lung ADC, and are used as predictors to evaluate the efficacy of ICIs before treatment.

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Association of computed tomography-based body composition with survival in metastatic renal cancer patient received immunotherapy: a multicenter, retrospective study

Cited by 9 publications

References 28 publications

Metabolic and histomorphological changes of adipose tissue in cachexia

Metabolic and histomorphological changes of adipose tissue in cachexia

Imaging-based adipose biomarkers for predicting clinical outcomes of cancer patients treated with immune checkpoint inhibitors: a systematic review

Clinicopathological characteristics correlated with programmed cell death-ligand 1 expression in advanced lung adenocarcinoma

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