Body Composition and Dose-limiting Toxicity in Colorectal Cancer Chemotherapy Treatment; a Systematic Review of the Literature. Could Muscle Mass be the New Body Surface Area in Chemotherapy Dosing?

Drami, Ioanna; Pring, Edward; Gould, Laura E.; Malietzis, George; Naghibi, M.; Athanasiou, Thanos; Glynne‐Jones, Rob; Jenkins, John T.

doi:10.1016/j.clon.2021.05.011

Cited by 22 publications

(18 citation statements)

References 70 publications

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“…A patient's body composition may correlate better with an individual's tacrolimus dose requirement. Within the field of oncology, the relation between body composition and medication dosage and toxicity was demonstrated previously [27]. Muscle mass was an especially important body composition parameter in terms of required chemotherapy dose and toxicity [28][29][30].…”

Section: Discussionmentioning

confidence: 83%

Body composition is associated with tacrolimus pharmacokinetics in kidney transplant recipients

Francke

Visser

Severs

et al. 2022

Eur J Clin Pharmacol

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Purpose A population pharmacokinetic (popPK) model may be used to improve tacrolimus dosing and minimize under- and overexposure in kidney transplant recipients. It is unknown how body composition parameters relate to tacrolimus pharmacokinetics and which parameter correlates best with tacrolimus exposure. The aims of this study were to investigate which body composition parameter has the best association with the pharmacokinetics of tacrolimus and to describe this relationship in a popPK model. Methods Body composition was assessed using bio-impedance spectroscopy (BIS). Pharmacokinetic analysis was performed using nonlinear mixed effects modeling (NONMEM). Lean tissue mass, adipose tissue mass, over-hydration, and phase angle were measured with BIS and then evaluated as covariates. The final popPK model was evaluated using goodness-of-fit plots, visual predictive checks, and a bootstrap analysis. Results In 46 kidney transplant recipients, 284 tacrolimus concentrations were measured. The base model without body composition parameters included age, plasma albumin, plasma creatinine, CYP3A4 and CYP3A5 genotypes, and hematocrit as covariates. After full forward inclusion and backward elimination, only the effect of the phase angle on clearance (dOFV = − 13.406; p < 0.01) was included in the final model. Phase angle was positively correlated with tacrolimus clearance. The inter-individual variability decreased from 41.7% in the base model to 34.2% in the final model. The model was successfully validated. Conclusion The phase angle is the bio-impedance spectroscopic parameter that correlates best with tacrolimus pharmacokinetics. Incorporation of the phase angle in a popPK model can improve the prediction of an individual’s tacrolimus dose requirement after transplantation.

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Section: Discussionmentioning

confidence: 83%

Body composition is associated with tacrolimus pharmacokinetics in kidney transplant recipients

Francke

Visser

Severs

et al. 2022

Eur J Clin Pharmacol

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“…Computed tomography (CT) scans are routinely obtained in oncology patients for diagnosis, surgical planning and surveillance. Measures of muscle and adipose tissue derived from CT images are predictive of surgical complications, 1 , 2 , 3 treatment toxicity, 4 and morbidity and mortality 5 after a cancer diagnosis, 1 , 6 , 7 demonstrating the importance of body composition to cancer outcomes. As automated tools to segment muscle and adipose tissue on CT images become more efficient, accurate and available, 8 , 9 , 10 , 11 , 12 , 13 these data have the potential to provide more than just research insights: Future applications might include improving patient care by providing personalized cancer treatments and tailoring lifestyle interventions for cancer survivors' individual body composition.…”

Section: Introductionmentioning

confidence: 99%

Body composition from single versus multi‐slice abdominal computed tomography: Concordance and associations with colorectal cancer survival

Anyene

Caan

Williams

et al. 2022

J cachexia sarcopenia muscle

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Background Computed tomography (CT) scans are routinely obtained in oncology and provide measures of muscle and adipose tissue predictive of morbidity and mortality. Automated segmentation of CT has advanced past single slices to multi‐slice measurements, but the concordance of these approaches and their associations with mortality after cancer diagnosis have not been compared. Methods A total of 2871 patients with colorectal cancer diagnosed during 2012–2017 at Kaiser Permanente Northern California underwent abdominal CT scans as part of routine clinical care from which mid‐L3 cross‐sectional areas and multi‐slice T12–L5 volumes of skeletal muscle (SKM), subcutaneous adipose (SAT), visceral adipose (VAT) and intermuscular adipose (IMAT) tissues were assessed using Data Analysis Facilitation Suite, an automated multi‐slice segmentation platform. To facilitate comparison between single‐slice and multi‐slice measurements, sex‐specific z‐scores were calculated. Pearson correlation coefficients and Bland–Altman analysis were used to quantify agreement. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for death adjusting for age, sex, race/ethnicity, height, and tumour site and stage. Results Single‐slice area and multi‐slice abdominal volumes were highly correlated for all tissues (SKM R = 0.92, P < 0.001; SAT R = 0.97, P < 0.001; VAT R = 0.98, P < 0.001; IMAT R = 0.89, P < 0.001). Bland–Altman plots had a bias of 0 (SE: 0.00), indicating high average agreement between measures. The limits of agreement were narrowest for VAT ( ± 0.42 SD) and SAT ( ± 0.44 SD), and widest for SKM ( ± 0.78 SD) and IMAT ( ± 0.92 SD). The HRs had overlapping CIs, and similar magnitudes and direction of effects; for example, a 1‐SD increase in SKM area was associated with an 18% decreased risk of death (HR = 0.82; 95% CI: 0.72–0.92), versus 15% for volume from T12 to L5 (HR = 0.85; 95% CI: 0.75–0.96). Conclusions Single‐slice L3 areas and multi‐slice T12–L5 abdominal volumes of SKM, VAT, SAT and IMAT are highly correlated. Associations between area and volume measures with all‐cause mortality were similar, suggesting that they are equivalent tools for population studies if body composition is assessed at a single timepoint. Future research should examine longitudinal changes in multi‐slice tissues to improve individual risk prediction.

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“…Weitere Publikationen belegen sogar, dass eine reduzierte Energie-und Nährstoffzufuhr zu Veränderungen des Stoffwechsels führt, welche wiederum einer erfolgreichen Krebstherapie entgegenwirken. Eine Mangelernährung kann auch die von PatientInnen maximal tolerierte Dosis an Zytostatika reduzieren und auf diese Weise zu Unterbrechungen im geplanten Behandlungsablauf führen [17][18][19][20].…”

Section: Mangelernährungunclassified

Supportive Ernährungstherapie für onkologische PatientInnen während der Behandlungsphase

Erickson

Saraç

Frank

2022

Deutsche Zeitschrift für Onkologie

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ZusammenfassungInsbesondere für onkologische PatientInnen besteht während der Therapiephase ein erhöhtes Risiko für eine reduzierte Flüssigkeits-, Energie- und Nährstoffzufuhr, was wiederum zur Mangelernährung führen kann. Zunehmende Evidenzen belegen den negativen Effekt der Mangelernährung auf Therapieerfolg, Morbidität und Mortalität. Daher sind angemessene ernährungstherapeutische Maßnahmen unabdingbar. Gezielte Ernährungsinterventionen sollen der Ätiologie einer Mangelernährung (wie z. B. Diarrhoe, Übelkeit und Appetitlosigkeit) entgegenwirken und sollten patientenzentriert erfolgen. Hierzu gehört auch die Beseitigung von Fehlinformation und die Vermittlung von praktischen und einsetzbaren Empfehlungen.

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Body Composition and Dose-limiting Toxicity in Colorectal Cancer Chemotherapy Treatment; a Systematic Review of the Literature. Could Muscle Mass be the New Body Surface Area in Chemotherapy Dosing?

Cited by 22 publications

References 70 publications

Body composition is associated with tacrolimus pharmacokinetics in kidney transplant recipients

Body composition is associated with tacrolimus pharmacokinetics in kidney transplant recipients

Body composition from single versus multi‐slice abdominal computed tomography: Concordance and associations with colorectal cancer survival

Supportive Ernährungstherapie für onkologische PatientInnen während der Behandlungsphase

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