Moderated Poster
Hiroki Ishihara
Medical Doctor
Tokyo Women's Medical University
Presentation Authors: Hiroki Ishihara*, Toshio Takagi, Tsunenori Kondo, Hironori Fukuda, Kazuhiko Yoshida, Junpei Iizuka, Hirohito Kobayashi, Masayoshi Okumi, Hideki Ishida, Kazunari Tanabe, Tokyo, Japan
Introduction: Sarcopenia is a state of degenerative skeletal muscle wasting induced by cancer cachexia. To evaluate the prognostic impact of change in skeletal muscle mass (SMM) during first-line sunitinib therapy on oncological outcomes in metastatic renal cell carcinoma (mRCC).
Methods: Sixty-nine patients were evaluated retrospectively. The skeletal muscle index (SMI) was calculated based on computed tomography images obtained before the initiation (pretreatment SMI) and after two cycles of sunitinib treatment (posttreatment SMI). The change in SMM was evaluated based on the value of δSMI which was calculated as [(posttreatment SMI-pretreatment SMI)/ pretreatment SMI] × 100. We divided the patients as follows: δSMI < 0 (SMM decrease) and δSMI ≥ 0 (SMM maintenance). Oncological outcomes were compared between the groups.
Results: A decrease in SMM was observed in 38 patients (55.1%). Progression-free survival (PFS) and overall survival (OS) after sunitinib therapy initiation were significantly shorter in patients with δSMI < 0 than in those with δSMI ≥ 0 (median PFS: 9.53 vs. 28.4 months, p < 0.0001; OS: 19.8 vs. 52.6 months, p = 0.0001). The δSMI was an independent factor for PFS (HR: 3.25, 95% CI: 1.74-6.29, p = 0.0002) and OS (HR: 4.53, 95% CI: 2.15-10.5, p < 0.0001). The objective response rate was significantly lower in patients with δSMI < 0 than in those with δSMI ≥ 0 (23.7% vs. 51.6%, p = 0.0164).
Conclusions: Decreased SMM during first-line sunitinib therapy can be a useful marker of outcome prediction for mRCC.
