The impact of sarcopenia on the efficacy and safety of immune checkpoint inhibitors in patients with solid tumours

Background Evidence suggests that sarcopenia is a significant predictive factor of worst outcomes and treatment-associated toxicities in patients with metastatic solid tumours. The aim of this study was to explore the relationship between low muscle mass and clinical outcomes and immune-related severe toxicities (IrST) in patients treated with immune checkpoint inhibitors (ICIs). Methods A retrospective cohort of 261 consecutive metastatic solid tumour patients treated with ICIs were included in our study. Low muscle mass was defined as skeletal muscle index <41 cm(2)/m(2) for females and <43 cm(2)/m(2) for males if body mass index (BMI) <25 kg/m(2) or <53 cm(2)/m(2) if BMI >= 25 kg/m(2). Severe toxicities (ST), including grade III-IV toxicities and side effects leading to treatment interruption, were recorded. Results The majority of patients (n = 179; 69%) included in this study had metastatic lung cancer. The prevalence of low muscle mass was 47%. The median progression-free survival (PFS) was 32.2 weeks for low muscle mass patients and 24.3 weeks for non-low muscle mass patients (adjusted HR, 0.80; 95% CI, 0.60-1.055; p = 0.11). For low muscle mass and non-low muscle mass lung cancer patients, median PFS was 24.0 weeks and 18.8 weeks (adjusted HR, 0.70; 95% CI, 0.50-0.98; p = 0.04) and median overall survival was 50.7 weeks and 41.1 weeks (adjusted HR, 0.77; 95% CI, 0.54-1.10, p = 0.15) respectively. Immune-related severe toxicities occurred in 3.3% and 9.4% of low muscle mass and non-low muscle mass patients respectively (adjusted OR, 0.69; 95% CI: 0.31-1.49; p = 0.35). Conclusion No difference in outcomes and safety was observed for low muscle mass and non-low muscle mass patients treated with ICIs.

Automated summary

Research shows that there is no significant difference in clinical outcomes and safety between patients with low muscle mass and those with non-low muscle mass treated with ICIs.