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Body composition and inflammation impact in non-small-cell lung cancer patients treated by first-line immunotherapy

    Cinzia Baldessari

    *Author for correspondence:

    E-mail Address: cinzia.baldessari@libero.it

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Annarita Pecchi

    Department of Radiology, University of Modena & Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Raffaella Marcheselli

    Department of Diagnostic, Clinical & Public Health Medicine, University of Modena & Reggio Emilia, Modena, Modena, 41124, Italy

    ,
    Giorgia Guaitoli

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Riccardo Bonacini

    Department of Radiology, University of Modena & Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Filippo Valoriani

    Unit of Metabolic Disorder & Clinical Nutrition, Department of Specialist Medicines, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Pietro Torricelli

    Department of Radiology, University of Modena & Reggio Emilia, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Linda Reverberi

    Unit of Metabolic Disorder & Clinical Nutrition, Department of Specialist Medicines, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Renata Menozzi

    Unit of Metabolic Disorder & Clinical Nutrition, Department of Specialist Medicines, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Giuseppe Pugliese

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Maria Giuseppa Vitale

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Roberto Sabbatini

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Federica Bertolini

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    ,
    Fausto Barbieri

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    &
    Massimo Dominici

    Department of Oncology & Hematology, Azienda Ospedaliero-Universitaria of Modena, Modena, 41124, Italy

    Published Online:https://doi.org/10.2217/imt-2021-0038

    Background: Immunotherapy changed the landscape of non-small-cell lung cancer (NSCLC). Efforts were made to implement its action. This study aims to describe body composition, nutritional and inflammatory status in NSCLC patients treated by first-line immunotherapy, their correlation, variation and impact. Patients and methods: We retrospectively analyzed 44 consecutive patients who received pembrolizumab treatment. Results: During the therapy, inflammation and visceral fat increased, whereas muscle and subcutaneous fat decreased. Parameters related to inflammation had an interesting prognostic impact. High numbers of white blood cells remained significantly correlated with a high risk of death in multivariate model. Conclusion: For the best treatment choice, a combination of clinical and biological factors will be most likely be necessary. Prospective and larger studies with a multidimensional approach are needed.

    Lay abstract

    Inflammation and malnutrition in cancer patients may affect the immune system and response to therapy. We noticed an increase in inflammation and visceral fat and a decrease in muscle and subcutaneous fat during therapy. No variation showed a significant correlation with survival. Muscle mass, adipose tissue and body mass index do not confirm any prognostic impact or relationship with response to therapy. More interesting results were observed with parameters related to inflammation. Probably, for the best treatment choice, a combination of clinical and biological factors will be necessary. Further studies with a multidimensional approach are needed to propose the best treatment and the best support to everyone.

    Tweetable abstract

    Body composition, nutritional and inflammatory status changed during first-line immunotherapy on NSCLC patients. Inflammation has interesting prognostic implications. Combined with other factors, these clinical characteristics may be important to optimize the care of patients.

    Graphical abstract

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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