Cachexia Index in Advanced Non-Small-Cell Lung Cancer Patients

the Cancer Therapy Advisor take:

The cachexia index is a novel index for estimating cachexia that is also associated with prognosis in both male and female patients with advanced non-small cell lung cancer (NSCLC), according to a study published in Clinical Medicine Insights: Oncology.

Because many patients with advanced NSCLC experience cancer cachexia, researchers developed the cachexia index to evaluate its extent.

For the study, researchers retrospectively analyzed data from 112 patients with metastatic NSCLC diagnosed between 2000 and mid-2011 at Louisiana State University Health Science Center.

Researchers used findings from patients’ abdominal computed tomography (CT) scans done within 1 month of diagnosis to estimate skeletal muscle area (SMA) and skeletal muscle index (SMI). Researchers then developed their cachexia index with the formula: cachexia index = (SMI x serum albumin)/(neutrophil-to-lymphocyte ratio).

Patients were then divided into 2 groups: those with a cachexia index 35 or greater (stage I cachexia) or a cachexia index less than 35 (stage II cachexia).

Researchers found that patients with stage II cachexia had significantly worse progression-free survival and overall survival compared with those with stage I cachexia.

The findings suggest that the cachexia index is an objective method for estimating the degree of cachexia in patients with advanced NSCLC, allowing it to be used to identify patients who are at high risk of early disease progression and identify those who should receive therapies directed against cancer cachexia.

References

Siegel R, Ma J, Zou Z, Jamal A. Cancer statistics 2014. CA Cancer J Clin. 2014;64(1):9–29.
Wagner PD. Possible mechanisms underlying the development of cachexia in COPD. Eur Respir J. 2008;31(3):492–501.
Anker SD, Sharma R. The syndrome of cardiac cachexia. Int J Cardiol. 2002;85(1):51–66.
Von Roenn JH, Roth EL, Craig R. HIV-related cachexia: potential mechanisms and treatment. Oncology. 1992;49(2):50–4.
Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12:489–95.
Tsoli M, Robertson G. Cancer cachexia: malignant inflammation, tumorkines, and metabolic mayhem. Trends Endocrinol Metab. 2013;24(4):174–83.
Ferraro CD, Grant M, Koczywas M, Dorr-Uemura L. Management of anoreixacachexia in late stage lung cancer patients. J Hosp Palliat Nurs. 2012;14(6):1–12.
Fox KM, Brooks JM, Gandra SR, Markus R, Chio CF. Estimation of cachexia among cancer patients based on four definitions. J Oncol. 2009;2009:693458.
Evans WJ, Morley JE, Argilés J, et al. Cachexia: a new definition. Clin Nutr. 2008;27(6):793–9.
Bozzetti F, Mariani L. Defining and classifying cancer cachexia: a proposal by the SCRINIO working group. J Parenter Enteral Nutr. 2009;33(4):361–7.
van der Meij BS, Schoonbeek CP, Smit EF, Muscaritoli M, van Leeuwen PA, Langius JA. Pre-cacehxia and cachexia at diagnosis of stage III non-small-cell lung carcinoma: an exploratory study comparing two consensus-based frame works. Br J Nutr. 2013;109(12):2231–9.
Fearon KC, Glass DJ, Guttridge DC. Cancer cachexia: mediators, signaling, and metabolic pathways. Cell Metab. 2012;16:153–66.
Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systemic review of the epidemiological literature. Nutr J. 2010;9:69.
Lin GN, Peng JW, Liu PP, Liu DY, Xiao JJ, Chen XQ. Elevated neutrophil-tolymphocyte ratio predicts poor outcome in patients with advanced non-small-cell lung cancer receiving first line gefitinib or erlotinib treatment. Asia Pac J Clin Oncol. 2014. [EPUB ahead of print].
Koch A, Fohlin H, Sorenson S. Prognostic significant of C-reactive protein and smoking in patients with advanced non-small cell lung cancer treated with first line palliative chemotherapy. J Thorac Oncol. 2009;4(3):326–32.
Martin L, Birdsell L, Macdonald N, et al. Cancer cachexia in the age of obesity: Skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 2013;31(12):1539–47.
Ryan AS, Ivey FM, Prior S, Li G, Hafer-Macko C. Skeletal muscle hypertrophy and muscle myostatin reduction after resistive training in storke survivors. Stroke. 2011;42(2):416–20.
Jafri SH, Shi R, Mills G. Advanced lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC):a retrospective review. BMC Cancer. 2013;13:158.
Alberici Pastore C, Pavia Orlandi S, Gonzalez MC. Association between inflammatory-nutritional index and nutritional status in cancer patients. Nutr Hosp. 2013;28(1):188–93.
Argilés JM, López-Soriano FJ, Toledo M, Betancourt A, Serpe R, Busquets S. The Cachexia Score (CASCO): a new tool for staging cachectic cancer patients. J Cachexia Sarcopenia Muscle. 2011;2(2):87–93.
Douglas E, McMillan DC. Towards a simple objective framework for the investigation and treatment of cancer cachexia: the Glasgow Prognostic Score. Cancer Treat Rev. 2014;40:685–91.
Kasymjanova G, MacDonald N, Agulnik JS, et al. The predictive value of pretreatment inflammatory markers in advanced non-small cell lung cancer. Curr Oncol. 2010;17(4):52–8.
Gagnon B, Agulnik JS, Gioulbasanis I, Kasymjanova G, Morris D, MacDonald N. Montreal prognostic score: estimating survival of patients with non-small cell lung cancer using clinical biomarkers. Br J Cancer. 2013;109:2066–71.

Source: Clinical Medicine Insights: Oncology

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Lung Cancer Non-Small Cell Lung Cancer Publishers Alliance

Cachexia Index in Advanced Non-Small-Cell Lung Cancer Patients

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