Higher drug doses according to lean body mass may be a significant predictor of chemotherapy-induced hematological toxicity in patients being treated for stage 3B/4 non-small cell lung cancer (NSCLC), according to a Norwegian study published in Lung Cancer.

Researchers led by Bjørg Sjøblom, MD, of the Oslo University Hospital, in Oslo, Norway, wanted to determine whether dose estimation of chemotherapeutic agents through body surface area rather than lean body mass contributed to increased toxicity in patients with NSCLC.

They examined 153 patients from a randomized phase 3 trial comparing two chemotherapy regimens who received intravenous gemcitabine with oral vinorelbine. Lean body mass was estimated from computed tomography images obtained before chemotherapy.

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Upon bivariate and multivariate analyses, the researchers found that higher doses of both gemcitabine and vinorelbine per kg of lean body mass was significantly associated with grade 3-4 hematological toxicity. There was no association between drug dosage per kg of lean body mass and dose reduction or stop of treatment.

“The results indicate that taking lean body mass into account may lead to a better dose individualization of chemotherapy,” the authors concluded.


  1. Sjøblom B, Grønberg BH, Benth, JS, et al. Low muscle mass is associated with chemotherapy-induced haematological toxicity in advanced non-small cell lung cancer. Lung Cancer. 2015. doi: http://dx.doi.org/10.1016/j.lungcan.2015.07.001.