Pretreatment cancer-associated weight loss may be more common in patients of low socioeconomic status (SES) who are diagnosed with non–small cell lung cancer (NSCLC), according to research published in the Journal of Oncology Practice.1
Cancer-associated weight loss, which can lead to worse tolerance to anticancer therapy and reduced quality of life, is linked to worse survival outcomes among patients with cancer. For this study, researchers evaluated whether SES, as assessed by primary payer, was an indicator for disease-associate weight loss among patients diagnosed with NSCLC between 2006 and 2013.
Of the 1366 included patients, the median age at NSCLC diagnosis was 64 years, 47% were women, and 67% were white; 21.2%, 8%, 26.6%, and 44.2% of patients had stage I, II, III, and IV disease, respectively.
Insurance status, higher age at diagnosis, African American ethnicity, single marital status, tobacco use, and disease stage were each associated with pretreatment weight loss; weight loss was seen in 17%, 14%, 32%, and 38% of patients with stage I, II, III, and IV disease, respectively. Patients with Medicaid (odds ratio, 2.17) or who were not insured (odds ratio, 2.32) were more likely than patients with private insurance to have pretreatment weight loss at diagnosis.
The median overall survival was 17 months. Patients with pretreatment weight loss had a worse survival if they were uninsured (hazard ratio, 1.63) compared with privately insured patients. No survival discrepancy was, however, found between insured and uninsured patients without weight loss.
On multivariate analysis, primary payer was not associated with survival among patients with weight loss.
The authors concluded that “use of cancer cachexia–directed therapies may improve outcomes, and further study on the biologic mechanisms of cancer cachexia will provide novel therapeutic avenues.”
- Lau SK, Gannavarapu BS, Carter K, et al. Impact of socioeconomic status on pretreatment weight loss and survival in non–small-cell lung cancer. J Oncol Pract. 2018 Mar 20. doi: 10.1200/JOP.2017.025239 [Epub ahead of print]