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Alvarez-Altamirano K, Miramontes-Balcon K, Cárcoba-Tenorio C, Bejarano-Rosales M, Amanda-Casillas M, Serrano-Olvera JA, Fuchs-Tarlovsky V. Resting energy expenditure changes after antineoplastic treatment in gynecological cancer: a prospective pilot study. NUTR HOSP 2023; 40:1199-1206. [PMID: 37929857 DOI: 10.20960/nh.04768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction Introduction: energy metabolism in cancer patients is influenced by different factors. However, the effect of antineoplastic treatment is not clear, especially in women. Objective: to evaluate resting energy expenditure (REE) by indirect calorimetry (IC) before (T0) and after (T1) first cycle period of antineoplastic therapy: radiotherapy (RT), chemotherapy (CT), and concomitant chemoradiation therapy (CRT), quality of life (QoL) and accuracy of REE were compared with international guidelines recommendations per kilogram (European Society for Clinical Nutrition and Metabolism [ESPEN]). Methods: an observational, longitudinal study was conducted in women with gynecological cancer diagnosis undergoing antineoplastic treatment: RT, CT and CRT. Weight loss, actual body weight and height were measured. REE was evaluated in T0-T1 and compared with ESPEN recommendations. Kruskal-Wallis test and Bland-Alman analysis were used to determine the agreement (± 10 % of energy predicted) of REE adjusted by physical activity (TEE) compared with ESPEN recommendations, respectively. Results: fifty-four women with cancer were included: 31.5 % (n = 17) for RT group, 31.5 % (n = 17) for CT group and 37 % (n = 20) for CRT group. REE showed statistical differences between T0 and T1 in the total population (p = 0.018), but these were not associated with anticancer therapy groups (p > 0.05). QoL had no significant changes after treatment (p > 0.05). Accuracy of 25 and 30 kcal/kg compared to TEE was less than 30 %. Conclusion: REE in women with gynecological cancer decreased after antineoplastic treatments but this is not associated with a particular antineoplastic therapy. It is needed to develop research to determine the accuracy of ESPEN recommendations with TEE estimated by IC and clinical factors in women with cancer.
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De Moura A, Turpin A, Neuzillet C. [Nutritional supportive care in the course of patients with esophagogastric cancers]. Bull Cancer 2023; 110:540-551. [PMID: 36202638 DOI: 10.1016/j.bulcan.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/02/2022] [Accepted: 08/13/2022] [Indexed: 05/09/2023]
Abstract
Supportive care plays a central role in the management of patients with esophagogastric cancers, at all disease stages. Malnutrition has a high prevalence in this population, reaching up to 60 % of the patients. Sarcopenia and cachexia are also common. These complications have negative impact on functional abilities, quality of life and overall survival. They impair anti-tumor treatments effectiveness and increase their toxicity. Early detection and management are needed, before reaching advanced stages, which are refractory to therapeutic interventions. Specific nutritional support is recommended, relying on different nutritional support tools (dietetic counseling, oral supplements, artificial nutrition), depending on the clinical situation. When artificial nutrition is recommended, enteral nutrition (nasogastric tube, gastrostomy or jejunostomy) should be preferred. When enteral nutrition is impossible or insufficient, parenteral nutrition could be necessary. For patients with advanced esophagogastric cancers, digestive prostheses and decompressive radiation therapy may have a symptomatic benefit on dysphagia. Adapted physical activity is also recommended at all stages of cancer care and ongoing clinical trials will help to specify its modalities and to optimize its place in the therapeutic strategy. Finally, psychosocial support could be useful. A combined approach of these different interventions on the nutritional, physical and psychological aspects is beneficial for patients with esophagogastric cancers. This multimodal and multidisciplinary approach applies to both the early stages of the disease, with prehabilitation and/or rehabilitation to reduce perioperative morbidity and mortality and the advanced stages, with a benefit on survival and quality of life, in parallel with anti-tumor treatments.
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Affiliation(s)
- Alexandre De Moura
- Institut Curie, université Versailles Saint-Quentin, université Paris Saclay, département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
| | - Anthony Turpin
- Université de Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277, CANTHER, Cancer heterogeneity plasticity and resistance to therapies, 59000 Lille, France
| | - Cindy Neuzillet
- Institut Curie, université Versailles Saint-Quentin, université Paris Saclay, département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France
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Bulmuş Tüccar T, Acar Tek N. Determining the factors affecting energy metabolism and energy requirement in cancer patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2021; 26:124. [PMID: 35126587 PMCID: PMC8772515 DOI: 10.4103/jrms.jrms_844_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/26/2020] [Accepted: 07/15/2021] [Indexed: 11/04/2022]
Abstract
Cancer is the second most common cause of death worldwide. It is a generic name for a large group of diseases that can affect any part of the body. Cancer affects both energy intake through the diet and the total energy expenditure (TEE) through the changes in energy metabolism, resulting in negative or positive energy balance. Determining daily energy requirement is very important in the regulation of the nutrition therapy in a cancer patients. Due to the difficulty in directly measuring the TEE, resting energy expenditure, which is the largest component of the TEE, is often used in the determination of the energy requirement. In this study, the effects of disease-specific factors such as tumor burden, inflammation, weight loss and cachexia on energy metabolism in cancer patients were investigated.
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Affiliation(s)
- Tuğçe Bulmuş Tüccar
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Yüksek İhtisas University, Ankara, Turkey
| | - Nilüfer Acar Tek
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Boudou-Rouquette P, Arrondeau J, Gervais C, Durand JP, Fabre E, De Percin S, Villeminey CV, Piketty AC, Rassy N, Ulmann G, Damotte D, Mansuet-Lupo A, Giraud F, Alifano M, Wislez M, Alexandre J, Jouinot A, Goldwasser F. Development and validation of a host-dependent, PDL1-independent, biomarker to predict 6-month progression-free survival in metastatic non-small cell lung cancer (mNSCLC) patients treated with anti-PD1 immune checkpoint inhibitors (ICI) in the CERTIM Cohort: The ELY study. EBioMedicine 2021; 73:103630. [PMID: 34688030 PMCID: PMC8536532 DOI: 10.1016/j.ebiom.2021.103630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/30/2021] [Accepted: 10/04/2021] [Indexed: 12/24/2022] Open
Abstract
Background Immune checkpoint inhibitors (ICI) are dramatically active in a minority of non-small cell lung cancer (NSCLC) patients. We studied here the relationship between patients's metabolism and outcome under ICI. Methods Metastatic NSCLC patients underwent a nutritional assessment prior to initiating immunotherapy. Resting energy expenditure (REE) was measured (mREE) using ambulatory indirect calorimetry and compared with the theoretical value (tREE) provided by the Harris and Benedict formula. The primary endpoint was 6-month progression-free survival (PFS). Secondary endpoints included objective response rate (ORR) and disease control rate (DCR) based on investigator review per RECIST v1.1. and overall survival (OS). The association of patient's metabolism with 6-month PFS was first explored in a single-center training cohort to estimate the effect size. The relationship between patient's metabolism and 6-month PFS was then tested in an independent non interventional observational prospective cohort (ELY) of 100 patients recruited in two tertiary university centers. Findings In the entire cohort, the ORR was 14% for the hypermetabolic group (n = 10/74) vs 38% for the normometabolic group (n = 26/68), respectively (estimated difference 25%, 95CI 9–40%, p = 0.001). The DCR was 28% for the hypermetabolic group (n = 21/74) vs 53% for the normometabolic group (n = 36/68), respectively (estimated difference 25%, 95CI 7–42%, p = 0.005). In the validation cohort (100 patients, 2 centers), normometabolic patients (defined as mREE/tREE < 110%) had increased 6-month PFS (57% versus 22%; odds ratio: 4.76; IC95 [1.87 – 12.89]; p<0.001) and improved overall survival (HR 2.20; IC95: 1.41–3.44; p<0.001). The positive and negative predictive values of normometabolism to identify non-progressive patients at 6 months, were 57% and 78% respectively, sensitivity was 72% and specificity was 66%. In multivariate analysis including PD-L1 tumor status, basal metabolism was an independent predictive factor for 6-month PFS. Interpretation Normometabolism is a new independent parameter to identify mNSCLC patients who will benefit from ICI, with both improved tumor response, 6-month PFS, and survival. Funding This work was supported by Baxter (04012016).
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Affiliation(s)
- Pascaline Boudou-Rouquette
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France.
| | - Jennifer Arrondeau
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France
| | - Claire Gervais
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France
| | - Jean-Philippe Durand
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Thoracic Oncology Department, Hôpital Européen Georges Pompidou (HEGP), AP-HP; Cancer Research for PErsonalized Medicine (CARPEM); Paris University, France
| | - Elizabeth Fabre
- Thoracic Oncology Department, Hôpital Européen Georges Pompidou (HEGP), AP-HP; Cancer Research for PErsonalized Medicine (CARPEM); Paris University, France
| | - Sixtine De Percin
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France
| | - Clémentine Vaquin Villeminey
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France
| | - Anne-Catherine Piketty
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France
| | - Nathalie Rassy
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France
| | - Guillaume Ulmann
- Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France; Clinical Chemistry, Cochin Hospital, AP-HP, Paris University, France; URP 4466 PRETRAM, AP-HP, Paris University, France
| | - Diane Damotte
- Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France; Pathology Department, Cochin Hospital, AP-HP, Paris University, France; Centre de recherche des Cordeliers, INSERM U1138, Paris University, France
| | - Audrey Mansuet-Lupo
- Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France; Pathology Department, Cochin Hospital, AP-HP, Paris University, France; Centre de recherche des Cordeliers, INSERM U1138, Paris University, France
| | - Frédérique Giraud
- Molecular Genetics Department, Cochin Hospital, AP-HP, Paris University, France
| | - Marco Alifano
- Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France; Thoracic Surgery Department, Cochin Hospital, AP-HP, Paris University, France
| | - Marie Wislez
- Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France; Pneumology Department, Cochin Hospital, AP-HP, Paris University, France
| | - Jérôme Alexandre
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France
| | - Anne Jouinot
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France
| | - François Goldwasser
- Medical Oncology Department, Cochin Hospital, AP-HP; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Immunomodulatory Therapies Multidisciplinary Study group (CERTIM), Cochin Hospital, AP-HP, 75014 Paris, France; URP 4466 PRETRAM, AP-HP, Paris University, France
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Bendavid I, Lobo DN, Barazzoni R, Cederholm T, Coëffier M, de van der Schueren M, Fontaine E, Hiesmayr M, Laviano A, Pichard C, Singer P. The centenary of the Harris-Benedict equations: How to assess energy requirements best? Recommendations from the ESPEN expert group. Clin Nutr 2021; 40:690-701. [PMID: 33279311 DOI: 10.1016/j.clnu.2020.11.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/18/2020] [Accepted: 11/10/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS The year 2019 marked the centenary of the publication of the Harris and Benedict equations for estimation of energy expenditure. In October 2019 a Scientific Symposium was organized by the European Society for Clinical Nutrition and Metabolism (ESPEN) in Vienna, Austria, to celebrate this historical landmark, looking at what is currently known about the estimation and measurement of energy expenditure. METHODS Current evidence was discussed during the symposium, including the scientific basis and clinical knowledge, and is summarized here to assist with the estimation and measurement of energy requirements that later translate into energy prescription. RESULTS In most clinical settings, the majority of predictive equations have low to moderate performance, with the best generally reaching an accuracy of no more than 70%, and often lead to large errors in estimating the true needs of patients. Generally speaking, the addition of body composition measurements did not add to the accuracy of predictive equations. Indirect calorimetry is the most reliable method to measure energy expenditure and guide energy prescription, but carries inherent limitations, greatly restricting its use in real life clinical practice. CONCLUSIONS While the limitations of predictive equations are clear, their use is still the mainstay in clinical practice. It is imperative to recognize specific patient populations for whom a specific equation should be preferred. When available, the use of indirect calorimetry is advised in a variety of clinical settings, aiming to avoid under-as well as overfeeding.
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Affiliation(s)
- Itai Bendavid
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden; Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Moïse Coëffier
- Department of Nutrition, CIC1404, Rouen University Hospital and Normandie University, UNIROUEN, Inserm UMR1073, Rouen, France
| | - Marian de van der Schueren
- Department of Nutrition and Dietetics, HAN University of Applied Sciences, School of Allied Health, Nijmegen, the Netherlands
| | - Eric Fontaine
- Université Grenoble Alpes, LBFA, INSERM U1055, Grenoble, France
| | - Michael Hiesmayr
- Division of Cardiac, Thoracic, Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Claude Pichard
- Clinical Nutrition, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel.
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Moreira M, Pobel C, Epaillard N, Simonaggio A, Oudard S, Vano YA. Resistance to cancer immunotherapy in metastatic renal cell carcinoma. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2020; 3:454-471. [PMID: 35582435 PMCID: PMC8992500 DOI: 10.20517/cdr.2020.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/06/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022]
Abstract
The prognosis of metastatic clear cell renal cell carcinoma (mccRCC) has changed dramatically over the years with the emergence of immune checkpoint inhibitors (ICI) used alone, or in combination with another ICI, or with vascular endothelial growth factor receptor tyrosine kinase inhibitor. Although major response rates have been observed with ICI, many patients do not respond, reflecting primary resistance, and durable responses remain exceptional, reflecting secondary resistance. Factors contributing to primary and acquired resistance are manifold, including patient-intrinsic factors, tumor cell-intrinsic factors and factors associated with the tumoral microenvironment (TME). While some mechanisms of resistance are common to several tumor types, others are specific to mccRCC. Predictive biomarkers and alternative strategies are needed to overcome this resistance. This review provides an overview of the major ICI resistance mechanisms, highlights the potential of the TME to induce resistance to ICI, and discusses the predictive biomarkers available to guide therapeutic choice.
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Affiliation(s)
- Marco Moreira
- Centre de Recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Paris F-75006, France.,Both authors contributed equally
| | - Cedric Pobel
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France.,University François Rabelais, Tours 37200, France.,Both authors contributed equally
| | - Nicolas Epaillard
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France
| | - Audrey Simonaggio
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France
| | - Stéphane Oudard
- Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France.,INSERM UMR-S1147, Paris 75006, France
| | - Yann-Alexandre Vano
- Centre de Recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Paris F-75006, France.,Department of Medical Oncology, European Hospital Georges Pompidou - APHP, Paris 75015, France
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Jouinot A, Ulmann G, Vazeille C, Durand JP, Boudou-Rouquette P, Arrondeau J, Tlemsani C, Fournel L, Alifano M, Wislez M, Chapron J, Le Bris C, Mansuet-Lupo A, Damotte D, Neveux N, De Bandt JP, Alexandre J, Cynober L, Goldwasser F. Hypermetabolism is an independent prognostic factor of survival in metastatic non-small cell lung cancer patients. Clin Nutr 2019; 39:1893-1899. [PMID: 31443979 DOI: 10.1016/j.clnu.2019.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Metastatic non-small cell lung cancer (NSCLC) is the first cause of cancer death worldwide. Increased resting energy expenditure (REE) is frequent among cancer patients and may contribute to cancer cachexia. The aim of this study was to examine the prognostic value of increased REE in metastatic NSCLC patients. METHODS This observational study was conducted between June 2012 and November 2017 in the outpatient unit of the oncology department of Cochin hospital, Paris. Consecutive patients with newly diagnosed stage IV NSCLC underwent measurement of REE by indirect calorimetry before treatment initiation. Uni- and multivariate analysis of overall survival (OS, Cox models) included age, sex, smoking habit, histological subtype, performance status, body mass index, weight loss, albumin and CRP levels and the ratio of measured REE to the REE predicted by the Harris Benedict formula (mREE/pREE). RESULTS 144 patients were enrolled: mean age 64 years, 63% male, 90% non-squamous carcinoma, including 17% with ALK/EGFR alteration. In univariate analysis, tobacco consumption (p = 0.007), histo-molecular subtype (p < 10-3), performance status (p = 0.04), weight loss (p < 10-4), albumin (p < 10-4), CRP (p = 0.001) and mREE/pREE ratio (>vs ≤ 120%: HR = 2.16, p < 10-3) were significant prognostic factors of OS. Median OS were 6.1 and 17.3 months in patients with mREE/pREE ratio > and ≤120%, respectively. In multivariate analysis, histo-molecular subtype (non-squamous ALK/EGFR mutated vs squamous carcinoma: HR = 0.25, p = 0.006), weight loss (>vs ≤ 5%: HR = 1.98, p = 0.004), albumin (≥vs < 35 g/L: HR = 0.56, p = 0.02) and mREE/pREE ratio (> vs ≤120%: HR = 1.90, p = 0.004) were identified as independent prognostic factors. CONCLUSIONS Elevated resting energy expenditure emerges as an independent prognostic factor in metastatic NSCLC.
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Affiliation(s)
- Anne Jouinot
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France; Institut Cochin, INSERM U1016, CNRS UMR8104, Paris Descartes University, Paris, France.
| | - Guillaume Ulmann
- Clinical Chemistry, Paris Centre Teaching Hospitals, AP-HP, Paris Descartes University, USPC, Paris, France; EA 4466 PRETRAM, Pharmacy Faculty, Paris Descartes University, USPC, Paris, France
| | - Clara Vazeille
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Jean-Philippe Durand
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France; EA 4466 PRETRAM, Pharmacy Faculty, Paris Descartes University, USPC, Paris, France
| | - Pascaline Boudou-Rouquette
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Jennifer Arrondeau
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Camille Tlemsani
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Ludovic Fournel
- Thoracic Surgery Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Paris Descartes University, Paris, France
| | - Marco Alifano
- Thoracic Surgery Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Paris Descartes University, Paris, France
| | - Marie Wislez
- Pneumology Department, Paris Centre Teaching Hospitals, AP-HP, Paris Descartes University, USPC, Paris, France
| | - Jeanne Chapron
- Pneumology Department, Paris Centre Teaching Hospitals, AP-HP, Paris Descartes University, USPC, Paris, France
| | - Camille Le Bris
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Audrey Mansuet-Lupo
- Pathology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Centre de recherche des Cordeliers, INSERM U1138, Paris Descartes University, USPC, Paris, France
| | - Diane Damotte
- Pathology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Centre de recherche des Cordeliers, INSERM U1138, Paris Descartes University, USPC, Paris, France
| | - Nathalie Neveux
- Clinical Chemistry, Paris Centre Teaching Hospitals, AP-HP, Paris Descartes University, USPC, Paris, France; EA 4466 PRETRAM, Pharmacy Faculty, Paris Descartes University, USPC, Paris, France
| | - Jean-Pascal De Bandt
- Clinical Chemistry, Paris Centre Teaching Hospitals, AP-HP, Paris Descartes University, USPC, Paris, France; EA 4466 PRETRAM, Pharmacy Faculty, Paris Descartes University, USPC, Paris, France
| | - Jérôme Alexandre
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France
| | - Luc Cynober
- Clinical Chemistry, Paris Centre Teaching Hospitals, AP-HP, Paris Descartes University, USPC, Paris, France; EA 4466 PRETRAM, Pharmacy Faculty, Paris Descartes University, USPC, Paris, France
| | - François Goldwasser
- Medical Oncology Department, Paris Centre Teaching Hospitals, AP-HP, Paris, France; Cancer Research for PErsonalized Medicine (CARPEM), Paris, France; Paris Descartes University, USPC, Paris, France; EA 4466 PRETRAM, Pharmacy Faculty, Paris Descartes University, USPC, Paris, France
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Rassy EE, Ghosn M, Rassy NA, Assi T, Robert C. Do immune checkpoint inhibitors perform identically in patients with weight extremes? Immunotherapy 2019; 10:733-736. [PMID: 30008261 DOI: 10.2217/imt-2018-0053] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The interaction between the two recent hallmarks of carcinogenesis, the immune system and energetic metabolism, has not been well investigated. The limited literature available on this topic describes a correlation between the efficacy and safety of immune checkpoint inhibitors with body mass index. A key knowledge gap is the understanding of this correlation as outcomes are strongly affected highlighting the need to prospective studies in this regard. This paper evaluates the rationale to these correlations at weight extremes and suggests the evaluation patient's weights and associated inflammatory profile before the initiation of immune checkpoint inhibition in cancer patients.
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Affiliation(s)
- Elie El Rassy
- Department of Medical Oncology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Lebanon
| | - Marwan Ghosn
- Department of Medical Oncology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Lebanon
| | - Nathalie Al Rassy
- Laboratory of Pathophysiology of Inflammatory Bone Diseases PMOI EA4490, University of Littoral Opal Coast ULCO, Boulogne sur Mer & University of Lille, Lille, France
| | - Tarek Assi
- Department of Medical Oncology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Lebanon.,Department of Medical Oncology, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, F-94805, France
| | - Caroline Robert
- Department of Onco-Dermatology, Institut Gustave Roussy & Université Paris-Sud, 114 Rue Edouard Vaillant, 94800 Villejuif, France
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Hilmi M, Jouinot A, Burns R, Pigneur F, Mounier R, Gondin J, Neuzillet C, Goldwasser F. Body composition and sarcopenia: The next-generation of personalized oncology and pharmacology? Pharmacol Ther 2018; 196:135-159. [PMID: 30521882 DOI: 10.1016/j.pharmthera.2018.12.003] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Body composition has gained increasing attention in oncology in recent years due to fact that sarcopenia has been revealed to be a strong prognostic indicator for survival across multiple stages and cancer types and a predictive factor for toxicity and surgery complications. Accumulating evidence over the last decade has unraveled the "pharmacology" of sarcopenia. Lean body mass may be more relevant to define drug dosing than the "classical" body surface area or flat-fixed dosing in patients with cancer. Since sarcopenia has a major impact on patient survival and quality of life, therapeutic interventions aiming at reducing muscle loss have been developed and are being prospectively evaluated in randomized controlled trials. It is now acknowledged that this supportive care dimension of oncological management is essential to ensure the success of any anticancer treatment. The field of sarcopenia and body composition in cancer is developing quickly, with (i) the newly identified concept of sarcopenic obesity defined as a specific pathophysiological entity, (ii) unsolved issues regarding the best evaluation modalities and cut-off for definition of sarcopenia on imaging, (iii) first results from clinical trials evaluating physical activity, and (iv) emerging body-composition-tailored drug administration schemes. In this context, we propose a comprehensive review providing a panoramic approach of the clinical, pharmacological and therapeutic implications of sarcopenia and body composition in oncology.
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Affiliation(s)
- Marc Hilmi
- Department of Medical Oncology, CAncer Research for PErsonalized Medicine (CARPEM), Paris Centre Teaching Hospitals, Paris Descartes University, USPC, Paris, France
| | - Anne Jouinot
- Department of Medical Oncology, CAncer Research for PErsonalized Medicine (CARPEM), Paris Centre Teaching Hospitals, Paris Descartes University, USPC, Paris, France
| | - Robert Burns
- Department of Radiology, Henri Mondor University Hospital, Créteil, France
| | - Frédéric Pigneur
- Department of Radiology, Henri Mondor University Hospital, Créteil, France
| | - Rémi Mounier
- Institut NeuroMyoGène (INMG) CNRS 5310 - INSERM U1217 - UCBL, Lyon, France
| | - Julien Gondin
- Institut NeuroMyoGène (INMG) CNRS 5310 - INSERM U1217 - UCBL, Lyon, France
| | - Cindy Neuzillet
- Department of Medical Oncology, Curie Institute, Versailles Saint-Quentin University, Saint-Cloud, France, and GERCOR group, Paris, France.
| | - François Goldwasser
- Department of Medical Oncology, CAncer Research for PErsonalized Medicine (CARPEM), Paris Centre Teaching Hospitals, Paris Descartes University, USPC, Paris, France
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