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Longitudinal Body Composition Identifies Hepatocellular Carcinoma With Cachexia Following Combined Immunotherapy and Target Therapy (CHANCE2213)

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收录情况： ◇ SCIE

作者：
Jin Zhi-Cheng[1,2] * ; Zhou Jia-Wei[3,4] * ; Chen Jian-Jian[1,2] * ; Ding Rong[5] * ; Scheiner Bernhard[6,7] ; Wang Si-Na[4] ; Li Hai-Liang[8] ; Shen Qing-Xia[1] ; Lu Qing-Yun[9] ; Liu Yi[10] ; Zhang Wei-Hua[1,2] ; Luo Biao[1] ; Shi Hai-Bin[11] ; Huang Ming[5] ; Wu Ye-Ming[1,2] ; Yuan Chun-Wang[12] ; Huang Ming-Sheng[13] ; Li Jia-Ping[14] ; Wu Jian-Bing[15] ; Zhu Xiao-Li[16] ; Zhong Bin-Yan[16] ; Zhou Hai-Feng[11] ; Wang Yu-Qing[1,2] ; Gu Shan-Zhi[17] ; Peng Zhi-Yi[18] ; Zheng Chuan-Sheng[19] ; Liu Rui-Bao[20] ; Xu Guo-Hui[21] ; Yang Wei-Zhu[22] ; Xu Ai-Bing[23] ; Liu Dong-Fang[1,2] ; Qi Xiaolong[24] ; Yeo Yee Hui[25] ; Zhu Hai-Dong[1,2] ; Zhao Yang[4] ; Pinato David J[7,26] ; Ji Fanpu[10,27] ; Teng Gao-Jun[1,2] ;
机构： [1]Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China. [2]Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, National Innovation Platform for Integration of Medical Engineering Education (NMEE) (Southeast University), State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, China. [3]Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, China. [4]Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China. [5]Department of Minimally Invasive Interventional Medicine, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, China. [6]Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. [7]Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK. [8]Department of Minimally Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China. [9]Department of Oncology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China. [10]Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. [11]Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. [12]Center of Interventional Oncology and Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China. [13]Department of Interventional Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. [14]Department of Interventional Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. [15]Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, China. [16]Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, China. [17]Interventional Department, Hunan Provincial Tumor Hospital, Changsha, China. [18]Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. [19]Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [20]Department of Interventional Radiology, The Tumor Hospital of Harbin Medical University, Harbin, China. [21]Department of Interventional Radiology, Sichuan Cancer Hospital and Institute, Chengdu, China. [22]Department of Interventional Radiology, Union Hospital of Fujian Medical University, Fuzhou, China. [23]Department of Interventional Therapy, Nantong Tumor Hospital, Nantong, China. [24]Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China. [25]Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. [26]Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale "A. Avogadro", Novara, Italy. [27]Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, China.
出处：
DOI： 10.1002/jcsm.13615
ISSN：

关键词： body composition cachexia hepatocellular carcinoma immunotherapy longitudinal trajectory molecular targeted therapy

摘要：
Cancer cachexia can impact prognosis, cause resistance to anticancer treatments and affect the tolerability of treatments. This study aims to identify hepatocellular carcinoma (HCC) with cachexia by characterizing longitudinal body composition (BC) trajectories.This longitudinal, multicentre cohort study included unresectable HCC patients treated with first-line programmed death-(ligand)1 inhibitors plus anti-vascular endothelial growth factor antibody/tyrosine kinase inhibitors between 01/2018-12/2022. BC measurements including skeletal muscle mass (SMM) and total adipose tissue area (TATA) were evaluated by computed tomography at the third lumbar vertebra at baseline and follow-up imaging. Unsupervised latent class growth mixed models were applied to distinguish potential longitudinal SMM and TATA trajectories for identifying cachexia. The primary study endpoint was overall survival (OS), with secondary endpoints including progression-free survival (PFS), objective response rate (ORR) and safety. Multiple Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) for survival.A total of 411 patients with 2138 time-point measurements were included. The median age was 56 years, and 50 (12.2%) patients were female. Two distinct trajectories were identified for SMM and TATA: sharp-falling and stable. SMM sharply declined in 58 patients (14.1%) and TATA in 71 of 406 patients (17.5%) with significant worse OS (for SMM, 17.0 vs. 24.9 months; p < 0.001; HR = 0.59; for TATA, 15.3 vs. 25.1 months; p < 0.001; HR = 0.44). Patients were categorized into three phases based on trajectories: pre-cachexia (SMM and TATA stable, n = 299, 73.6%), cachexia (SMM or TATA sharp-falling, n = 86, 21.2%) and refractory cachexia (SMM and TATA sharp-falling, n = 21, 5.2%). Patients with refractory cachexia exhibited the worst OS, PFS and ORR, followed by those with cachexia. The median OS was 11.5 months for refractory cachexia, 17.7 for cachexia and 26.0 for pre-cachexia; median PFS was 6.0, 7.9 and 10.9 months, respectively, with ORR of 4.8%, 39.5% and 54.2%, respectively (all ps < 0.001). Multivariable Cox analysis identified refractory cachexia as an independent risk factor for both OS (HR = 3.31; p < 0.001) and PFS (HR = 2.94; p < 0.001), with cachexia also showing significant impacts. Grade 3-4 adverse events were higher in patients with refractory cachexia (23.8%) and cachexia (8.1%) compared with pre-cachexia (6.0%; p = 0.010).HCC patients with cachexia and refractory cachexia were identified by longitudinal BC trajectories. Falling trajectories of BC identified refractory cachexia patients with worst response, survival and poor tolerability from systemic therapy combinations.ClinicalTrials.gov identifier: NCT05278195.© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.

基金：
The study was supported by National Natural Science Foundation of China (82130060 and 82170626), National Key Research and Development Program (2018YFA0704100 and 2018YFA0704104), Jiangsu Provincial Medical Innovation Center (CXZX202219), Fundamental Research Funds for the Central Universities (No. xtr062023003), Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Nanjing Life Health Science and Technology Project (202205045), Medical Science and Technology Development Fund Project of Nanjing (YKK23268) and Postgraduate Research and Practice Innovation Program of Jiangsu Province (KYCX21_0158). The funding sources had no role in the writing of the report or decision to submit the paper for publication
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出版当年[2024]版：
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最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 老年医学 1 区 医学：内科
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出版当年[2024]版：
无
最新[2023]版：
Q1 GERIATRICS & GERONTOLOGY Q1 MEDICINE, GENERAL & INTERNAL

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2023版]

第一作者：
第一作者机构： [1]Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China. [2]Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, National Innovation Platform for Integration of Medical Engineering Education (NMEE) (Southeast University), State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, China.
共同第一作者：
通讯作者：
通讯机构： [1]Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China. [2]Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, National Innovation Platform for Integration of Medical Engineering Education (NMEE) (Southeast University), State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing, China. [10]Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. [27]Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, China.
推荐引用方式(GB/T 7714)：
Jin Zhi-Cheng,Zhou Jia-Wei,Chen Jian-Jian,et al.Longitudinal Body Composition Identifies Hepatocellular Carcinoma With Cachexia Following Combined Immunotherapy and Target Therapy (CHANCE2213)[J].Journal Of Cachexia, Sarcopenia And Muscle.2024,15(6):2705-2716.doi:10.1002/jcsm.13615.
APA：
Jin Zhi-Cheng,Zhou Jia-Wei,Chen Jian-Jian,Ding Rong,Scheiner Bernhard...&Teng Gao-Jun.(2024).Longitudinal Body Composition Identifies Hepatocellular Carcinoma With Cachexia Following Combined Immunotherapy and Target Therapy (CHANCE2213).Journal Of Cachexia, Sarcopenia And Muscle,15,(6)
MLA：
Jin Zhi-Cheng,et al."Longitudinal Body Composition Identifies Hepatocellular Carcinoma With Cachexia Following Combined Immunotherapy and Target Therapy (CHANCE2213)".Journal Of Cachexia, Sarcopenia And Muscle 15..6(2024):2705-2716

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