Impact of sarcopenia in patients with advanced non–small cell lung cancer treated with PD-1 inhibitors: A preliminary retrospective study

The aim of this study was to investigate the clinical impact of sarcopeniaon the efficacy of programmed death (PD)-1 inhibitors. We retrospectively reviewed the medical records of all patients treated with nivolumabor pembrolizumabbetween January 2016 and September 2018 for previously treated advanced non–small cell lung cancer (NSCLC). The cross-sectional area of the psoasmuscle at the level of the third lumbar vertebraon baseline computed tomography was assessed to calculate the psoasmuscle index (PMI). Sarcopeniawas defined based on PMI cut-off values for Asian adults (6.36 cm2/m2 for males and 3.92 cm2/m2 for females). A total of 42 patients were analysed. The prevalence of sarcopeniawas 52.4%. Sarcopeniawas significantly associated with poorer progression-free survival (PFS) (median, 2.1 vs. 6.8 months, p = 0.004). Compared to patients with sarcopenia, those without sarcopeniahad a higher overall response rate (40.0% vs. 9.1%, p = 0.025) and 1-year PFS rate (38.1% vs. 10.1%). In conclusion, sarcopeniaat baseline as determined using computed tomography is a significant predictor of worse outcome in patients with advanced NSCLC receiving PD-1 blockade. Screening for sarcopeniamay help identify patients more likely to achieve a long-term response in routine clinical practice.