NAZIM CAN DEMİRCAN, CEREN ÖZGE ENGÜR, TUĞBA AKIN TELLİ, TUĞBA BAŞOĞLU, RUKİYE ARIKAN, ALPER YAŞAR, ABDUSSAMET ÇELEBİ, ÖZKAN ALAN, SELVER IŞIK, SALİH ÖZGÜVEN, ÖZLEM ERCELEP, FAYSAL DANE, HANDAN KAYA, TUNÇ ÖNEŞ, PERRAN FULDEN YUMUK
Turkish Journal of Oncology - 2022;37(4):379-387
OBJECTIVE We investigated the relationship of baseline sarcopenia with toxicities, treatment response, and survival in patients who had non-small cell lung cancer (NSCLC) harboring an epidermal growth factor receptor (EGFR) mutation and received erlotinib. METHODS Computed tomography images from PET/CT scans before erlotinib treatment were retrospectively assessed. Skeletal muscle index, calculated as skeletal muscle area at third lumbar vertebra level/square of height, was used to define sarcopenia with <52.4 cm2/m2 for males and <38.5 cm2/m2 for females. Cox hazard models were conducted to determine predictors of survival. RESULTS The study included 30 patients, and 11 (36.7%) were sarcopenic. All-grade and Grade 3 toxicities were more frequent in sarcopenic group, although it was statistically insignificant (81.8% vs. 63.2%, p=0.282 for all-grade, and 18.2% vs. 10.5%, p=0.552 for grade 3). Response rates were 63.6% in sarcopenic and 68.4% in non-sarcopenic patients (p=0.789). Median progression-free survival was 7.9 and 9.2 months in sarcopenic and non-sarcopenic cases, respectively (p=0.561). However, median overall survival (OS) of sarcopenic patients was significantly shorter than non-sarcopenic ones (11.8 vs. 30.2 months, p=0.023), and sarcopenia predicted OS independently in multivariate analysis (Hazard ratio=2.63, p=0.029). CONCLUSION Early recognition, treatment, and prevention of sarcopenia may improve long-term survival in EGFRmutant NSCLC patients treated with first-line erlotinib.
