Visceral obesity and sarcopenia as predictors of efficacy and hematological toxicity in patients with metastatic breast cancer treated with CDK 4/6 inhibitors


Yücel K. B., AYDOS U., SÜTCÜOĞLU O., Kılıç A. C. K., ÖZDEMİR N., ÖZET A., ...Daha Fazla

Cancer Chemotherapy and Pharmacology, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1007/s00280-024-04641-z
  • Dergi Adı: Cancer Chemotherapy and Pharmacology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, PASCAL, BIOSIS, CINAHL, EMBASE
  • Anahtar Kelimeler: CDK 4/6 inhibitors, Hematological toxicity, Metastatic breast cancer, Sarcopenia, Visceral obesity
  • Gazi Üniversitesi Adresli: Evet

Özet

Purpose: We aimed to investigate whether visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle area (SMA) index are predictive for efficacy and hematological toxicity in ER + HER2—metastatic breast cancer (BC) patients who received CDK 4/6 inhibitors. Methods: This retrospective cohort study analyzed 52 patients who were treated with CDK 4/6 inhibitors between January 2018 and February 2021. The values of VAT, SAT, SMA indices and hematological parameters were noted before the start, at the third and sixth months of this treatment. The skeletal muscle area (SMA) and adipose tissue measurements were calculated at the level of the third lumbar vertebra. A SMA-index value of <40 cm2/m2 was accepted as the threshold value for sarcopenia. Results: Patients with sarcopenia had a worse progression-free survival (PFS) compared to patients without sarcopenia (19.6 vs. 9.0 months, p = 0.005). Patients with a high-VAT-index had a better PFS (20.4 vs. 9.3 months, p = 0.033). Only the baseline low-SMA- index (HR: 3.89; 95% CI: 1.35–11.25, p = 0.012) and baseline low-VAT-index (HR: 2.15; 95% CI: 1.02–4.53, p = 0.042) had significantly related to poor PFS in univariate analyses. The low-SMA-index was the only independent factor associated with poor PFS (HR: 3.99; 95% CI: 1.38–11.54, p = 0.011). No relationship was observed between body composition parameters and grade 3–4 hematological toxicity. Conclusion: The present study supported the significance of sarcopenia and low visceral adipose tissue as potential early indicators of poor PFS in patients treated with CDK 4/6 inhibitors.