Author of

• 12592

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  P3.10 - Poster Session 3 - Chemotherapy (ID 210)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12639

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    P3.10-047 - Weight Gain During First-line Chemotherapy for Locally Advanced and Metastatic Non-Small-Cell Lung Cancer is Associated With Improved Survival (ID 2864)

    09:30 - 09:30  |  Author(s): S. Sims
    • Abstract

    Background
    Two previous studies from our institution have shown that weight gain in the course of chemoradiotherapy for locally advanced or oligomestastatic NSCLC is associated with improved survival (Sher et al, 2013 and Gielda et al, 2010). This study aimed to determine the prognostic value of weight and serum albumin changes in patients with locally advanced and metastatic NSCLC receiving first-line platinum doublet chemotherapy.

    Methods
    Patients with newly-diagnosed locally advanced or metastatic NSCLC treated in the first-line setting with platinum doublet chemotherapy from June, 2011 to August, 2012 at RUMC were included for analysis. Weight and albumin values were recorded at baseline, 3, 6, and 12-week intervals from initiation of therapy. Their association with overall survival (OS) was assessed using Kaplan Meir methods and Cox proportional hazards regression.

    Results
    A total of 139 patients were included. Median age was 68 years (range 31-85). ECOG performance status (PS) was 0 in 29.5%, 1 in 46.7%, and 2 or greater in 16.5% of patients. Median baseline weight was 68.17 kg (range 40.1-123.4). Patients who experienced weight gain at 6 weeks had a significantly higher OS compared to those who lost weight, 20.4 months versus 13.6 months median survival respectively (log-rank p=0.025), Fig 1. In Cox regression analysis the hazard ratio (HR) for 1 kg of weight gain at 6 weeks was 0.84 (p <0.001). A marginal improvement in OS was seen for those who gained weight at 12 weeks, median survival not reached versus 15.5 months in those who lost weight (log-rank p=0.07). The HR for 1 kg weight gain by 12 weeks was 0.91 (p=0.002). Baseline albumin level was available for 97 patients. Median baseline albumin was 3.5 (range 1.5-4.7). A higher baseline albumin was found to be significantly associated with longer survival (HR 0.31, p<0.001). In a multivariate analysis, weight gain in 6 weeks was strongly associated (HR 0.81, p=0.003), and higher baseline albumin was associated (HR 0.49, p=0.03) with improved OS after adjusting for age, PS, and baseline weight. Figure 1: Figure 1

    Conclusion
    Higher baseline albumin and weight gain during first-line chemotherapy for locally advanced and metastatic NSCLC, appear to be associated with improved overall survival and may constitute important predictors of outcome. Study of molecular mechanisms involved in weight gain during anti-neoplastic treatment might provide ideas for novel therapeutic strategies.