Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial
Abstract Background Low skeletal muscle index (SMI) in metastatic colorectal cancer (mCRC) patients is associated with poor outcomes. The prognostic impact of SMI changes during consecutive palliative systemic treatments is unknown. Methods This is a retrospective analysis of the phase 3 CAIRO3 stud...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2787 |
| _version_ | 1827147808035045376 |
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| author | Sophie A. Kurk Petra H. M. Peeters Bram Dorresteijn Pim A. deJong Marion Jourdan Geert‐Jan M. Creemers Frans L. G. Erdkamp Felix E. deJongh Peter A. M. Kint Boelo J. Poppema Sandra A. Radema Lieke H. J. Simkens Bea C. Tanis Manuel L. R. Tjin‐A‐Ton Ankie Van Der Velden Cornelis J. A. Punt Miriam Koopman Anne M. May |
| author_facet | Sophie A. Kurk Petra H. M. Peeters Bram Dorresteijn Pim A. deJong Marion Jourdan Geert‐Jan M. Creemers Frans L. G. Erdkamp Felix E. deJongh Peter A. M. Kint Boelo J. Poppema Sandra A. Radema Lieke H. J. Simkens Bea C. Tanis Manuel L. R. Tjin‐A‐Ton Ankie Van Der Velden Cornelis J. A. Punt Miriam Koopman Anne M. May |
| author_sort | Sophie A. Kurk |
| collection | DOAJ |
| description | Abstract Background Low skeletal muscle index (SMI) in metastatic colorectal cancer (mCRC) patients is associated with poor outcomes. The prognostic impact of SMI changes during consecutive palliative systemic treatments is unknown. Methods This is a retrospective analysis of the phase 3 CAIRO3 study. The CAIRO3 study randomized 557 patients between maintenance capecitabine + bevacizumab (CAP‐B) or observation, after six cycles capecitabine + oxaliplatin + bevacizumab (CAPOX‐B). Upon first disease progression (PD1), CAPOX‐B was reintroduced until second progression (PD2). SMI was assessed by computed tomography (CT) (total 1355 scans). SMI and body mass index (BMI) changes were analyzed for three time‐periods; p1: during initial CAPOX‐B, p2: randomization to PD1, and p3: PD1 to PD2. The association between absolute and change in SMI and BMI (both per 1 standard deviation) during p1‐p3, with PD1, PD2, and survival was studied by Cox regression models. Results This analysis included 450 of the 557 patients randomized in the CAIRO3 study. Mean SMI decreased during p1: mean −0.6 SMI units [95% CI −1.07;‐0.26] and p3: −2.2 units [−2.7;‐1.8], whereas during p2, SMI increased + 1.2 units [0.8‐1.6]. BMI changes did not reflect changes in SMI. SMI loss during p2 and p3 was significantly associated with shorter survival (HR 1.19 [1.09‐1.35]; 1.54 [1.31‐1.79], respectively). Sarcopenia at PD1 was significantly associated with early PD2 (HR 1.40 [1.10‐1.70]). BMI loss independent of SMI loss was only associated with shorter overall survival during p3 (HR 1.35 [1.14‐1.63]). Conclusions In mCRC patients, SMI loss during palliative systemic treatment was related with early disease progression and reduced survival. BMI did not reflect changes in SMI and could not identify patients at risk of poor outcome during early treatment lines. |
| first_indexed | 2024-04-11T07:09:59Z |
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| language | English |
| last_indexed | 2025-03-20T20:52:16Z |
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| series | Cancer Medicine |
| spelling | doaj.art-434f0b15ebe24d0abcf39821804c932c2024-08-14T10:35:48ZengWileyCancer Medicine2045-76342020-02-01931033104310.1002/cam4.2787Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trialSophie A. Kurk0Petra H. M. Peeters1Bram Dorresteijn2Pim A. deJong3Marion Jourdan4Geert‐Jan M. Creemers5Frans L. G. Erdkamp6Felix E. deJongh7Peter A. M. Kint8Boelo J. Poppema9Sandra A. Radema10Lieke H. J. Simkens11Bea C. Tanis12Manuel L. R. Tjin‐A‐Ton13Ankie Van Der Velden14Cornelis J. A. Punt15Miriam Koopman16Anne M. May17Department of Medical Oncology University Medical Center Utrecht Utrecht University Utrecht The NetherlandsDepartment of Epidemiology Julius Center for Health Sciences and Primary Care Utrecht University Utrecht The NetherlandsDanone Nutricia Research Nutricia Advanced Medical Nutrition Utrecht The NetherlandsDepartment of Radiology University Medical Center Utrecht Utrecht University Utrecht The NetherlandsDanone Nutricia Research Nutricia Advanced Medical Nutrition Utrecht The NetherlandsDepartment of Medical Oncology Catharina Hospital Eindhoven The NetherlandsDepartment of Medical Oncology Zuyderland Hospital Sittard The NetherlandsDepartment of Medical Oncology Ikazia Hospital Rotterdam The NetherlandsDepartment of Radiology Amphia Hospital Breda The NetherlandsDepartment of Radiology Department of Medical Oncology Ommelander Hospital Group Groningen The NetherlandsDepartment of Medical Oncology Radboud University Medical Center Nijmegen The NetherlandsDepartment of Medical Oncology Maxima Medical Center Eindhoven The NetherlandsDepartment of Medical Oncology Groene Hart Hospital Gouda The NetherlandsDepartment of Medical Oncology Rivierenland Hospital Tiel the NetherlandsDepartment of Medical Oncology Tergooi Hospital Blaricum The NetherlandsDepartment of Medical Oncology Amsterdam University Medical Center University Amsterdam Amsterdam The NetherlandsDepartment of Medical Oncology University Medical Center Utrecht Utrecht University Utrecht The NetherlandsDepartment of Epidemiology Julius Center for Health Sciences and Primary Care Utrecht University Utrecht The NetherlandsAbstract Background Low skeletal muscle index (SMI) in metastatic colorectal cancer (mCRC) patients is associated with poor outcomes. The prognostic impact of SMI changes during consecutive palliative systemic treatments is unknown. Methods This is a retrospective analysis of the phase 3 CAIRO3 study. The CAIRO3 study randomized 557 patients between maintenance capecitabine + bevacizumab (CAP‐B) or observation, after six cycles capecitabine + oxaliplatin + bevacizumab (CAPOX‐B). Upon first disease progression (PD1), CAPOX‐B was reintroduced until second progression (PD2). SMI was assessed by computed tomography (CT) (total 1355 scans). SMI and body mass index (BMI) changes were analyzed for three time‐periods; p1: during initial CAPOX‐B, p2: randomization to PD1, and p3: PD1 to PD2. The association between absolute and change in SMI and BMI (both per 1 standard deviation) during p1‐p3, with PD1, PD2, and survival was studied by Cox regression models. Results This analysis included 450 of the 557 patients randomized in the CAIRO3 study. Mean SMI decreased during p1: mean −0.6 SMI units [95% CI −1.07;‐0.26] and p3: −2.2 units [−2.7;‐1.8], whereas during p2, SMI increased + 1.2 units [0.8‐1.6]. BMI changes did not reflect changes in SMI. SMI loss during p2 and p3 was significantly associated with shorter survival (HR 1.19 [1.09‐1.35]; 1.54 [1.31‐1.79], respectively). Sarcopenia at PD1 was significantly associated with early PD2 (HR 1.40 [1.10‐1.70]). BMI loss independent of SMI loss was only associated with shorter overall survival during p3 (HR 1.35 [1.14‐1.63]). Conclusions In mCRC patients, SMI loss during palliative systemic treatment was related with early disease progression and reduced survival. BMI did not reflect changes in SMI and could not identify patients at risk of poor outcome during early treatment lines.https://doi.org/10.1002/cam4.2787Body compositionbody mass indexchemotherapymetastatic colorectal cancersarcopeniaskeletal muscle mass |
| spellingShingle | Sophie A. Kurk Petra H. M. Peeters Bram Dorresteijn Pim A. deJong Marion Jourdan Geert‐Jan M. Creemers Frans L. G. Erdkamp Felix E. deJongh Peter A. M. Kint Boelo J. Poppema Sandra A. Radema Lieke H. J. Simkens Bea C. Tanis Manuel L. R. Tjin‐A‐Ton Ankie Van Der Velden Cornelis J. A. Punt Miriam Koopman Anne M. May Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial Cancer Medicine Body composition body mass index chemotherapy metastatic colorectal cancer sarcopenia skeletal muscle mass |
| title | Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial |
| title_full | Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial |
| title_fullStr | Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial |
| title_full_unstemmed | Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial |
| title_short | Loss of skeletal muscle index and survival in patients with metastatic colorectal cancer: Secondary analysis of the phase 3 CAIRO3 trial |
| title_sort | loss of skeletal muscle index and survival in patients with metastatic colorectal cancer secondary analysis of the phase 3 cairo3 trial |
| topic | Body composition body mass index chemotherapy metastatic colorectal cancer sarcopenia skeletal muscle mass |
| url | https://doi.org/10.1002/cam4.2787 |
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