Abstract：
OBJECTIVE: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：我们的目的是调查内脏脂肪组织(VAT)皮下脂肪组织（SAT），和骨骼肌面积(SMA)指数可预测接受CDK4/6抑制剂的ER+HER2转移性乳腺癌(BC)患者的疗效和血液学毒性。
方法：这项回顾性队列研究分析了2018年1月至2021年2月期间接受CDK4/6抑制剂治疗的52例患者。增值税的价值，SAT,开始前记录SMA指标和血液学参数，在治疗的第三个月和第六个月。在第三腰椎水平计算骨骼肌面积（SMA）和脂肪组织测量值。SMA指数值<40cm2/m2被认为是肌少症的阈值。
结果：与没有肌肉减少症的患者相比，患有肌肉减少症的患者的无进展生存期（PFS）较差（19.6vs.9.0个月，p=0.005)。增值税指数高的患者有更好的PFS（20.4vs.9.3个月,p=0.033)。在单变量分析中,只有基线低SMA指数(HR:3.89;95%CI:1.35-11.25,p=0.012)和基线低VAT指数(HR:2.15;95%CI:1.02-4.53,p=0.042)与不良PFS显著相关。低SMA指数是与不良PFS相关的唯一独立因素(HR:3.99;95%CI:1.38-11.54,p=0.011)。在身体组成参数和3-4级血液学毒性之间没有观察到关系。
结论：本研究支持肌少症和低内脏脂肪组织作为CDK4/6抑制剂治疗患者PFS不良的潜在早期指标的意义。
方法：这项回顾性队列研究分析了2018年1月至2021年2月期间接受CDK4/6抑制剂治疗的52例患者。增值税的价值，SAT,开始前记录SMA指标和血液学参数，在治疗的第三个月和第六个月。在第三腰椎水平计算骨骼肌面积（SMA）和脂肪组织测量值。SMA指数值<40cm2/m2被认为是肌少症的阈值。
结果：与没有肌肉减少症的患者相比，患有肌肉减少症的患者的无进展生存期（PFS）较差（19.6vs.9.0个月，p=0.005)。增值税指数高的患者有更好的PFS（20.4vs.9.3个月,p=0.033)。在单变量分析中,只有基线低SMA指数(HR:3.89;95%CI:1.35-11.25,p=0.012)和基线低VAT指数(HR:2.15;95%CI:1.02-4.53,p=0.042)与不良PFS显著相关。低SMA指数是与不良PFS相关的唯一独立因素(HR:3.99;95%CI:1.38-11.54,p=0.011)。在身体组成参数和3-4级血液学毒性之间没有观察到关系。
结论：本研究支持肌少症和低内脏脂肪组织作为CDK4/6抑制剂治疗患者PFS不良的潜在早期指标的意义。
