Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients

BACKGROUND: Knowledge of the evolution of BMI and skeletal muscle index (SMI) measurements during advanced cancer and their relationships with disease progression (PD) is relevant to improve the timing of interventions that may improve cachexia-associated outcomes. OBJECTIVES: We investigated BMI an...

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Autores principales: Kurk, Sophie A, Stellato, Rebecca K, Peeters, Petra H M, Dorresteijn, Bram, Jourdan, Marion, Oskam, Marieke J, Punt, Cornelis J A, Koopman, Miriam, May, Anne M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995835/
https://www.ncbi.nlm.nih.gov/pubmed/31515555
http://dx.doi.org/10.1093/ajcn/nqz209
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author Kurk, Sophie A
Stellato, Rebecca K
Peeters, Petra H M
Dorresteijn, Bram
Jourdan, Marion
Oskam, Marieke J
Punt, Cornelis J A
Koopman, Miriam
May, Anne M
author_facet Kurk, Sophie A
Stellato, Rebecca K
Peeters, Petra H M
Dorresteijn, Bram
Jourdan, Marion
Oskam, Marieke J
Punt, Cornelis J A
Koopman, Miriam
May, Anne M
author_sort Kurk, Sophie A
collection PubMed
description BACKGROUND: Knowledge of the evolution of BMI and skeletal muscle index (SMI) measurements during advanced cancer and their relationships with disease progression (PD) is relevant to improve the timing of interventions that may improve cachexia-associated outcomes. OBJECTIVES: We investigated BMI and SMI trajectories and their associations with PD in metastatic colorectal cancer (mCRC) patients during consecutive palliative systemic regimens. METHODS: In a secondary analysis of the primary CAIRO3 trial, we included 533 mCRC patients with BMI measurements repeated every 3 wk and 95 randomly selected patients with SMI measurements repeated every 9 wk. We studied 2 periods: p1, during first-line maintenance capecitabine + bevacizumab or observation until the first progression of disease (PD1); and p2, during capecitabine + oxaliplatin + bevacizumab or another reintroduction treatment from PD1 until the second progression of disease (PD2). BMI and SMI trajectories were modeled separately throughout both periods, and joint longitudinal-survival modeling was used to investigate the relationships between slopes in BMI and SMI with PD at 9 and 3 wk pre-PD. A multivariate longitudinal joint model was used to investigate the association between the BMI trajectory and PD at time of PD, independent of SMI. RESULTS: During p1, the slopes in BMI and SMI were associated with early PD1 [HRs for 9-wk BMI: 1.54 (95% CI: 1.33, 1.76); 9-wk SMI: 1.38 (95% CI: 0.87, 1.89), NS; 3-wk BMI: 1.74 (95% CI: 1.48, 1.99); 3-wk SMI: 2.65 (95% CI: 1.97, 3.32)]. During p2, only the slope in SMI was related to PD2 [9-wk BMI: 1.09 (95%: CI: 0.73, 1.45), NS; 9-wk SMI: 1.64 (95% CI: 1.25, 2.04); 3-wk BMI: 1.17 (95% CI: 0.77, 1.57); 3-wk SMI: 1.11 (95% CI: 0.70, 1.53)]. In models mutually adjusting for BMI and SMI, SMI was associated with PD in p1 [p1 ( n = 95), HR BMI: 1.32 (95% CI: 0.74, 2.39), NS; p1, HR SMI: 1.50 (95% CI: 1.04, 2.14); p2 ( n = 50), BMI: 0.98 (95% CI: 0.55, 1.75), NS; p2, HR SMI: 1.11 (95% CI: 0.61, 2.05), NS]. CONCLUSIONS: In mCRC patients during palliative systemic treatment, SMI losses, irrespective of BMI losses, may be a marker for the early initiation of cachexia interventions.
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spelling pubmed-69958352020-02-10 Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients Kurk, Sophie A Stellato, Rebecca K Peeters, Petra H M Dorresteijn, Bram Jourdan, Marion Oskam, Marieke J Punt, Cornelis J A Koopman, Miriam May, Anne M Am J Clin Nutr Original Research Communications BACKGROUND: Knowledge of the evolution of BMI and skeletal muscle index (SMI) measurements during advanced cancer and their relationships with disease progression (PD) is relevant to improve the timing of interventions that may improve cachexia-associated outcomes. OBJECTIVES: We investigated BMI and SMI trajectories and their associations with PD in metastatic colorectal cancer (mCRC) patients during consecutive palliative systemic regimens. METHODS: In a secondary analysis of the primary CAIRO3 trial, we included 533 mCRC patients with BMI measurements repeated every 3 wk and 95 randomly selected patients with SMI measurements repeated every 9 wk. We studied 2 periods: p1, during first-line maintenance capecitabine + bevacizumab or observation until the first progression of disease (PD1); and p2, during capecitabine + oxaliplatin + bevacizumab or another reintroduction treatment from PD1 until the second progression of disease (PD2). BMI and SMI trajectories were modeled separately throughout both periods, and joint longitudinal-survival modeling was used to investigate the relationships between slopes in BMI and SMI with PD at 9 and 3 wk pre-PD. A multivariate longitudinal joint model was used to investigate the association between the BMI trajectory and PD at time of PD, independent of SMI. RESULTS: During p1, the slopes in BMI and SMI were associated with early PD1 [HRs for 9-wk BMI: 1.54 (95% CI: 1.33, 1.76); 9-wk SMI: 1.38 (95% CI: 0.87, 1.89), NS; 3-wk BMI: 1.74 (95% CI: 1.48, 1.99); 3-wk SMI: 2.65 (95% CI: 1.97, 3.32)]. During p2, only the slope in SMI was related to PD2 [9-wk BMI: 1.09 (95%: CI: 0.73, 1.45), NS; 9-wk SMI: 1.64 (95% CI: 1.25, 2.04); 3-wk BMI: 1.17 (95% CI: 0.77, 1.57); 3-wk SMI: 1.11 (95% CI: 0.70, 1.53)]. In models mutually adjusting for BMI and SMI, SMI was associated with PD in p1 [p1 ( n = 95), HR BMI: 1.32 (95% CI: 0.74, 2.39), NS; p1, HR SMI: 1.50 (95% CI: 1.04, 2.14); p2 ( n = 50), BMI: 0.98 (95% CI: 0.55, 1.75), NS; p2, HR SMI: 1.11 (95% CI: 0.61, 2.05), NS]. CONCLUSIONS: In mCRC patients during palliative systemic treatment, SMI losses, irrespective of BMI losses, may be a marker for the early initiation of cachexia interventions. Oxford University Press 2019-12 2019-09-12 /pmc/articles/PMC6995835/ /pubmed/31515555 http://dx.doi.org/10.1093/ajcn/nqz209 Text en Copyright © The Author(s) 2019. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Research Communications
Kurk, Sophie A
Stellato, Rebecca K
Peeters, Petra H M
Dorresteijn, Bram
Jourdan, Marion
Oskam, Marieke J
Punt, Cornelis J A
Koopman, Miriam
May, Anne M
Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
title Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
title_full Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
title_fullStr Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
title_full_unstemmed Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
title_short Trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
title_sort trajectory of body mass and skeletal muscle indices and disease progression in metastatic colorectal cancer patients
topic Original Research Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995835/
https://www.ncbi.nlm.nih.gov/pubmed/31515555
http://dx.doi.org/10.1093/ajcn/nqz209
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