Korean J Intern Med.  2016 Nov;31(6):1140-1149. 10.3904/kjim.2015.062.

Nutritional status in the era of target therapy: poor nutrition is a prognostic factor in non-small cell lung cancer with activating epidermal growth factor receptor mutations

• Park S
• Park S
• Lee SH
• Suh B
• Keam B
• Kim TM
• Kim DW
• Kim YW
• Heo DS

• KMID: 2382864
• DOI: http://doi.org/10.3904/kjim.2015.062

Abstract

BACKGROUND/AIMS
Pretreatment nutritional status is an important prognostic factor in patients treated with conventional cytotoxic chemotherapy. In the era of target therapies, its value is overlooked and has not been investigated. The aim of our study is to evaluate the value of nutritional status in targeted therapy.
METHODS
A total of 2012 patients with non-small cell lung cancer (NSCLC) were reviewed and 630 patients with activating epidermal growth factor receptor (EGFR) mutation treated with EGFR tyrosine kinase inhibitor (TKI) were enrolled for the final analysis. Anemia, body mass index (BMI), and prognostic nutritional index (PNI) were considered as nutritional factors. Hazard ratio (HR), progression-free survival (PFS) and overall survival (OS) for each group were calculated by Cox proportional analysis. In addition, scores were applied for each category and the sum of scores was used for survival analysis.
RESULTS
In univariable analysis, anemia (HR, 1.29; p = 0.015), BMI lower than 18.5 (HR, 1.98; p = 0.002), and PNI lower than 45 (HR, 1.57; p < 0.001) were poor prognostic factors for PFS. Among them, BMI and PNI were independent in multi-variable analysis. All of these were also significant prognostic values for OS. The higher the sum of scores, the poorer PFS and OS were observed.
CONCLUSIONS
Pretreatment nutritional status is a prognostic marker in NSCLC patients treated with EGFR TKI. Hence, baseline nutritional status should be more carefully evaluated and adequate nutrition should be supplied to these patients.

Keyword

Nutrition status; Carcinoma, non-small-cell lung; Receptor; Epidermal growth factor; Epidermal growth factor receptor tyrosine kinase inhibitor

MeSH Terms

Anemia
Body Mass Index
Carcinoma, Non-Small-Cell Lung*
Disease-Free Survival
Drug Therapy
Epidermal Growth Factor*
Humans
Nutrition Assessment
Nutritional Status*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor*
Epidermal Growth Factor
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor