Cancer survivorship, excess body fatness and weight-loss intervention—where are we in 2020?

Anderson, Annie S.; Martin, Richard M.; Renehan, Andrew G.; Cade, Janet; Copson, Ellen; Cross, Amanda J.; Grimmett, Chloe; Keaver, Laura; King, Angela G.; Riboli, Elio; Shaw, Clare; Saxton, John

doi:10.1038/s41416-020-01155-2

Cited by 37 publications

(34 citation statements)

References 66 publications

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“…various treatments. On the other hand, the obesity paradox, which implies that ideal or high body weight may be associated with survival benefits in patients with cancer, has also been observed in patients with NSCLC [52]. Although the mechanisms remain to be clarified, an ideal or high body weight of a patient with cancer may reflect that the cancer is less invasive than those who are underweight.…”

Section: Discussionmentioning

confidence: 99%

“…Although the mechanisms remain to be clarified, an ideal or high body weight of a patient with cancer may reflect that the cancer is less invasive than those who are underweight. In addition, multiple anticancer treatments may be more tolerable to cancer patients with ideal or high body weight, which may also explain the better survival in these patients [52].…”

Section: Discussionmentioning

confidence: 99%

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Geriatric Nutritional Risk Index as a Prognostic Factor of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis

Yang

Liu

et al. 2022

Horm Metab Res

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Geriatric nutritional risk index (GNRI), a newly developed indicator of nutritional status retrieved by serum albumin concentration and ideal body weight, has been suggested as a prognostic factor for various malignancies. The aim of the study was to summarize the prognostic role of GNRI for patients with non-small cell lung cancer (NSCLC) in a meta-analysis. Cohort studies evaluating the relationship between GNRI at baseline and survival OF NSCLC were retrieved by search of PubMed, Embase, and Web of Science databases from inception to January 12, 2022. A conservative random-effect model incorporating the possible influence of between-study heterogeneity was used to pool the results. Eleven cohorts including 2865 patients with NSCLC were included. Compared to those with higher GNRI, NSCLC patients with lower GNRI were associated with poorer overall survival [OS, hazard ratio (HR): 2.39, 95% CI: 1.97–2.91, p<0.001; I2=29%), progression-free survival (HR: 1.94, 95% CI: 1.52–2.47, p<0.001; I2=29%), and cancer-specific survival (HR: 2.59, 95% CI: 1.55–4.35, p<0.001; I2=0%). Subgroup analyses showed that the significant association between lower GNRI and worse OS in patients with NSCLC was not affected by study characteristics including study location, design, cancer stage, treatment, or follow-up durations (p for subgroup effects all<0.001). In conclusion, a lower GNRI in patients with NSCLC may be a predictor of poor survival. Nutritional status indicated by GNRI may be important for the prognostic prediction of patients with NSCLC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Geriatric Nutritional Risk Index as a Prognostic Factor of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis

Yang

Liu

et al. 2022

Horm Metab Res

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“…Overcoming this “metabolic immunobarrier” could be achieved on three levels: (1) systemically, (2) at the level of tumor or (3) at the level of T cells. Targeting the systemic deregulated lipid metabolism by weight management in overweight and obese cancer patients is discussed to promote survival and delay progression [ 151 ]. Unfortunately, the data situation in human cancer patients is so far rather insufficient and requires further studies that are currently running worldwide [ 152 , 153 , 154 , 155 ].…”

Section: Discussionmentioning

confidence: 99%

Lipotoxicity as a Barrier for T Cell-Based Therapies

et al. 2022

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Nowadays, T-cell-based approaches play an increasing role in cancer treatment. In particular, the use of (genetically engineered) T-cells has heralded a novel era for various diseases with previously poor outcomes. Concurrently, the relationship between the functional behavior of immune cells and their metabolic state, known as immunometabolism, has been found to be an important determinant for the success of immunotherapy. In this context, immune cell metabolism is not only controlled by the expression of transcription factors, enzymes and transport proteins but also by nutrient availability and the presence of intermediate metabolites. The lack of as well as an oversupply of nutrients can be detrimental and lead to cellular dysfunction and damage, potentially resulting in reduced metabolic fitness and/or cell death. This review focusses on the detrimental effects of excessive exposure of T cells to fatty acids, known as lipotoxicity, in the context of an altered lipid tumor microenvironment. Furthermore, implications of T cell-related lipotoxicity for immunotherapy will be discussed, as well as potential therapeutic approaches.

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“…Older adults ought to be screened for malnutrition and obesity upon a diagnosis of cancer and regularly throughout survivorship, especially at major cancer treatment-and health-related milestones and events (Table 1) [13]. Malnutrition, when diagnosed early, can be addressed with diet to prevent or treat sarcopenia, especially as part of a multimodal intervention with exercise [14].…”

Section: Screening For and Addressing Malnutrition And Obesitymentioning

confidence: 99%