Changes in skeletal muscle area and lean body mass during pazopanib vs sunitinib therapy for metastatic renal cancer

Köstek, Osman; Yılmaz, Erdem; Hacıoğlu, Muhammet Bekir; Demircan, Nazım Can; Gökyer, Ali; Uzunoğlu, Sernaz; Tunçbilek, Nermin; Çiçin, İrfan; Erdoğan, Bülent

doi:10.1007/s00280-019-03779-5

Cited by 6 publications

(11 citation statements)

References 33 publications

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“…Our search was conducted until July 2020. Table 1 detailed the results of the eleven studies [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ] assessing the effect of TKI treatment on skeletal muscle mass from computerized tomography (CT) scan at the third lumbar (L3) vertebra.…”

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

“…Sunitinib is the reference standard of care for the first-line treatment of metastatic RCC or pancreatic neuroendocrine tumors (PNETs), and for the second-line treatment for patients affected by unresectable and/or metastatic GISTs who had a failure to imatinib. One study found a significant decrease in lean body mass (LBM) ( p = 0.02) [ 35 ] and skeletal muscle area SMA ( p = 0.02) in 18 metastatic RCC patients after starting sunitinib treatment (3–4 months) compared with baseline. Gu et al [ 34 ] also found in 30 (out of 101) patients treated with sunitinib a reduction in the mean SMI from 41.6 to 39.9 cm 2 /m 2 after 3–4 months of therapy.…”

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

“…Pazopanib is a VEGFR inhibitor with activity against vascular EGFR-1, -2, and -3, and PDGFRs [ 48 ]. Kostek et al [ 35 ] found, in 18 metastatic RCC patients, a non-significant decrease in LBM and SMA after starting pazopanib. Conversely, they noted that SMA and LBM were significantly reduced with sunitinib therapy compared with pazopanib therapy.…”

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

“…Conversely, they noted that SMA and LBM were significantly reduced with sunitinib therapy compared with pazopanib therapy. The reason for these discrepancies is unclear, but it might be related to their different kinase selectivities [ 35 ]. Indeed, sunitinib was shown to inhibit more kinases than pazopanib [ 49 ].…”

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

“…Moreover, low SMI is predictive of treatment-related toxicity in patients with metastatic RCC receiving sunitinib [ 54 ] or sorafenib [ 31 , 55 ]. Particularly, Kostek et al noted that loss of SMA and LBM with sunitinib was more substantial than with pazopanib [ 35 ]. Although treatment efficacies of both drugs were similar, DLTs were more frequent in RCC patients treated with sunitinib compared with pazopanib.…”

Section: Implications Of Muscle Wasting In Clinical Outcomes In Pamentioning

confidence: 99%

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Skeletal Muscle Loss during Multikinase Inhibitors Therapy: Molecular Pathways, Clinical Implications, and Nutritional Challenges

Rinninella

Cintoni²,

Raoul

et al. 2020

Nutrients

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In cancer patients, loss of muscle mass is significantly associated with low tolerability of chemotherapy and poor survival. Despite the great strides in the treatment of cancer, targeted therapies such as tyrosine kinase inhibitors (TKIs) could exacerbate muscle wasting. Over recent years, the impact of skeletal muscle loss during TKI therapy on clinical outcomes has been in the spotlight. In this review, we focus on the different molecular pathways of TKIs potentially involved in muscle wasting. Then, we report the results of the studies assessing the effects of different TKI therapies—such as sorafenib, regorafenib, sunitinib, and lenvatinib—on muscle mass, and highlight their potential clinical implications. Finally, we discuss an integrative nutritional approach to be adopted during TKI treatment. The assessment of muscle mass from computerized tomography imaging could be helpful in predicting toxicity and prognosis in patients treated with TKI such as sorafenib. Early recognition of low muscle mass and effective personalized nutritional support could prevent or attenuate muscle mass wasting. However, the role of nutrition is still overlooked, and future clinical trials are needed to find the optimal nutritional support to countermeasure muscle mass depletion during TKI therapy.

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Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

Section: Impact Of Tki Treatment On Muscle Wastingmentioning

confidence: 99%

Section: Implications Of Muscle Wasting In Clinical Outcomes In Pamentioning

confidence: 99%

See 3 more Smart Citations

Skeletal Muscle Loss during Multikinase Inhibitors Therapy: Molecular Pathways, Clinical Implications, and Nutritional Challenges

Rinninella

Cintoni²,

Raoul

et al. 2020

Nutrients

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Prognostic value of skeletal muscle mass during tyrosine kinase inhibitor (TKI) therapy in cancer patients: a systematic review and meta-analysis

et al. 2020

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Low muscle mass has been associated with worse clinical outcomes in various cancers. This work investigated whether, during tyrosine kinases inhibitors (TKIs) therapy, low muscle mass was associated with treatment toxicity and survival outcomes. A systematic literature search was performed in Pubmed, Web of Science, and Scopus databases from inception to June 2020, based on fixed inclusion and exclusion criteria. Effect sizes were estimated with hazard ratios (HR) and odds ratios (OR) with 95% confidence interval (CI) and heterogeneity was assessed by measuring inconsistency (I2) based on the Chi squared test. A total of 24 retrospective studies were identified, enrolling patients treated with sorafenib (n = 12), sunitinib (n = 6), lenvatinib (n = 3), regorafenib (n = 2), gefitinib (n = 1), imatinib (n = 1), and pazopanib (n = 1). Thirteen studies were deemed eligible for pooled analyses. Meta-analyses found a significant effect of low muscle mass on dose-limiting toxicity (DLT) (OR 2.40, 95% CI 1.26–4.58, p = 0.008, I2 = 51%) in patients treated with TKI therapy. A subgroup analysis by treatment showed an association between DLT and low muscle during sorafenib or sunitinib, although not significant. A significant association between low skeletal muscle index and poorer overall survival was observed in HCC patients treated with sorafenib (HR 1.45, 95% CI 1.07–1.96, p = 0.02). For other TKIs, although some results showed an association between low muscle mass and worse outcomes, the number of studies for each TKI therapy was too small to reach conclusions. Skeletal muscle mass could influence the prognosis of some TKI-treated patients. This effect is demonstrated in sorafenib-treated HCC patients but remains almost unexplored in other cancer patients undergoing TKI therapy. Further prospective studies with large sample size and sufficient follow-up are needed to clarify the role of muscle mass in the metabolism of TKI-based cancer treatment, and its association with toxicity and survival.

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Linear Muscle Segmentation for Metastatic Renal Cell Carcinoma: Changes in Clinic-Friendly Estimation Predict Survival Following Cytoreductive Nephrectomy

Nicaise,

Schmeusser,

Ali

et al. 2024

Clinical Genitourinary Cancer

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Changes in skeletal muscle area and lean body mass during pazopanib vs sunitinib therapy for metastatic renal cancer

Cited by 6 publications

References 33 publications

Skeletal Muscle Loss during Multikinase Inhibitors Therapy: Molecular Pathways, Clinical Implications, and Nutritional Challenges

Skeletal Muscle Loss during Multikinase Inhibitors Therapy: Molecular Pathways, Clinical Implications, and Nutritional Challenges

Prognostic value of skeletal muscle mass during tyrosine kinase inhibitor (TKI) therapy in cancer patients: a systematic review and meta-analysis

Linear Muscle Segmentation for Metastatic Renal Cell Carcinoma: Changes in Clinic-Friendly Estimation Predict Survival Following Cytoreductive Nephrectomy

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