Weight Loss Associated with Platinum-Based Chemotherapy in Patients with Advanced Lung Cancer

Minami, Toshiyuki; Sozu, Takashi; Niki, Kazuyuki; Kijima, Takashi; Uejima, Etsuko; Morio, Kayoko

doi:10.1159/000443983

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Amongst UWL patients, the most common prescribed medications were statins, calcium channel blockers and calcium, which were prescribed for treatment of common co-morbidities including dyslipidemia and hypertension. The prescription of chemotherapy was significantly higher in older patients with UWL, similar to previous studies [ 46 , 47 ]. Chemotherapy contributes to changes in taste such as altered structure of taste buds and number of taste cell receptors, and detection of drug sensation via saliva [ 48 , 49 ].…”

Section: Discussionsupporting

confidence: 90%

Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital

et al. 2021

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Background Unintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital. Methods A case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records. Results The mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37–4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62–9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32–4.63; P = 0.005) were factors significantly associated with UWL. Conclusions Factors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.

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Section: Discussionsupporting

confidence: 90%

Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital

et al. 2021

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“…These findings suggest the necessity for nutritional intervention in these patients. Moreover, although one study found that toxicities were more common in advanced lung cancer patients with weight loss when receiving platinum-based chemotherapy 16 , we didn't find any significant difference in adverse events between two groups in this analysis, which may be because the toxicities of EGFR-TKI were slight and all population could be well tolerated.…”

Section: Discussionmentioning

confidence: 62%

Impact of Weight Loss at Presentation on Survival in Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors (EGFR-TKI) Sensitive Mutant Advanced Non-small Cell Lung Cancer (NSCLC) Treated with First-line EGFR-TKI

Lin¹,

Zhao²,

Hu³

et al. 2018

J. Cancer

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Purpose The aim of this study is to evaluate the impact of weight loss at presentation on treatment outcomes of first-line EGFR-tyrosine kinase inhibitors (EGFR-TKI) in EGFR-TKI sensitive mutant NSCLC patients.Methods We retrospectively analyzed the clinical outcomes of 75 consecutive advanced NSCLC patients with EGFR-TKI sensitive mutations (exon 19 deletion or exon 21 L858R) received first-line gefitinib or erlotinib therapy according to weight loss status at presentation in our single center.Results Of 75 EGFR-TKI sensitive mutant NSCLC patients, 49 (65.3%) patients had no weight loss and 26 (34.7%) had weight loss at presentation, the objective response rate (ORR) to EGFR-TKI treatment were similar between the two groups (79.6% vs. 76.9%, p = 0.533). Patients without weight loss at presentation had significantly longer median progression free survival (PFS) (12.4 months vs. 7.6 months; hazard ratio [HR] 0.356, 95% confidence interval [CI] 0.212-0.596, p < 0.001) and overall survival (OS) (28.5 months vs. 20.7 months; HR 0.408, 95% CI 0.215-0.776, p = 0.006) than those with weight loss at presentation; moreover, the stratified analysis by EGFR-TKI sensitive mutation types also found similar trend between these two groups except for OS in EGFR exon 21 L858R mutation patients. Multivariate analysis identified weight loss at presentation and EGFR-TKI sensitive mutation types were independent predictive factors for PFS and OS.Conclusions Weight loss at presentation had a detrimental impact on PFS and OS in EGFR-TKI sensitive mutant advanced NSCLC patients treated with first-line EGFR-TKI. It should be considered as an important factor in the treatment decision or designing of EGFR-TKI clinical trials.

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“…In the present study, CLF resulted in a body weight reduction of 19% and vitamin C supplementation did not attenuate weight loss induced by cyclophosphamide. However, weight loss was more gradual than the acute effect observed in the group that did not receive vitamin C. This significant weight loss may have occurred due to the side effects of the drug (e.g., diarrhea, nausea, and/ or inappetence) as well the immunosuppressive state that may result in reduced feed intake and body weight loss as observed in humans 40 , but these side effects were not evaluated in this study.…”

Section: Discussionmentioning

confidence: 82%

The effect of vitamin C supplementation on neutropenia induced by cyclophosphamide in mice

et al. 2019

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Neutropenia is one of the adverse effects caused by the administration of chemotherapy drugs. The present study aimed at investigating the effect of vitamin C supplementation in a model of immunosuppression induced by cyclophosphamide in mice. Vitamin C supplementation (50 mg/kg/day) administered intraperitoneally (i.p.) for 7 consecutive days in adult Swiss albino female. Mice were divided into four groups (n= 8/group): 1. Control (only distilled water i.p.), 2. Cyclophosphamide group (cyclophosphamide i.p. 150 and 100 mg/kg on days 1 and 4, respectively and distilled water daily), 3. Vitamin C group (Vitamin C 50 mg/kg i.p. and distilled water daily), and 4. Cyclophosphamide and Vitamin C group (cyclophosphamide i.p. 150 and 100 mg/kg on days 1 and 4, respectively and vitamin C 50 mg/kg i.p. daily). Vitamin C did not interfere in leukocytes count, but when co-administered with cyclophosphamide, significant interaction was observed, intensifying the neutropenia caused by cyclophosphamide. Vitamin C did not influence body weight during treatment, but groups receiving cyclophosphamide had a significant weight loss from the third day of treatment until the end of experiment compared to the control group. Vitamin C supplementation intensified neutropenia induced by cyclophosphamide and did not prevent weight loss induced by cyclophosphamide in mice.

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Weight Loss Associated with Platinum-Based Chemotherapy in Patients with Advanced Lung Cancer

Cited by 7 publications

References 22 publications

Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital

Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital

Impact of Weight Loss at Presentation on Survival in Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors (EGFR-TKI) Sensitive Mutant Advanced Non-small Cell Lung Cancer (NSCLC) Treated with First-line EGFR-TKI

The effect of vitamin C supplementation on neutropenia induced by cyclophosphamide in mice

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