Reversible sarcopenia in patients with gastrointestinal stromal tumor treated with imatinib

Journal of Cachexia, Sarcopenia and Muscle

Frédérick Moryoussef³  Marion Dhooge²  Julien Volet³  Coralie Barbe²  Catherine Brezault²  Christine Hoeffel¹  Romain Coriat² 

[1] Department of Radiology, CHU Reims, Hôpital Robert-Debré, Reims, France;Department of Gastro-Enterology, Cochin Teaching Hospital, AP-HP, Université´ Paris Descartes, Paris, France;Department of Gastro-Enterology and Digestive Oncology, CHU Reims, Hôpital Robert-Debré, Reims, France

关键词: Imatinib;    C‐kit inhibitors;    Sarcopenia;    Gastrointestinal stromal tumours;    Toxicity;    Body composition;   

DOI  :  10.1002/jcsm.12047

来源: Wiley

【 摘 要 】

Abstract

Background

Imatinib is a long-term, oral, targeted therapy for high-risk resected and advanced gastrointestinal stromal tumours (GIST). It is known that sarcopenia affects prognosis and treatment tolerance in patients with various solid cancers. We analysed lumbar skeletal muscle index changes in imatinib-treated GIST patients. Imatinib tolerance was also assessed to evaluate the influence of pre-treatment sarcopenia.

Methods

Thirty-one patients with advanced (n = 16) or high-risk resected (n = 15) GIST treated with imatinib (400 mg/day) were analysed retrospectively. Lumbar skeletal muscle indexes were evaluated on computed tomography images obtained before starting imatinib for all patients and at 6 months for those initially sarcopenic. Sarcopenia was defined using consensual cutoffs. Imatinib-induced toxicities were assessed after 3 months of administration.

Results

Twelve (38.7%) of the 31 patients were sarcopenic, including one unassessable at 6 months. Seven (63.6%) of the 11 assessable sarcopenic patients became non-sarcopenic after 6 months of imatinib. Pre-treatment sarcopenia was not associated with grades 3–4 toxicities, but the mean number of all-grade toxicities per sarcopenic patient was significantly higher for those non-sarcopenic (4.1 vs. 1.7, respectively, p < 0.01) after 3 months of treatment. Grades 1–2 anaemia and grades 1–2 fatigue were more frequent for sarcopenic than non-sarcopenic patients (83% vs. 26%, P < 0.01 and 42% vs. 5%, P = 0.02, respectively).

Conclusions

Sarcopenia is reversible in some GIST patients treated with imatinib. Pre-imatinib sarcopenia is predictive of non-severe toxicities, particularly anaemia and fatigue.

【 授权许可】

CC BY-NC-ND   
© 2015 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders

Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.