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Youn S, Reif R, Chu MP, et al. Myosteatosis is prognostic in metastatic melanoma treated with nivolumab. Clin Nutr ESPEN. 2021;42:348-353doi: 10.1016/j.clnesp.2021.01.009.
Youn, S., Reif, R., Chu, M. P., Smylie, M., Walker, J., Eurich, D. T., Ghosh, S., & Sawyer, M. B. (2021). Myosteatosis is prognostic in metastatic melanoma treated with nivolumab. Clinical nutrition ESPEN, 42348-353. https://doi.org/10.1016/j.clnesp.2021.01.009
Youn, Susie, et al. "Myosteatosis is prognostic in metastatic melanoma treated with nivolumab." Clinical nutrition ESPEN vol. 42 (2021): 348-353. doi: https://doi.org/10.1016/j.clnesp.2021.01.009
Youn S, Reif R, Chu MP, Smylie M, Walker J, Eurich DT, Ghosh S, Sawyer MB. Myosteatosis is prognostic in metastatic melanoma treated with nivolumab. Clin Nutr ESPEN. 2021 Apr;42:348-353. doi: 10.1016/j.clnesp.2021.01.009. Epub 2021 Jan 20. PMID: 33745604.
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Clin Nutr ESPEN. 2021 Apr;42:348-353. doi: 10.1016/j.clnesp.2021.01.009. Epub 2021 Jan 20.

Myosteatosis is prognostic in metastatic melanoma treated with nivolumab.

Clinical nutrition ESPEN

Susie Youn, Rebecca Reif, Michael P Chu, Michael Smylie, John Walker, Dean T Eurich, Sunita Ghosh, Michael B Sawyer

Affiliations

  1. Department of Surgery, University of Alberta, Edmonton, AB, Canada; School of Public Health, University of Alberta, Edmonton, AB, Canada.
  2. Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
  3. School of Public Health, University of Alberta, Edmonton, AB, Canada.
  4. Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada. Electronic address: [email protected].

PMID: 33745604 DOI: 10.1016/j.clnesp.2021.01.009

Abstract

BACKGROUND: While immunotherapy agents have improved outcomes in metastatic melanoma (MM), predictive biomarkers in these patients are lacking. Parameters identified from body composition analysis, such as low SMD (also termed myosteatosis), may prognosticate MM patients on immunotherapy.

METHODS: In this retrospective study, 44 MM patients received nivolumab, either as monotherapy or in combination with ipilimumab. Pre-treatment computed tomography (CT) scans were analyzed to determine skeletal muscle density (SMD) in Hounsfield units (HU) and muscle surface area (MSA) in cm

RESULTS: Low SMD was associated with worse overall survival (OS) by log rank test (median 12.03 vs. 34.96 months, p = 0.001) and in multivariate analysis when accounting for age, sex, performance status, and number of prior lines of therapy (HR 4.40, 95% CI 1.44-13.42, p = 0.009). Lower nivolumab dosing by MSA was significantly associated with improved OS (median 42.9 vs. 12.3 months, p < 0.001). This association remained significant in multivariate analysis with age, sex, performance status, and number of prior lines of therapy (HR 0.05, 95% CI 0.01-0.30, p = 0.001). Neither SMD nor higher nivolumab dose per MSA were associated with increased incidence of treatment toxicity.

CONCLUSIONS: Low SMD is prognostic in MM treated with nivolumab immunotherapy. Presence of myosteatosis or higher nivolumab dose based on body composition did not predict treatment toxicity.

Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Keywords: Body composition; Immunotherapy; Melanoma; Myosteatosis; Nivolumab; Prognosis; Survival

Conflict of interest statement

Declaration of competing interest None declared.

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