MP14-13 EVALUATING BASELINE AND CHANGE IN BODY COMPOSITION IN PATIENTS WITH METASTATIC RENAL CELL CARCINOMA WITH FRONT-LINE SYSTEMIC THERAPY: IMPLICATIONS FOR ADVERSE EVENTS AND OVERALL SURVIVAL

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (MP14)1 Sep 2021MP14-13 EVALUATING BASELINE AND CHANGE IN BODY COMPOSITION IN PATIENTS WITH METASTATIC RENAL CELL CARCINOMA WITH FRONT-LINE SYSTEMIC THERAPY: IMPLICATIONS FOR ADVERSE EVENTS AND OVERALL SURVIVAL Delaney Orcutt, Maria M. Wrobel, Sofiane Mrah, J. Peter Marquardt, Florian Fintelmann, Duncan Hussey, Evan Gross, Elliott Trott, Joel Kramer, Kaylee Oliva, John Gore, George R. Schade, Dan Lin, Yaw Nyame, Scott Tykodi, John Thompson, Evan Hall, Ryan O'Malley, and Sarah Psutka Delaney OrcuttDelaney Orcutt More articles by this author , Maria M. WrobelMaria M. Wrobel More articles by this author , Sofiane MrahSofiane Mrah More articles by this author , J. Peter MarquardtJ. Peter Marquardt More articles by this author , Florian FintelmannFlorian Fintelmann More articles by this author , Duncan HusseyDuncan Hussey More articles by this author , Evan GrossEvan Gross More articles by this author , Elliott TrottElliott Trott More articles by this author , Joel KramerJoel Kramer More articles by this author , Kaylee OlivaKaylee Oliva More articles by this author , John GoreJohn Gore More articles by this author , George R. SchadeGeorge R. Schade More articles by this author , Dan LinDan Lin More articles by this author , Yaw NyameYaw Nyame More articles by this author , Scott TykodiScott Tykodi More articles by this author , John ThompsonJohn Thompson More articles by this author , Evan HallEvan Hall More articles by this author , Ryan O'MalleyRyan O'Malley More articles by this author , and Sarah PsutkaSarah Psutka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001995.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Skeletal muscle index (SMI) is associated with oncologic outcomes in metastatic renal cell carcinoma (mRCC). Little is known regarding changes in body composition (SMI, skeletal muscle density (SMD), and fat mass index (FMI)) in patients with mRCC treated with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). We analyze changes in body composition (BC) with front-line systemic therapy (Tx) and evaluate associations with adverse events (AEs) and overall survival (OS). METHODS: We retrospectively identified patients with mRCC treated with Tx from 2005-20 and compared computed tomography (CT) obtained within 60 days of therapy start to first follow-up CT. We estimated associations of absolute (∆) and relative change (%∆) of SMI (cm2/m2), SMD (Hounsfield Units, HU), and FMI (kg/m2) at the level of the third lumbar vertebra with Grade 3-5 AEs during Tx (Common Terminology Criteria for Adverse Events v5.0), time on Tx, and OS using multivariable regression adjusted for Tx type. Median time to follow-up was 35.2 months. RESULTS: We identified 136 patients (median age 61 years) of whom 16.2% received ICIs, 55.1% received TKIs (55.1%); 28.7% received other systemic therapies. Median time between baseline and first follow-up CT was 98 days. Median ∆SMI was -1.4 (-3.1%, p<0.001), ∆SMD was -0.3 (-0.1%, p=0.18), and ∆FMI was -0.2 (-4.0%, p=0.009). BC changes across therapies were compared (Table). 41 patients (30.2%) experienced one or more grade 3-5 AEs while on Tx. Lower baseline SMD was significantly associated with higher AE risk (OR=0.95, p=0.03), while baseline FMI (p=0.26) and SMI were not (p=0.054). Baseline BC or changes thereof were not associated with length of time on Tx (median 5 months; IQR 2.1, 11.4) or OS. CONCLUSIONS: Patients with mRCC lost approximately 3% of their muscle mass during the first 3 months of treatment, while fat mass loss varied considerably across therapies. Baseline SMD, a surrogate for muscle quality, is associated with risk of high-grade AEs on front-line systemic therapy. Further work is needed to understand the implications of body composition changes with mRCC systemic therapy to determine the need for interventions to mitigate potentially debilitating changes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e258-e258 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Delaney Orcutt More articles by this author Maria M. Wrobel More articles by this author Sofiane Mrah More articles by this author J. Peter Marquardt More articles by this author Florian Fintelmann More articles by this author Duncan Hussey More articles by this author Evan Gross More articles by this author Elliott Trott More articles by this author Joel Kramer More articles by this author Kaylee Oliva More articles by this author John Gore More articles by this author George R. Schade More articles by this author Dan Lin More articles by this author Yaw Nyame More articles by this author Scott Tykodi More articles by this author John Thompson More articles by this author Evan Hall More articles by this author Ryan O'Malley More articles by this author Sarah Psutka More articles by this author Expand All Advertisement PDF downloadLoading ...