Evaluation of Weight Gain and Overall Survival of Men Versus Women With Advanced Non-Small Cell Lung Cancer.

BACKGROUND

Weight stabilization or gain during cancer treatment is associated with increased survival. Analyses of weight gain by sex during cancer treatment and the effects of weight on survival have not been fully studied.

This post hoc analysis retrospectively examined the relationship between sex, weight gain and overall survival (OS) in patients with advanced non-small cell lung cancer (NSCLC) receiving standard-of-care chemotherapy.

METHODS

Data from the control arms of three randomized phase III clinical studies (NCT00596830, NCT00254891, NCT00254904) of adult patients with advanced NSCLC were pooled; patients received platinum-based doublet chemotherapy. Weight was recorded according to each study’s schedule.

Analyses compared weight gain categories from baseline up to 3 months after chemotherapy initiation (> 0% vs. ≤ 0%, > 2.5% vs. ≤ 2.5% and > 5% vs. ≤ 5%). Stepwise Cox proportional hazards modelling of OS (time from treatment initiation to death due to any cause) was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs); differences between groups were tested with log-rank tests.

RESULTS

Of the 1030 patients, most were men (70.5%) with stage IV NSCLC.

Median (range) age was 62 (34-87) years for men and 60 (34-83) years for women, and the mean body mass index (standard deviation) was 24.5 (4.2) and 24.8 kg/m 2 (4.8), respectively. Weight gain of > 0%, > 2.5% and > 5% was observed in 44.0%, 24.5% and 11.7% of the patients, respectively.

Any weight gain (> 0% vs. ≤ 0%) was associated with a significantly reduced risk of death in both men (HR 0.62 [95% CI 0.522, 0.742]; p  2.5% vs. ≤ 2.5% was associated with a significantly reduced risk of death in men (HR 0.64; 95% CI 0.516, 0.784; p < 0.0001) and a risk reduction in women (HR 0.73; 95% CI 0.518, 1.034; p = 0.0767).

Weight gain of > 5% vs. ≤ 5% was associated with a significantly reduced risk of death in men (HR 0.67; 95% CI 0.503, 0.879; p = 0.0042), but not in women (HR 0.90; 95% CI 0.542, 1.509; p = 0.70). Despite these differences, the overall interaction of weight gain by sex was not significant (p = 0.61 for > 0% vs. ≤ 0%, p = 0.43 for > 2.5% vs. ≤ 2.5% and p = 0.37 for > 5% vs. ≤ 5%).

CONCLUSIONS

Any weight gain during treatment of advanced NSCLC was associated with a significantly reduced risk of death, regardless of sex.

TRIAL REGISTRATION

NCT00596830; NCT00254891; NCT00254904.