Bioimpedance-derived body composition parameters predict mortality and dose-limiting toxicity: the multicenter ONCO-BIVA study
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: In patients with cancer, lean body mass loss is frequent and associated with worse outcomes, including reduced treatment tolerance and survival. Bioelectrical impedance analysis (BIA) is a popular method for body composition assessment. We evaluated the value of BIA-derived body composition parameters in predicting mortality and, for the first time, dose-limiting toxicity (DLT). PATIENTS AND METHODS: We conducted a prospective multicenter (n = 12) observational study in adult patients with solid neoplastic disease and receiving primary systemic treatment. We collected information on BIA-derived parameters: phase angle (PhA) <5th percentile of age and gender-specific normative values; standardized PhA (SPA) <-1.65; Nutrigram® <660 mg/24 h/m and <510 mg/24 h/m for males and females, respectively. The primary outcome and the key secondary were 1-year mortality and DLT (any-type severe toxicity requiring a delay in systemic treatment administration or a reduction of its dosage), respectively. RESULTS: In total, 640 patients were included. At 12 months, death occurred in 286 patients (47.6%). All BIA-derived body composition parameters were independently associated with death: SPA, hazard ratio (HR) = 1.59 [95% confidence interval (CI) 1.30-1.95] (P < 0.001); PhA, HR = 1.38 (95% CI 1.13-1.69) (P = 0.002); Nutrigram®, HR = 1.71 (95% CI 1.42-2.04) (P < 0.001). DLT occurred in 208 patients (32.5%) and body composition parameters were associated with this outcome, particularly SPA: odds ratio = 6.37 (95% CI 2.33-17.44) (P < 0.001). CONCLUSIONS: The study confirmed that BIA-derived body composition parameters are independently associated not only with survival but also with DLT. Although our findings were limited to patients receiving first-line systemic treatment, the evidence reported may have important practice implications for the improvement of the clinical work-up of cancer patients.
Source: ESMO Open
Authors: E. Cereda, A. Casirati, C. Klersy, M. Nardi, G. Vandoni, E. Agnello, S. Crotti, S. Masi, A. Ferrari, P. Pedrazzoli, R. Caccialanza, Riccardo Caccialanza, Emanuele Cereda, Amanda Casirati, Silvia Crotti, Sara Masi, Catherine Klersy, Alessandra Ferrari, Paolo Pedrazzoli, Cecilia Gavazzi, Giulia Vandoni, Gabriella Farina, Nicla La Verde, Vittorina Zagonel, Maria Teresa Nardi, Ilaria Baldan, Francesco Di Costanzo, Annalisa Mascheroni, Ilaria Trestini, Filippo Valoriani, Lucio Lucchin, Giuseppe Aprile, Antonella De Francesco, Elena Agnello, Filippo Giovanardi
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,730
OpenAlex ID: W4401511327