Kanser Hastalarında İmmünoterapi Etkinliğinin Sarkopeni ve Sistemik İnflamatuvar Belirteçler ile Olan İlişkisinin İncelenmesi
Özet
Üçgül E. The Effects of Sarcopenia and Systemic İnflammatory Markers on İmmunotherapy response in Patients with Cancer Hacettepe University Faculty Of Medicine Department Of Internal Medicine, Thesis of Specialization in Medicine, Ankara, 2022. Research for estimating immunotherapy response has been continuing in recent years. Although new markers predicting immunotherapy response have been found, the requirement in this area has continued. Our study aimed to determine the effects of sarcopenia and systemic inflammation on immunotherapy response. We included 100 patients treated with immunotherapy between 2015-2021 years and had an abdomen CT scan before the first immunotherapy dose. Sex-specific cutoffs were used for the diagnosis of sarcopenia. CRP, sedimentation, NLR, PLR, albumin, and lactate dehydrogenase were used for systemic inflammation markers. These markers and sarcopenia were evaluated with univariable and multivariable analyses for OS and PFS. Sarcopenia was significant prognostic factor to estimate poor PFS (HR, 2.33; 95% GA, 1.45-3.74; p <0.001). Although patients with sarcopenia had worse OS than nonsarcopenic patients (6,3 vs 12,1 months), sarcopenia was not an independent factor associated with OS in multivariable analysis (HR 1,24; 95% CI, 0,71-2,16; p=0,432). Hypoalbuminemia was found as a significant prognostic factor to predict OS (HR, 2,10;95% CI, 1,21-3,66; p=0,008). İn our compound model with ECOG PS and sarcopenia, worsening ECOG PS and accompanying sarcopenia were associated with worse PFS (HR, 7,8; 95% (CI), 4,12-14,84; p<0,001). Our research, including systemic inflammatory markers and sarcopenia, is one of the most comprehensive studies in the literature. Following up on sarcopenia closer and preventing sarcopenia may help the results of OS and PFS improve. İn addition to these, our compound model may help oncologists predict immunotherapy responses.
