{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:42:56Z","timestamp":1790084576327,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Response rates of immune checkpoint inhibitor (ICI) therapy for recurrent and\/or metastatic head and neck squamous cell carcinoma (R\/M HNSCC) are low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>This retrospective multicentre cohort study evaluates the predictive and prognostic value of weight loss and changes in body composition prior and during therapy. Patient, tumor, and treatment characteristics of 98 patients were retrieved, including neutrophil and platelet\u2010lymphocyte\u2010ratio (NLR and PLR). Programmed death\u2010ligand 1 (PD\u2010L1) expression was determined on residual material. Cachexia was defined according to Fearon et al. (2011). Skeletal muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were evaluated on computed tomography scans at the third lumbar vertebrae level. Univariable and multivariable regression analyses were performed for 6\u2009months progression free survival (PFS6m) and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant early weight loss (&gt;2%) during the first 6\u2009weeks of therapy was shown in 34 patients (35%). This patient subgroup had a significantly higher NLR and PLR at baseline. NLR and PLR were inversely correlated with SM and VAT index. Independent predictors of PFS6m were lower World Health Organization performance status (HR 0.16 [0.04\u20130.54] <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003), higher baseline SAT index (HR 1.045 [1.02\u20131.08] <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003), and weight loss &lt;2% (HR 0.85 [0.74\u20130.98] <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). Baseline cachexia in combination with &gt;2% early weight loss remained a predictor of OS, independent of PD\u2010L1 expression (HR 2.09 [1.11\u20133.92] <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02, HR 2.18 [1.13\u20134.21] <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We conclude that the combination of cachexia at baseline and weight loss during ICI therapy is associated with worse OS in R\/M HNSCC patients, independent of PD\u2010L1 expression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5522","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T12:25:16Z","timestamp":1670588716000},"page":"7699-7712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The predictive and prognostic value of weight loss and body composition prior to and during immune checkpoint inhibition in recurrent or metastatic head and neck cancer patients"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8595-0739","authenticated-orcid":false,"given":"Anna C. H.","family":"Willemsen","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"GROW\u2010School of Oncology and Developmental Biology Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9041-3869","authenticated-orcid":false,"given":"Nina","family":"De Moor","sequence":"additional","affiliation":[{"name":"Department of Oncology Leuven Cancer Institute, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5084-8710","authenticated-orcid":false,"given":"Jeroen","family":"Van Dessel","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, KU Leuven &amp; Oral and Maxillofacial Surgery University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1406-6425","authenticated-orcid":false,"given":"Laura W. J.","family":"Baijens","sequence":"additional","affiliation":[{"name":"GROW\u2010School of Oncology and Developmental Biology Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7735-4665","authenticated-orcid":false,"given":"Michel","family":"Bila","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, KU Leuven &amp; Oral and Maxillofacial Surgery University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8688-9231","authenticated-orcid":false,"given":"Esther","family":"Hauben","sequence":"additional","affiliation":[{"name":"Department of Pathology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-5952","authenticated-orcid":false,"given":"Mari F. 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