{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:31:16Z","timestamp":1783467076704,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013170","name":"Ono Pharmaceutical","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013170","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cancer cachexia complicates advanced non\u2010small cell lung cancer (NSCLC); however, it remains unclear how often cachexia occurs and how it affects the course of chemotherapy in patients receiving first\u2010line systemic therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicentre, prospective observational study and enrolled previously untreated NSCLC patients with Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0\u20132 and cachexia between September 2020 and September 2021. The primary outcome measure was the trends in the Functional Assessment of Anorexia\/Cachexia Treatment and Anorexia\/Cachexia Subscale [FAACT (A\/CS)] scores by cohort. Secondary outcome measures included the incidence of cachexia before the initiation of first\u2010line systemic therapy, quality of life (QOL) measures, body weight (BW) changes, and efficacy and safety of first\u2010line systemic therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 887 consecutive patients with previously untreated advanced NSCLC and ECOG PS of 0\u20132 who were initiated on first\u2010line systemic therapy were evaluated. A total of 281 patients (31.7%) experienced BW loss consistent with the criteria of cachexia, and 186 were evaluated for QOL, BW and outcome measurements. Overall, 180\/186 patients received first\u2010line systemic therapy. Cohort 1 (targeted therapy), cohort 2 [cytotoxic chemotherapy (CTx)\u2009\u00b1\u2009immune checkpoint inhibitors (ICIs)] and cohort 3 (ICIs) included 42, 98 and 40 patients, respectively. There were significant variations in QOL trends by cohort, with chemotherapy\u2010associated emesis affecting early appetite\u2010related QOL. The change in the FAACT (A\/CS) score at 1\u2009week from baseline was worse in cohort 2 (the least square mean change\u2009\u00b1\u2009standard error: \u22123.0\u2009\u00b1\u20090.9) than in cohorts 1 (1.6\u2009\u00b1\u20091.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) and 3 (1.8\u2009\u00b1\u20091.0, <jats:italic>p<\/jats:italic>\u2009=\u20090.002); meanwhile, the change at 6\u2009weeks was worse in cohort 1 (\u22121.5\u2009\u00b1\u20091.2) than in cohorts 2 (3.6\u2009\u00b1\u20090.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and 3 (3.5\u2009\u00b1\u20091.1, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). BW reduction was observed in all cohorts within 6\u2009weeks of therapy initiation. The targeted therapy cohort demonstrated superior progression\u2010free survival (PFS) and overall survival (OS) to CTx\u2009\u00b1\u2009ICIs cohort or ICIs cohort (median PFS was 9.7\u2009months, 6.3\u2009months, 3.1\u2009months, in cohort 1, 2, 3, respectively (cohort 1 vs. cohort 2: HR, 0.58, <jats:italic>p<\/jats:italic>\u2009=\u20090.018; cohort 1 vs. cohort 3: HR, 0.41, <jats:italic>p<\/jats:italic>\u2009=\u20090.001); median OS was not reached, 15.8\u2009months, 9.9\u2009months, respectively (cohort 1 vs. cohort 2: HR, 0.52, <jats:italic>p<\/jats:italic>\u2009=\u20090.033; cohort 1 vs. cohort 3: HR, 0.37, <jats:italic>p<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately 1\/3 patients with previously untreated advanced NSCLC have cachexia. Appetite\u2010related QOL trends vary based on the type of first\u2010line systemic therapy in cachectic NSCLC patients, and the PFS and OS of these patients seemed to be shorter.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13606","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T08:40:47Z","timestamp":1727772047000},"page":"2618-2628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Cachexia and First\u2010Line Systemic Therapy for Previously Untreated Advanced Non\u2010Small Cell Lung Cancer: NEJ050A"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2685-5616","authenticated-orcid":false,"given":"Keita","family":"Miura","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine Juntendo University Graduate School of Medicine  Tokyo 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School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiki","family":"Hakozaki","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology and Respiratory Medicine Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Hamai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Hiroshima Prefectural Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Respiratory Disease Hiroshima red Cross Hospital &amp; Atomic\u2010Bomb Survivors Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Miyagi Cancer Center  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