{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:51:12Z","timestamp":1790661072636,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82130060"],"award-info":[{"award-number":["82130060"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170626"],"award-info":[{"award-number":["82170626"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2018YFA0704100"],"award-info":[{"award-number":["2018YFA0704100"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2018YFA0704104"],"award-info":[{"award-number":["2018YFA0704104"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["xtr062023003"],"award-info":[{"award-number":["xtr062023003"]}],"id":[{"id":"10.13039\/501100012226","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":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Cancer cachexia can impact prognosis, cause resistance to anticancer treatments and affect the tolerability of treatments. This study aims to identify hepatocellular carcinoma (HCC) with cachexia by characterizing longitudinal body composition (\n BC<\/jats:sc>\n ) trajectories.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This longitudinal, multicentre cohort study included unresectable HCC patients treated with first\u2010line programmed death\u2010(ligand)1 inhibitors plus anti\u2010vascular endothelial growth factor antibody\/tyrosine kinase inhibitors between 01\/2018\u201312\/2022.\n BC<\/jats:sc>\n measurements including skeletal muscle mass (SMM) and total adipose tissue area (TATA) were evaluated by computed tomography at the third lumbar vertebra at baseline and follow\u2010up imaging. Unsupervised latent class growth mixed models were applied to distinguish potential longitudinal SMM and TATA trajectories for identifying cachexia. The primary study endpoint was overall survival (OS), with secondary endpoints including progression\u2010free survival (PFS), objective response rate (ORR) and safety. Multiple Cox proportional hazards models were used to calculate adjusted hazard ratios (HRs) for survival.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 411 patients with 2138 time\u2010point measurements were included. The median age was 56\u2009years, and 50 (12.2%) patients were female. Two distinct trajectories were identified for SMM and TATA: sharp\u2010falling and stable. SMM sharply declined in 58 patients (14.1%) and TATA in 71 of 406 patients (17.5%) with significant worse OS (for SMM, 17.0 vs. 24.9\u2009months;\n p<\/jats:italic>\n \u2009<\u20090.001; HR\u2009=\u20090.59; for TATA, 15.3 vs. 25.1\u2009months;\n p<\/jats:italic>\n \u2009<\u20090.001; HR\u2009=\u20090.44). Patients were categorized into three phases based on trajectories: pre\u2010cachexia (SMM and TATA stable,\n n<\/jats:italic>\n \u2009=\u2009299, 73.6%), cachexia (SMM or TATA sharp\u2010falling,\n n<\/jats:italic>\n \u2009=\u200986, 21.2%) and refractory cachexia (SMM and TATA sharp\u2010falling,\n n<\/jats:italic>\n \u2009=\u200921, 5.2%). Patients with refractory cachexia exhibited the worst OS, PFS and ORR, followed by those with cachexia. The median OS was 11.5\u2009months for refractory cachexia, 17.7 for cachexia and 26.0 for pre\u2010cachexia; median PFS was 6.0, 7.9 and 10.9\u2009months, respectively, with ORR of 4.8%, 39.5% and 54.2%, respectively (all\n p<\/jats:italic>\n s\u2009<\u20090.001). Multivariable Cox analysis identified refractory cachexia as an independent risk factor for both OS (HR\u2009=\u20093.31;\n p<\/jats:italic>\n \u2009<\u20090.001) and PFS (HR\u2009=\u20092.94;\n p<\/jats:italic>\n \u2009<\u20090.001), with cachexia also showing significant impacts. Grade 3\u20134 adverse events were higher in patients with refractory cachexia (23.8%) and cachexia (8.1%) compared with pre\u2010cachexia (6.0%;\n p<\/jats:italic>\n \u2009=\u20090.010).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HCC patients with cachexia and refractory cachexia were identified by longitudinal\n BC<\/jats:sc>\n trajectories. Falling trajectories of\n BC<\/jats:sc>\n identified refractory cachexia patients with worst response, survival and poor tolerability from systemic therapy combinations.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov<\/jats:ext-link>\n identifier: NCT05278195\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcsm.13615","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T23:40:24Z","timestamp":1732750824000},"page":"2705-2716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Longitudinal Body Composition Identifies Hepatocellular Carcinoma With Cachexia Following Combined Immunotherapy and Target Therapy (CHANCE2213)"],"prefix":"10.1002","volume":"15","author":[{"given":"Zhi\u2010Cheng","family":"Jin","sequence":"first","affiliation":[{"name":"Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing China"},{"name":"Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, National Innovation Platform for Integration of Medical Engineering Education (NMEE) (Southeast University), State Key Laboratory of Digital Medical Engineering Southeast University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Wei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Health Statistics, School of Public Health Chongqing Medical University Chongqing China"},{"name":"Department of Biostatistics, School of Public Health Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Jian","family":"Chen","sequence":"additional","affiliation":[{"name":"Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School Southeast University Nanjing 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Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, National Innovation Platform for Integration of Medical Engineering Education (NMEE) (Southeast University), State Key Laboratory of Digital Medical Engineering Southeast University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Wang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Center of Interventional Oncology and Liver Diseases Beijing Youan Hospital, Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Sheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, the Third Affiliated Hospital Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Interventional Oncology The First 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