{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:50:09Z","timestamp":1791010209315,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R61\u2010AR076824"],"award-info":[{"award-number":["R61\u2010AR076824"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K08AR081391"],"award-info":[{"award-number":["K08AR081391"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000092","name":"U.S. National Library of Medicine","doi-asserted-by":"publisher","award":["1F31LM014201"],"award-info":[{"award-number":["1F31LM014201"]}],"id":[{"id":"10.13039\/100000092","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":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer\u2010associated cachexia can inhibit immune checkpoint inhibitor (ICI) therapy efficacy. Cachexia's effect on ICI therapy has not been studied in large cohorts of cancer patients aside from lung cancer. We studied associations between real\u2010world routinely collected clinical cachexia markers and disability\u2010free, hospitalization\u2010free and overall survival of cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted of electronic health records (EHR) of patients with lung, renal cell, melanoma and other cancers treated with ICI therapy at Northwestern Medicine of Chicago, IL, United States, between March 2011 and January 2022. Weight, body mass index, absolute neutrophil and lymphocyte counts, albumin and C\u2010reactive protein (CRP) measures were analysed to calculate the Fearon consensus criteria for cachexia, weight loss grading system (WLGS) score, neutrophil\u2010lymphocyte ratio (NLR), Prognostic Nutritional Index (PNI) and modified Glasgow Prognostic Score (mGPS) at ICI therapy initiation. Kaplan\u2013Meier and Cox proportional hazards analyses were used to determine associations between these metrics and disability\u2010free, hospitalization\u2010free and overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      EHR analysis uncovered 3285 cancer patients on ICI therapy (54%\u2009&gt;\u200965\u2009years of age, 50.7% male, 77.7% White). At ICI therapy initiation, 1282 (39.0%) patients had cachexia (consensus criteria), 1641 (50.0%) had a WLGS score \u2265\u20092, 1806 (55.0%) had an NLR\u2009&gt;\u20093, 1087 (33.1%) had albumin &lt;\u20093.5\u2009g\/dL and 1318 (40.1%) had a PNI\u2009&lt;\u200944. Missing measurements included CRP missing for 98.2% and mGPS missing for 98.6% of patients. Disability\u2010free (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091373), hospitalization\u2010free (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092374) and overall survival (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091599) events were analysed with 1\u2010year rates of 65% (64%\u201367%), 35% (34%\u201337%) and 65% (63%\u201366%), respectively. Multivariate Cox model analyses showed hazard ratios (HR) for cachexia at 1.58 (95% CI 1.38\u20131.80), 1.47 (95% CI 1.33\u20131.63) and 1.97 (95% CI 1.75\u20132.23) for disability, hospitalization and death, respectively. HRs for WLGS \u2265\u20092 were 1.45 (95% CI 1.28\u20131.66), 1.37 (95% CI 1.24\u20131.51) and 1.91 (95% CI 1.69\u20132.17). HRs for NLR\u2009&gt;\u20093 were 1.57 (95% CI 1.35\u20131.83), 1.40 (95% CI 1.25\u20131.58) and 1.95 (95% CI 1.67\u20132.27). HRs for albumin &lt;\u20093.5\u2009g\/dL were 1.33 (95% CI 1.15\u20131.54), 1.67 (95% CI 1.50\u20131.86) and 2.09 (95% CI 1.84\u20132.36). HRs for PNI\u2009&lt;\u200944 were 1.60 (95% CI 1.39\u20131.84), 1.46 (95% CI 1.31\u20131.63) and 2.07 (95% CI 1.80\u20132.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fearon consensus criteria, WLGS, NLR, albumin and PNI were routinely collected at ICI initiation in regular clinical practice and predictive of worse disability\u2010free, hospitalization\u2010free and overall survival in cancer patients receiving ICI therapy. These routine clinical measures may aid prognostication and decision\u2010making in cancer patients with cachexia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13685","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T07:22:04Z","timestamp":1737012124000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Weight and Blood\u2010Based Markers of Cachexia Predict Disability, Hospitalization and Worse Survival in Cancer Immunotherapy Patients"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-2348","authenticated-orcid":false,"given":"Steven\u00a0D.","family":"Tran","sequence":"first","affiliation":[{"name":"Center for Health Information Partnerships Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Feinberg School of Medicine Northwestern University  Chicago Illinois 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Ryan AbilityLab  Chicago Illinois USA"},{"name":"Department of Physical Medicine and Rehabilitation Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-3650","authenticated-orcid":false,"given":"Theresa\u00a0L.","family":"Walunas","sequence":"additional","affiliation":[{"name":"Center for Health Information Partnerships Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Robert H Lurie Comprehensive Cancer Center of Northwestern University  Chicago Illinois USA"},{"name":"Department of Medicine, Division of General Internal Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois 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