{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:07:12Z","timestamp":1790255232624,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia, a loss of muscle strength, quantity and performance that occurs primarily from ageing or secondary to disease, is hypothesized to worsen treatment outcomes in patients with cancer. Most published studies, however, focus solely on muscle quantity in patients under 70. Here, we evaluate the association between sarcopenia, defined as both a loss of strength and muscle quantity, and treatment tolerability in older adults receiving cancer treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This secondary analysis examines data from a randomized clinical trial evaluating a geriatric assessment intervention (NCT02054741). Older adults (\u2265\u200970\u2009years) with advanced cancer starting a new treatment regimen were recruited from community oncology practices across the United States. We analysed data from 161 participants in the usual care arm with baseline standard of care computed tomography (CT) scans. Sarcopenia was defined by reduced strength (chair stand &gt;\u200916.7\u2009s for five rises) and either a reduction in muscle quantity (skeletal muscle index [SMI]\u2009&lt;\u200941\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      women, &lt; 43\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      men with BMI\u2009&lt;\u200924.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      or &lt;\u200953\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      men with BMI\u2009\u2265\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) or muscle quality. Sarcopenia was considered severe when the above criteria were met along with impaired physical performance (TUG &gt;\u200913.5\u2009s). Treatment toxicity was assessed via Common Terminology Criteria for Adverse Events (CTCAE) v4.0.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 161 participants (mean age: 76.6\u2009\u00b1\u20094.7; 61% male, 94% non\u2010Hispanic white), 57% (91\/161) met criteria for sarcopenia, of which 59% (54\/91) were considered severe. Sarcopenia was associated with deficits in multiple geriatric assessment domains (nutrition, activities of daily living, instrumental activities and cognition;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In multivariable logistic regression and Cox proportional hazards regression analyses, patients with sarcopenia were more likely to experience severe non\u2010hematologic toxicities (Grades 3\u20135; OR\u2009=\u20092.24, 95% confidence interval [CI]: 1.12\u20134.47). In participants receiving first\u2010line therapy, sarcopenia was associated with worse 1\u2010year survival (46% survival [95% CI: 35%\u201355%]; HR\u2009=\u20092.12 [95% CI: 1.14\u20133.93]; 49 events) compared to those without sarcopenia (60% survival [95% CI: 48%\u201370%]; 28 events). SMI alone was not significantly associated with severe nonhematologic toxicity or survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sarcopenia is highly prevalent in older patients with cancer and is associated with severe toxicity and mortality. Our findings highlight the importance of assessing muscle strength, quantity, quality and performance when evaluating older adults with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT02054741\n                    <\/jats:title>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70388","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:40:53Z","timestamp":1790253653000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sarcopenia Is Associated With Severe Treatment Toxicity and Mortality in Older Adults With Advanced Cancer: A Secondary Analysis"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-9309","authenticated-orcid":false,"given":"Lindsey J.","family":"Mattick","sequence":"first","affiliation":[{"name":"Division of Supportive Care in Cancer, Department of Surgery, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin\u2010Shang","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Supportive Care in Cancer, Department of Surgery, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael G.","family":"Tylock","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kah Poh","family":"Loh","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie A.","family":"Flannery","sequence":"additional","affiliation":[{"name":"School of Nursing University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke J.","family":"Peppone","sequence":"additional","affiliation":[{"name":"Division of Supportive Care in Cancer, Department of Surgery, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Ju","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Supportive Care in Cancer, Department of Surgery, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus D.","family":"Goncalves","sequence":"additional","affiliation":[{"name":"Department of Medicine New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bette J.","family":"Caan","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Cespedes Feliciano","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karteek","family":"Popuri","sequence":"additional","affiliation":[{"name":"Department of Computer Science Memorial University of Newfoundland  St. John's NL Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirza Faisal","family":"Beg","sequence":"additional","affiliation":[{"name":"School of Engineering Science Simon Fraser University  Burnaby BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Bearden","sequence":"additional","affiliation":[{"name":"Upstate Carolina Consortium Community Oncology Research Program (UPSTATE) NCORP  Spartanburg South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Berenberg","sequence":"additional","affiliation":[{"name":"Hawaii NCORP  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Katato","sequence":"additional","affiliation":[{"name":"Michigan Cancer Research Consortium (MCRC) NCORP  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Mustian","sequence":"additional","affiliation":[{"name":"Division of Supportive Care in Cancer, Department of Surgery, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya G.","family":"Mohile","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Dunne","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, School of Medicine and Dentistry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"12","volume-title":"SEER Cancer Statistics Review, 1975\u20132010","author":"Howlader N.","year":"2013"},{"issue":"22","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"4626","DOI":"10.1200\/JCO.2004.02.175","article-title":"Enrollment of Elderly Patients in Clinical Trials for Cancer Drug Registration: A 7\u2010Year Experience by the US Food and Drug Administration","volume":"22","author":"Talarico L.","year":"2004","journal-title":"Journal of Clinical Oncology"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"78","article-title":"Older Adult Participation in Cancer Clinical Trials: A Systematic Review of Barriers and Interventions","volume":"71","author":"Sedrak M. 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