Sarcopenia in Metastatic Colorectal Carcinoma

Česká verzia

Authors: T. Büchler; J. Hornová
Authors place of work: Onkologická klinika 1. LF UK a Thomayerova nemocnice, Praha
Published in the journal: Klin Onkol 2019; 32(6): 406-410
Category:
doi: https://doi.org/10.14735/amko2019406

Summary

Sarcopenia is the loss of skeletal muscle mass (SMM) and is associated with decreased muscle strength and/or decreased physical performance. Sarcopenia in patients with malignancies is a multifactorial problem, caused by chronic inflammation associated with malignancies, aging, nutritional deficiency, inactivity, and antineoplastic treatment. Sarcopenia is present in approximately 30–60% of patients with metastatic colorectal cancer (mCRC). It is an objective, measurable predictor of survival and systemic toxicity. The detection and quantification of sarcopenia in routine clinical practice does not require any particular test beyond routine imaging. Initial results show that regimens used to treat mCRC can have differential effect on skeletal mass. SMM tends to decrease during intensive regimens. Conversely, SMM tends to increase during low-intensity maintenance therapy or in patients with stable disease. The status of the underlying disease is another determinant of muscle mass changes, and SMM decreases during disease progression. Third-line therapy with regorafenib, a tyrosine kinase inhibitor of the vascular endothelial growth factor receptor, results in more skeletal muscle loss than trifluridine/tipiracil chemotherapy, which may have consequences for the survival or quality of life of patients. Larger prospective studies are needed to elucidate the importance of SMM changes during mCRC treatment.

TB received fees for lectures and consultations related to the treatment of colorectal cancer from Merck, Amgen, Eli Lilly, Servier, Roche, Sanofi and Bayer. JH declares she has no potencional conflict of interest.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted: 15. 9. 2019

Accepted: 25. 10. 2019

Keywords:

molecular targeted therapy

Zdroje

1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing 2010; 39 (4): 412–423. doi: 10.1093/ageing/afq034.

2. Steffl M, Sima J, Shiells K et al. The increase in health care costs associated with muscle weakness in older people without long-term illnesses in the Czech Republic: results from the Survey of Health, Ageing and Retirement in Europe (SHARE). Clin Interv Aging 2017; 12: 2003–2007. doi: 10.2147/CIA.S150826.

3. Mauricio SF, de Vasconcelos Generoso S, Leandro Marciano Vieira E et al. Relationship between sarcopenia and mTOR pathway in patients with colorectal cancer: preliminary report. Nutr Cancer 2019; 71 (1): 172–177. doi: 10.1080/01635581.2018.1540716.

4. Okugawa Y, Toiyama Y, Yamamoto A et al. Close relationship between immunological/inflammatory markers and myopenia and myosteatosis in patients with colorectal cancer: a propensity score matching analysis. JPEN J Parenter Enteral Nutr 2019; 43 (4): 508–515. doi: 10.1002/jpen.1 459.

5. Xiao J, Caan BJ, Weltzien E et al. Associations of pre-existing co-morbidities with skeletal muscle mass and radiodensity in patients with non-metastatic colorectal cancer. J Cachexia Sarcopenia Muscle 2018; 9 (4): 654–663. doi: 10.1002/jcsm.12301.

6. Olfert IM, Howlett RA, Tang K et al. Muscle-specific VEGF deficiency greatly reduces exercise endurance in mice. J Physiol 2009; 587 (8): 1755–1767. doi: 10.1113/jphysiol.2008.164384.

7. Olfert IM, Baum O, Hellsten Y et al. Advances and challenges in skeletal muscle angiogenesis. Am J Physiol Heart Circ Physiol 2016; 310 (3): 326–336. doi: 10.1152/ajpheart.00635.2015.

8. Dhillon RJ, Hasni S. Pathogenesis and management of sarcopenia. Clin Geriatr Med 2017; 33 (1): 17–26. doi: 10.1016/j.cger.2016.08.002.

9. Martin L, Birdsell L, Macdonald N et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 2013; 31 (12): 1539–1547. doi: 10.1200/JCO.2012.45.2722.

10. Prado CM, Lieffers JR, McCargar LJ et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 2008; 9 (7): 629–635. doi: 10.1016/S1470-2045 (08) 70153-0.

11. Mourtzakis M, Prado CM, Lieffers JR et al. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab 2008; 33 (5): 997–1006. doi: 10.1139/H08-075.

12. Heymsfield SB, Smith R, Aulet M et al. Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am J Clin Nutr 1990; 52 (2): 214–218. doi: 10.1093/ajcn/52.2.214.

13. Cruz-Jentoft AJ, Bahat G, Bauer J et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48 (1): 16–31. doi: 10.1093/ageing/afy169.

14. van Vugt JL, Levolger S, Gharbharan A et al. A comparative study of software programmes for cross-sectional skeletal muscle and adipose tissue measurements on abdominal computed tomography scans of rectal cancer patients. J Cachexia Sarcopenia Muscle 2017; 8 (2): 285–297. doi: 10.1002/jcsm.12158.

15. Fearon K, Strasser F, Anker SD et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011; 12 (5): 489–495. doi: 10.1016/S1470-2045 (10) 70218-7.

16. da Cunha LP, Silveira MN, Mendes MC et al. Sarcopenia as an independent prognostic factor in patients with metastatic colorectal cancer: a retrospective evaluation. Clin Nutr ESPEN 2019; 32: 107–112. doi: 10.1016/ j.clnesp.2019.04.004.

17. Kurk S, Peeters P, Stellato R et al. Skeletal muscle mass loss and dose-limiting toxicities in metastatic colorectal cancer patients. J Cachexia Sarcopenia Muscle 2019; 10 (4): 803–813. doi: 10.1002/jcsm.12436.

18. Sasaki S, Oki E, Saeki H et al. Skeletal muscle loss during systemic chemotherapy for colorectal cancer indicates treatment response: a pooled analysis of a multicenter clinical trial (KSCC 1605-A). Int J Clin Oncol 2019; 20 (10): 1204–1213. doi: 10.1007/s10147-019-01 460-8.

19. Huemer F, Schlintl V, Hecht S et al. Regorafenib is associated with increased skeletal muscle loss compared to TAS-102 in metastatic colorectal cancer. Clin Colorectal Cancer 2019; 18 (2): 159–166. doi: 10.1016/j.clcc.2019.04. 003.

20. Jung YS, Kim NH, Ryu S et al. Association between low relative muscle mass and the risk of colorectal neoplasms. J Clin Gastroenterol 2017; 51 (10): 83–89. doi: 10.1097/MCG.0000000000000724.

21. Park YS, Kim JW, Kim BG et al. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia. Int J Colorectal Dis 2017; 32 (4): 557–565. doi: 10.1007/s00384-016-2738-8.

22. Hong JT, Kim TJ, Pyo JH et al. Impact of sarcopenia on the risk of advanced colorectal neoplasia. J Gastroenterol Hepatol 2019; 34 (1): 162–168. doi: 10.1111/jgh.14309.

23. Martin L, Hopkins J, Malietzis G et al. Assessment of computed tomography (CT) -defined muscle and adipose tissue features in relation to short-term outcomes after elective surgery for colorectal cancer: a multicenter approach. Ann Surg Oncol 2018; 25 (9): 2669–2680. doi: 10.1245/s10434-018-6652-x.

24. van Vugt JL, Braam HJ, van Oudheusden TR et al. Skeletal muscle depletion is associated with severe postoperative complications in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol 2015; 22 (11): 3625–3631. doi: 10.1245/s10434-015-4429-z.

25. Hopkins JJ, Reif R, Bigam D et al. Change in skeletal muscle following resection of stage I-III colorectal cancer is predictive of poor survival: a cohort study. World J Surg 2019; 43 (10): 2518–2526. doi: 10.1007/s00268-019-05054-3.

26. Charette N, Vandeputte C, Ameye L et al. Prognostic value of adipose tissue and muscle mass in advanced colorectal cancer: a post hoc analysis of two non-randomized phase II trials. BMC Cancer 2019; 19 (1): 134. doi: 10.1186/s12885-019-5319-8.

27. Park SE, Hwang IG, Choi CH et al. Sarcopenia is poor prognostic factor in older patients with locally advanced rectal cancer who received preoperative or postoperative chemoradiotherapy. Medicine (Baltimore) 2018; 97 (48): e13363. doi: 10.1097/MD.0000000000013363.

28. Takeda Y, Akiyoshi T, Matsueda K et al. Skeletal muscle loss is an independent negative prognostic factor in patients with advanced lower rectal cancer treated with neoadjuvant chemoradiotherapy. PLoS One 2018; 13 (4): e0195406. doi: 10.1371/journal.pone.0195406.

29. Vashi PG, Gorsuch K, Wan L et al. Sarcopenia supersedes subjective global assessment as a predictor of survival in colorectal cancer. PLoS One 2019; 14 (6): e0218761. doi: 10.1371/journal.pone.0218761.

30. Prado CM, Lieffers JR, Bowthorpe L et al. Sarcopenia and physical function in overweight patients with advanced cancer. Can J Diet Pract Res 2013; 74 (2): 69–74. doi: 10.3148/74.2.2013.69.

31. Barret M, Antoun S, Dalban C et al. Sarcopenia is linked to treatment toxicity in patients with metastatic colorectal cancer. Nutr Cancer 2014; 66 (4): 583–589. doi: 10.1080/01635581.2014.894103.

32. Derksen JW, Kurk SA, Oskam MJ et al. Factors contributing to cancer-related muscle wasting during first-line systemic treatment for metastatic colorectal cancer. JNCI Cancer Spectr 2019; 3 (2): pkz014. doi: 10.1093/jncics/pkz016.

33. Chemama S, Bayar MA, Lanoy E et al. Sarcopenia is associated with chemotherapy toxicity in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer. Ann Surg Oncol 2016; 23 (12): 3891–3898. doi: 10.1245/s10434-016-5360-7.

34. Kurk SA, Peeters PH, Dorresteijn B et al. Impact of different palliative systemic treatments on skeletal muscle mass in metastatic colorectal cancer patients. J Cachexia Sarcopenia Muscle 2018; 9 (5): 909–919. doi: 10.1002/jcsm.12337.

35. Gokyer A, Kucukarda A, Kostek O et al. Relation between sarcopenia and dose-limiting toxicity in patients with metastatic colorectal cancer who received regorafenib. Clin Transl Oncol 2019; 21 (11): 1518–1523. doi: 10.1007/s12094-019-02080-4.

36. Antoun S, Baracos VE, Birdsell L et al. Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann Oncol 2010; 21 (8): 1594–1598. doi: 10.1093/annonc/mdp605.

37. Mir O, Coriat R, Blanchet B et al. Sarcopenia predicts early dose-limiting toxicities and pharmacokinetics of sorafenib in patients with hepatocellular carcinoma. PLoS One 2012; 7 (5): e37563. doi: 10.1371/journal.pone.0037563.

38. Huillard O, Mir O, Peyromaure M et al. Sarcopenia and body mass index predict sunitinib-induced early dose-limiting toxicities in renal cancer patients. Br J Cancer 2013; 108 (5): 1034–1041. doi: 10.1038/bjc.2013.58.

39. Williams GR, Deal AM, Shachar SS et al. The impact of skeletal muscle on the pharmacokinetics and toxicity of 5-fluorouracil in colorectal cancer. Cancer Chemother Pharmacol 2018; 81 (2): 413–417. doi: 10.1007/s00280-017-3487-2.

40. Miyamoto Y, Baba Y, Sakamoto Y et al. Negative impact of skeletal muscle loss after systemic chemotherapy in patients with unresectable colorectal cancer. PLoS One 2015; 10 (6): e0129742. doi: 10.1371/journal.pone.0129742.

41. Kroenke CH, Prado CM, Meyerhardt JA et al. Muscle radiodensity and mortality in patients with colorectal cancer. Cancer 2018; 124 (14): 3008–3015. doi: 10.1002/cncr.31405.