Cancer treatment and research communications · 2026
Baseline visceral adipose tissue radiodensity as biomarker of survival in advanced NSCLC treated with first-line single-agent immunotherapy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Piazza Francesca, Monti Alessandro, Riva Matteo, Gatelli Fabio, Carola Giorgia, Baggi Alice, Ammoni Luca, Rondi Paolo, Signoroni Alberto, Farina Davide, Berruti Alfredo, Ravanelli Marco, Grisanti Salvatore
Аннотация
INTRODUCTION: Body composition (BC) has emerged as a potential prognostic biomarker in oncology. In advanced non-small cell lung cancer (NSCLC), the impact of adipose tissue quality on outcomes with first-line immune checkpoint inhibitors (ICIs) remains unclear. We investigated the association between CT-derived BC parameters and survival in patients treated with single-agent immunotherapy.
METHODS: We conducted a retrospective single-center cohort study including 140 patients with advanced NSCLC (PD-L1 ≥50%) treated with first-line single-agent ICIs. Baseline contrast-enhanced CT scans were analyzed using automated volumetric segmentation (L2-L4) to quantify visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle (SM) radiodensity. Associations with overall survival (OS) and progression-free survival (PFS) were evaluated using multivariable Cox models adjusted for age, sex, and ECOG PS, histology, disease stage, smoking history, PD-L1 expression. Sensitivity analysis was performed using L3 single-slice segmentation.
RESULTS: In multivariable Cox models adjusted for clinical covariates, higher VAT radiodensity was independently associated with worse OS (HR 1.02 per 1-HU increase; 95% CI 1.01-1.03; p<0.001) and PFS (HR 1.02 per 1-HU increase; 95% CI 1.01-1.03; p<0.001). SAT radiodensity showed weaker associations with outcomes, whereas SM radiodensity was not prognostic. The addition of VAT radiodensity improved discrimination compared with clinical variables alone (ΔC-index +0.044 for OS and +0.037 for PFS). Findings were consistent in pembrolizumab-only and L3 single-slice analyses.
CONCLUSION: Baseline VAT radiodensity emerged as an independent prognostic biomarker in advanced NSCLC treated with first-line immunotherapy. Adipose tissue quality may represent a relevant host-related factor associated with ICI outcomes.
METHODS: We conducted a retrospective single-center cohort study including 140 patients with advanced NSCLC (PD-L1 ≥50%) treated with first-line single-agent ICIs. Baseline contrast-enhanced CT scans were analyzed using automated volumetric segmentation (L2-L4) to quantify visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle (SM) radiodensity. Associations with overall survival (OS) and progression-free survival (PFS) were evaluated using multivariable Cox models adjusted for age, sex, and ECOG PS, histology, disease stage, smoking history, PD-L1 expression. Sensitivity analysis was performed using L3 single-slice segmentation.
RESULTS: In multivariable Cox models adjusted for clinical covariates, higher VAT radiodensity was independently associated with worse OS (HR 1.02 per 1-HU increase; 95% CI 1.01-1.03; p<0.001) and PFS (HR 1.02 per 1-HU increase; 95% CI 1.01-1.03; p<0.001). SAT radiodensity showed weaker associations with outcomes, whereas SM radiodensity was not prognostic. The addition of VAT radiodensity improved discrimination compared with clinical variables alone (ΔC-index +0.044 for OS and +0.037 for PFS). Findings were consistent in pembrolizumab-only and L3 single-slice analyses.
CONCLUSION: Baseline VAT radiodensity emerged as an independent prognostic biomarker in advanced NSCLC treated with first-line immunotherapy. Adipose tissue quality may represent a relevant host-related factor associated with ICI outcomes.