+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Nutritional Status, Body Surface, and Low Lean Body Mass/Body Mass Index Are Related to Dose Reduction and Severe Gastrointestinal Toxicity Induced by Afatinib in Patients With Non-Small Cell Lung Cancer



Nutritional Status, Body Surface, and Low Lean Body Mass/Body Mass Index Are Related to Dose Reduction and Severe Gastrointestinal Toxicity Induced by Afatinib in Patients With Non-Small Cell Lung Cancer



Oncologist 20(8): 967-974



The main reason for dose reduction of afatinib is gastrointestinal toxicity (GT). In a phase II study, we analyzed anthropometrical, nutritional, and biochemical factors associated with GT induced by afatinib. Patients diagnosed with non-small cell lung cancer who progressed to prior chemotherapy received 40 mg of afatinib. Malnutrition was determined by Subjective Global Assessment, and lean body mass (LBM) was determined by computed tomography scan analysis using a pre-established Hounsfield unit threshold. Toxicity was obtained during four cycles by Common Terminology Criteria for Adverse Events. Eighty-four patients were enrolled. Afatinib was administered as the second, third, and fourth line of treatment in 54.8%, 38.1%, and 7.12% of patients, respectively. Severe diarrhea, mucositis, and overall severe GT were present in 38.9%, 28.8%, and 57.5%, respectively. Of the patients, 50% developed dose-limiting toxicity (DLT). Patients with malnutrition have higher risk for severe GT. Patients with lower LBM and body mass index developed more DLT (71.4% vs. 18.8%). Malnutrition is associated with a higher risk of severe GT induced by afatinib. Determination of nutritional status and body composition are helpful in identifying patients at higher risk of severe GT and could allow initiating treatment with lower doses according to tolerance.

(PDF emailed within 0-6 h: $19.90)

Accession: 058441565

Download citation: RISBibTeXText

PMID: 26173839

DOI: 10.1634/theoncologist.2015-0058


Related references

Evaluation of gefitinib efficacy according to body mass index, body surface area, and body weight in patients with EGFR-mutated advanced non-small cell lung cancer. Cancer ChemoTherapy and Pharmacology 79(3): 497-505, 2017

Beyond Body Mass Index. Is the Body Cell Mass Index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?: Body Cell Mass Index links in elderly. Clinical Nutrition 37(3): 934-939, 2017

Reference Centiles for the Evaluation of Nutritional Status in Children using Body Fat Percentage, Fat Mass and Lean Body Mass Index. Journal of Clinical Densitometry 2019, 2019

Lean body mass determined by creatinine kinetics over dry body weight A simple index of nutritional status in hemodialysis patients. Journal of the American Society of Nephrology 9(PROGRAM AND ABSTR ISSUE): 207A, Sept, 1998

Evaluation of osimertinib efficacy according to body surface area and body mass index in patients with non-small cell lung cancer harboring an EGFR mutation: A prospective observational study. Thoracic Cancer 2019, 2019

Drug Dose Per Kilogram Lean Body Mass Predicts Hematologic Toxicity From Carboplatin-Doublet Chemotherapy in Advanced Non-Small-Cell Lung Cancer. Clinical Lung Cancer 18(2): E129-E136, 2016

Sources of variation in estimates of lean body mass by creatinine kinetics and by methods based on body water or body mass index in patients on continuous peritoneal dialysis. Journal of Renal Nutrition 20(2): 91-100, 2010

Body mass index (body mass.body height-2) as indicator of nutritional status in adults: review of the literature. Revista de Saude Publica 26(6): 431-436, 1992

Evaluating hemodialysis patient's nutritional status: Body Mass Index or Body Cell Mass Index?. Nephrology 2018, 2018

Body mass index: different nutritional status according to WHO, OPAS and Lipschitz classifications in gastrointestinal cancer patients. Arquivos de Gastroenterologia 49(2): 169-171, 2012

Association between asthenia and nutritional status, lean body mass, anemia, psychological status, and tumor mass in patients with advanced breast cancer. Journal of Pain and Symptom Management 4(2): 59-63, 1989

Contrast enhancement during hepatic computed tomography: effect of total body weight, height, body mass index, blood volume, lean body weight, and body surface area. Journal of Computer Assisted Tomography 37(2): 159-164, 2013

Impact of Body Mass Index (BMI) and Fat Mass Index (FMI) on Precision of DXA Body Composition Measurements of Lean Mass (LM), Fat Mass (FM) and Visceral Adipose Tissue (VAT). Journal of Clinical Densitometry 18(3): 430-431, 2015

James Lean Body Weight Formula Is Not Appropriate for Determining CT Contrast Media Dose in Patients with High Body Mass Index. Radiology 278(3): 956-957, 2016

Body mass index and nutritional status: the effect of adjusting body mass index for the relative sitting height on estimates of the prevalence of chronic energy deficiency, overweight and obesity. Asia Pacific Journal of Clinical Nutrition 4(1): 137-139, 1995