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Abstract: TH-PO0181

Assessing the Effects of Immune Checkpoint Inhibitors and Pretreatment Kidney Function on Muscle Mass and Density

Session Information

Category: Onconephrology

  • 1700 Onconephrology

Authors

  • Ziolkowski, Susan, Stanford University, Stanford, California, United States
  • Matheson, Bryn E., University of Calgary, Calgary, Alberta, Canada
  • Walle, Matthias, University of Calgary, Calgary, Alberta, Canada
  • Fettahoglu, Ates, Stanford University, Stanford, California, United States
  • Gill, Jasmine, University of Calgary, Calgary, Alberta, Canada
  • Boyd, Steven, University of Calgary, Calgary, Alberta, Canada
  • Ye, Carrie, University of Calgary, Calgary, Alberta, Canada
Background

The association between skeletal muscle wasting and immune checkpoint inhibitor (ICI) use is unknown. Chronic kidney disease (CKD) is associated with sarcopenia. The relationship between pre-treatment kidney function on change in muscle mass and density while on immunotherapy is unknown.

Methods

Single center retrospective cohort study of patients with melanoma with both a baseline CT or PET-CT scan and a follow-up scan within one year (± three months). ICI users were defined as patients with stage 3 melanoma who received at least 6 months of ICI therapy. The control group, referred to as non-ICI users, consisted of patients with stage 2 melanoma who had a baseline CT or PET-CT but did not receive any ICI therapy or chemotherapy prior to their follow-up scan. Paired t tests were used to examine the change in psoas muscle cross sectional area (CSA, cm2) and psoas muscle density [PMD, Hounsfield Units (HU)] at L3 between baseline and follow-up. Independent t tests were used to determine whether there were differences in the mean change from baseline to follow-up between the non-ICI users and the ICI users. Pearson correlation was used to assess the relationship between baseline estimated glomerular filtration rate (eGFR, ml/min/1.73m2) and baseline muscle measurements.

Results

The mean age ± SD of patients in the non-ICI group was of 66.4 ± 12.8 years. The mean age in the ICI group was 58.4 ± 15.4 years. 76.19% of the non-ICI users were male compared to 56.25% in the ICI users. Baseline eGFR for non-ICI users was 73 ± 18 and 85 ± 20 ml/min/1.73m2 for ICI users. Baseline eGFR did not correlate with baseline CSA or PMD. The mean decline in CSA over 1 year in ICI users was -3.14 ± 16.02 and -3.11 ± 7.39 in non-ICI users. The mean decline in PMD was -3.75 ± 11.33 HU in ICI users and -0.31 ± 8.67 HU in non-ICI users. Compared to baseline values, both ICI and non-ICI users had significant difference in CSA and PMD on follow up scans. The difference in CSA and PMD were not significantly different between groups.

Conclusion

Over 1-year, skeletal muscle area and density declines in both ICI users and non-ICI users. This work will inform linear regression models accounting for co-variates to further assess our findings and whether baseline eGFR modifies these associations.

Digital Object Identifier (DOI)