Body Composition Measures as Determinants of Alpelisib-Related Toxicity
TAKE-HOME MESSAGE
- This retrospective study analyzed data from 38 patients with metastatic breast cancer who received alpelisib therapy, evaluating treatment-related toxicity and efficacy outcomes according to body composition measures, such as sarcopenia. Half of the patients had sarcopenia, regardless of whether they were classified as normal weight or obese. A lower skeletal muscle density was associated with hyperglycemia, and a lower visceral adipose tissue measurement was associated with rash.
- Body composition measures, derived from abdominal CT images, may potentially help clinicians predict patients who will experience certain types of toxicity with alpelisib therapy. Larger studies are warranted.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Body composition has emerged as an important prognostic factor in patients treated with cancer. Severe depletion of skeletal muscle, sarcopenia, has been associated with poor performance status and worse oncological outcomes. We studied patients with metastatic breast cancer receiving alpelisib, to determine if sarcopenia and additional body composition measures accounting for muscle and adiposity are associated with toxicity.
METHODS
A retrospective observational analysis was conducted, including 38 women with metastatic breast cancer and a PIK3CA mutation, treated with alpelisib as advanced line of therapy. Sarcopenia was determined by measuring skeletal muscle cross-sectional area at the third lumbar vertebra using computerized tomography. Various body composition metrics were assessed along with drug toxicity, dose reductions, treatment discontinuation, hospitalizations, time to treatment failure and overall survival.
RESULTS
Sarcopenia was observed in half of the patients (n = 19, 50%), spanning normal weight, overweight, and obese individuals. Among the body composition measures, lower skeletal muscle density (SMD) was associated with an increased risk of treatment-related hyperglycaemia (P = 0.03). Additionally, lower visceral adipose tissue (VAT) was associated with alpelisib-induced rash (P = 0.04) and hospitalizations (P = 0.04). Notably, alpelisib treatment discontinuation was not impacted by alpelisib toxicity.
CONCLUSION
Body composition measures, specifically SMD and VAT may provide an opportunity to identify patients at higher risk for severe alpelisib related hyperglycemia, and cutaneous toxicity. These findings suggest the potential use of body composition assessment to caution toxicity risk, allowing for personalized therapeutic observation and intervention.
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Additional Info
Body composition measures as a determinant of Alpelisib related toxicity
Breast Cancer Res Treat 2024 Apr 07;[EPub Ahead of Print], E Shachar, A Raphael, U Katz, R Kessner, SS ShacharFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.