The Effects Of Neoadjuvant Axitinib On Anthropometric Parameters In Patients With Locally Advanced Non-Metastatic Renal Cell Carcinoma

To examine the effect that neoadjuvant axitinib for the treatment of localized renal cell carcinoma has on body compartment composition.

The study was based on a single-institution, single-arm clinical trial that enrolled 24 patients with locally advanced non-metastatic biopsy-proven clear cell renal cell carcinoma. Patients received axitinib orally for up to 12 weeks. Computed tomography scans were completed before the start of treatment, after 7 weeks of treatment and at the completion of 12 weeks of treatment. Patients underwent nephrectomy after axitinib treatment. The primary outcome of the current study was change in body compartment composition. Secondary outcomes included development of new-onset sarcopenia and changes in body weight.

A total of 23 patients had a complete set of imaging for evaluation, of which 19 (82.6%) lost weight. Median weight loss was 4.5 kg (p < 0.001). Seven patients (30.4%) had sarcopenia prior to treatment, with an additional 5 (21.7%) developing sarcopenia during treatment. Median decrease in skeletal muscle was 2.9 cm(2)/m(2) (p < 0.001), visceral adipose tissue was 4.9 cm(2)/m(2) (p = 0.132), and subcutaneous adipose tissue was 1.0 cm(2)/m(2) (p = 0.043). Ten(62.5%) of the 16 patients without baseline sarcopenia achieved a partial response, while only one(14.3%) of the 7 patients with baseline pretreatment sarcopenia achieved a partial response (p=0.069).

Neoadjuvant axitinib resulted in a decrease in skeletal muscle and subcutaneous adipose tissue, as well as weight loss. Patients with baseline sarcopenia tended to have a lower response rate to neoadjuvant axitinib.

Urology. 2017 Jul 10 [Epub ahead of print]

Lisly Chéry, Leonardo D Borregales, Bryan Fellman, Diana L Urbauer, Naveen Garg, Nathan Parker, Matthew H G Katz, Christopher G Wood, Jose A Karam

Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: .

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