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- Title
Undiagnosed cardiac deficits in non-small cell carcinoma patients in the candidate population for anti-cachexia clinical trials.
- Authors
Kazemi-Bajestani, Seyyed Mohammad Reza; Becher, Harald; Butts, Charles; Basappa, Naveen S.; Smylie, Michael; Joy, Anil Abraham; Sangha, Randeep; Gallivan, Andrea; Chu, Quincy; Baracos, Vickie E.
- Abstract
<bold>Purpose: </bold>Currently, there is no approved therapy for cancer cachexia. According to European and American regulatory agencies, physical function improvements would be approvable co-primary endpoints of new anti-cachexia medications. As physical functioning is in part dependent on cardiac functioning, we aimed to explore the cardiac status of a group of patients meeting current criteria for inclusion in cachexia clinical trials.<bold>Methods: </bold>Seventy treatment-naive patients with metastatic NSCLC [36 (51.4%) male; 96% ECOG 0-1; eligible for carboplatin-based therapy and meeting eligibility criteria for cachexia clinical trials] were recruited before the start of first-line carboplatin-based chemotherapy. Patients were evaluated by echocardiography, electrocardiography, and scales for fatigue and dyspnea. Computed tomography cross-sectional images were utilized for body composition analysis.<bold>Results: </bold>In 9/70 patients (12.8%), echocardiography allowed discovery of clinically relevant cardiac disorders [seven patients with left ventricular ejection fraction (LVEF) 32%-47%; one patient with severe right ventricular dilation and severe pulmonary hypertension and one patient with severe pericardial effusion warranted hospitalization and drainage]. Another 10/70 (14.3%) patients had diastolic dysfunction with preserved LVEF. The cardiac conditions were associated with aggravated fatigue (p < 0.05), dyspnea (p < 0.05), and anemia (p = 0.06). Five out of seven patients with LVEF < 50% were sarcopenic and one was borderline sarcopenic.<bold>Conclusion: </bold>Baseline cardiac status of the metastatic NSCLC patients adds potential heterogeneity for anti-cachexia clinical trials. Detailed cardiac screening data might be useful for inclusion/exclusion criteria, randomization, and post hoc analysis.
- Subjects
CLINICAL trials; HEART disease diagnosis; HEART disease epidemiology; LUNG cancer complications; LUNG cancer treatment; TREATMENT of lung tumors; HEART disease complications; MEDICAL error statistics; CACHEXIA; DIAGNOSIS; HEART diseases; LEFT heart ventricle; HEART physiology; LUNG cancer; LUNG tumors; CROSS-sectional method; PATIENT selection; DISEASE complications
- Publication
Supportive Care in Cancer, 2019, Vol 27, Issue 4, p1551
- ISSN
0941-4355
- Publication type
journal article
- DOI
10.1007/s00520-018-4561-y