Abstract 7649: Inflammatory biomarkers by sarcopenia status in diverse individuals with lung cancer
Authors: Cecily A. Byrne, Giamila Fantuzzi, Vanessa M. Oddo, Sage Kim, Timothy J. Koh, Sandra L. Gomez
Journal: Cancer Research (2024)

Abstract Background: Sarcopenia and inflammation are independent prognostic indicators of poor survival in lung cancer. Systemic inflammation contributes to sarcopenia or low muscle mass through increased catabolism and decreased synthesis of muscle protein. In turn, sarcopenia leads to inflammation in the muscle and exacerbation of systemic inflammation. Specific Aim: The aim of this study was to determine the association between sarcopenia and systemic biomarkers of inflammation including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and albumin in diverse individuals with lung cancer and determine their use as prognostic indicators of sarcopenia. Methods: This retrospective cross-sectional study included 218 non-Hispanic Black (n=111) and White (n=107) individuals with lung cancer. Computed tomography scans were analyzed to calculate skeletal mass index (SMI) at the third lumbar vertebra. Sarcopenia was defined using published sex-specific criteria for SMI in healthy individuals then categorized into the binary variable of sarcopenia/no sarcopenia. NLR, PLR, and albumin were analyzed as both continuous and categorical variables, with NLR&amp;gt; 3, PLR &amp;gt;150, and albumin &amp;lt;3.5 defining moderate to high inflammation. T-tests, Mann Whitney U, Chi square, and adjusted Logistic Regression were used as appropriate. Results: Subjects presented with a mean age of 68.5 + 9.8 years, BMI of 26.3 + 5.9 kg/m2, 50.9% non-Hispanic Black, and 49.5% female with significantly higher prevalence of late-stage lung cancer (61.9% versus 38.1% early-stage, p&amp;lt;0.001) and no differences in age and BMI by race/ethnicity. Mean NLR (6.2 + 7.2), PLR (226.9 + 157.9), and albumin (3.2 + 0.6) indicated an inflammatory state in diverse individuals with lung cancer, with significantly higher NLR (8.5 + 9.7 versus 4.7 + 4.2, p&amp;lt;0.001) and PLR (268.9 + 204.5 versus 198.7 + 108.9, p&amp;lt;0.01) and significantly lower albumin (3.1 + 0.7 versus 3.4 + 0.5, p&amp;lt;0.01) in those with sarcopenia compared to those without sarcopenia. The odds of sarcopenia were 2.2 higher with NLR &amp;gt; 3 compared to NLR &amp;lt;3 (95% CI: 1.1, 4.4) and 2.5 higher with albumin &amp;lt;3.5 compared to albumin &amp;gt;3.5 (95% CI: 1.2, 5.3) after controlling for race/ethnicity, stage of cancer, age, and BMI. PLR &amp;gt; 150 was not a significant predictor of sarcopenia. Conclusion: Diverse individuals with sarcopenia of lung cancer present with higher inflammation compared to individuals with lung cancer but without sarcopenia as indicated by NLR, PLR, and albumin levels. Moderate to high levels of inflammation as indicated by high NLR and low albumin may help predict sarcopenia status in diverse individuals with lung cancer. Citation Format: Cecily A. Byrne, Giamila Fantuzzi, Vanessa M. Oddo, Sage Kim, Timothy J. Koh, Sandra L. Gomez. Inflammatory biomarkers by sarcopenia status in diverse individuals with lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7649.