Abstract Background The association between skeletal muscle wasting and immune checkpoint inhibitor (ICI) use for cancer and whether pre-treatment kidney function modifies this relationship is unknown. Materials and Methods Single center retrospective cohort study of patients with non-metastatic melanoma treated with or without ICIs, with a pre-treatment CT or PET-CT scan and follow-up scan within one year (± three months). Paired t tests examined the change in abdominal skeletal muscle index (SMI, cm2/height in meters) and psoas muscle density (PMD, Hounsfield Units) at L3. Independent t tests compared differences in the mean change between the ICI and non-ICI groups. Multivariable linear regression models assessed whether the change in SMI and PMD was different between groups and whether baseline estimated glomerular filtration rate (eGFR, ml/min/1.73m2) modified this association. Results 36 patients treated with ICIs and 41 not treated with ICIs met inclusion criteria. The non-ICI group was older (mean age ± SD = 67.0 ± 12.9 years) and more commonly male (78%) compared to the ICI group (58.9 ± 14.9 years; 50% male). The mean change in SMI was not significantly different between groups (p = 0.38). The mean change in PMD in the ICI group was -5.93 (95% CI -9.58 to -2.28), which was significantly greater than the non-ICI group (-1.18, 95% CI -3.51 to 1.15), after adjusting for baseline variables (p = 0.002). Findings were not affected by baseline eGFR. Conclusion Patients treated with ICIs had a significantly higher decline in PMD as compared to patient s not treated with ICIs, which was not affected by baseline eGFR.
Ziolkowski et al. (Tue,) studied this question.