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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1499650

Evaluation of patient immunocompetence for immune checkpoint inhibitor therapy using the psoas muscle index: a retrospective cohort study

Provisionally accepted
Toshiaki Tsurui Toshiaki Tsurui 1*Kazuyuki Hamada Kazuyuki Hamada 2Emiko Mura Emiko Mura 1Risako Suzuki Risako Suzuki 1Nana Iriguchi Nana Iriguchi 1Tomoyuki Ishiguro Tomoyuki Ishiguro 1Yuya Hirasawa Yuya Hirasawa 1Ryotaro Ohkuma Ryotaro Ohkuma 1Masahiro Shimokawa Masahiro Shimokawa 1Hirotsugu Ariizumi Hirotsugu Ariizumi 1Yutaro Kubota Yutaro Kubota 1Atsushi Horiike Atsushi Horiike 1Satoshi Wada Satoshi Wada 1Kiyoshi Yoshimura Kiyoshi Yoshimura 1Mayumi Tsuji Mayumi Tsuji 1Yuji Kiuchi Yuji Kiuchi 1Takuya Tsunoda Takuya Tsunoda 1
  • 1 Showa University, Shinagawa, Japan
  • 2 Fukushima Medical University, Fukushima, Fukushima, Japan

The final, formatted version of the article will be published soon.

    In patients with cancer, sarcopenia is an indicator of poor prognosis and is associated with an increased risk of chemotherapy-related adverse events. Skeletal muscle interacts with the immune system, and sarcopenia is associated with immune senescence. However, the association between sarcopenia and the response to immune checkpoint inhibitor (ICI) therapy remains unclear. Methods: This retrospective study included patients with advanced or recurrent non-small cell lung cancer treated with nivolumab or pembrolizumab monotherapy. The association between the psoas muscle index (PMI) and both clinical response and immune-related adverse events (irAEs) was assessed using logistic regression. The PMI was calculated as the cross-sectional area of the psoas muscle divided by the square of the height based on computed tomography scans performed before the initial administration of ICI therapy. Results: A total of 67 patients were included in the analysis. Logistic regression analysis showed that PMI was associated with the overall response (odds ratio [OR]: 1.52; 95% confidence interval [CI]: 1.04-2.22; p = 0.030) and the risk of severe irAEs (OR: 1.72; 95% CI: 1.05-2.80; p = 0.031). Conclusion: These findings suggest that PMI is both an indicator of prognosis and a surrogate marker of immunocompetence in predicting the clinical response to ICI therapy.

    Keywords: immune checkpoint inhibitors, Immunotherapy, Lung Neoplasms, Sarcopenia, Retrospective study

    Received: 23 Sep 2024; Accepted: 16 Jan 2025.

    Copyright: © 2025 Tsurui, Hamada, Mura, Suzuki, Iriguchi, Ishiguro, Hirasawa, Ohkuma, Shimokawa, Ariizumi, Kubota, Horiike, Wada, Yoshimura, Tsuji, Kiuchi and Tsunoda. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Toshiaki Tsurui, Showa University, Shinagawa, Japan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.