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Peer-reviewedCC BYCurrent oncology (Toronto, Ont.)

Skeletal Muscle Index and Baseline Biomarkers in Atezolizumab-Treated Extensive-Stage Small-Cell Lung Cancer: A Real-World Cohort Study.

  • Taliha Güçlü Kantar1
  • Tolga Doğan1
  • Burcu Yapar Taşköylü2
  • Atike Gökçen Demiray2
  • Arzu Yaren2
  • Tarık Şengöz3
  • Gamze Gököz Doğu2
  1. 1Department of Medical Oncology, Denizli State Hospital, Denizli 20070, Türkiye.
  2. 2Department of Medical Oncology, School of Medicine, Pamukkale University, Denizli 20070, Türkiye.
  3. 3Department of Nuclear Medicine, School of Medicine, Pamukkale University, Denizli 20070, Türkiye.
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Abstract

Body composition and routinely available blood biomarkers may help characterize prognosis in extensive-stage small-cell lung cancer (ES-SCLC). We retrospectively evaluated 81 patients who received first-line carboplatin, etoposide, and atezolizumab. Baseline L3 skeletal muscle index (SMI) was derived from [18F]FDG PET/CT and classified using the Martin criteria. Overall survival (OS) was assessed using Kaplan-Meier and Cox regression. Of 80 classifiable patients, 33 (41.3%) had low SMI. Median OS was 10.51 months (95% CI, 7.98-14.26) and was 8.48 versus 14.26 months in patients with low versus normal SMI (log-rank p = 0.050). In the primary multivariable model, low SMI was associated with higher mortality (HR, 2.03; 95% CI, 1.07-3.86; p = 0.030); lower albumin and higher lactate dehydrogenase were also associated with mortality. In exploratory analyses, the low-SMI association persisted after post hoc adjustment for bone metastasis (HR, 2.16; 95% CI, 1.05-4.42; p = 0.035), although diagnostics suggested time-varying effects. Continuous SMI and alternative thresholds were not associated with OS, and low SMI was not associated with progression-free survival. Martin-defined low SMI may complement routine biomarkers in prognostic assessment, but its cutoff- and time-dependent association requires cautious interpretation and external evaluation.

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Cite

BibTeXRIS
BibTeX
@article{kantar2026skeletal,
  title = {{Skeletal Muscle Index and Baseline Biomarkers in Atezolizumab-Treated Extensive-Stage Small-Cell Lung Cancer: A Real-World Cohort Study.}},
  author = {Taliha Güçlü Kantar and Tolga Doğan and Burcu Yapar Taşköylü and Atike Gökçen Demiray and Arzu Yaren and Tarık Şengöz and Gamze Gököz Doğu},
  journal = {Current oncology (Toronto, Ont.)},
  year = {2026},
  month = oct,
  doi = {10.3390/curroncol33100639},
  url = {https://europepmc.org/article/MED/42930206},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Skeletal Muscle Index and Baseline Biomarkers in Atezolizumab-Treated Extensive-Stage Small-Cell Lung Cancer: A Real-World Cohort Study.
AU  - Taliha Güçlü Kantar
AU  - Tolga Doğan
AU  - Burcu Yapar Taşköylü
AU  - Atike Gökçen Demiray
AU  - Arzu Yaren
AU  - Tarık Şengöz
AU  - Gamze Gököz Doğu
PY  - 2026
DA  - 2026/10/21
JO  - Current oncology (Toronto, Ont.)
DO  - 10.3390/curroncol33100639
UR  - https://europepmc.org/article/MED/42930206
AB  - Body composition and routinely available blood biomarkers may help characterize prognosis in extensive-stage small-cell lung cancer (ES-SCLC). We retrospectively evaluated 81 patients who received first-line carboplatin, etoposide, and atezolizumab. Baseline L3 skeletal muscle index (SMI) was derived from [18F]FDG PET/CT and classified using the Martin criteria. Overall survival (OS) was assessed using Kaplan-Meier and Cox regression. Of 80 classifiable patients, 33 (41.3%) had low SMI. Median OS was 10.51 months (95% CI, 7.98-14.26) and was 8.48 versus 14.26 months in patients with low versus normal SMI (log-rank p = 0.050). In the primary multivariable model, low SMI was associated with higher mortality (HR, 2.03; 95% CI, 1.07-3.86; p = 0.030); lower albumin and higher lactate dehydrogenase were also associated with mortality. In exploratory analyses, the low-SMI association persisted after post hoc adjustment for bone metastasis (HR, 2.16; 95% CI, 1.05-4.42; p = 0.035), although diagnostics suggested time-varying effects. Continuous SMI and alternative thresholds were not associated with OS, and low SMI was not associated with progression-free survival. Martin-defined low SMI may complement routine biomarkers in prognostic assessment, but its cutoff- and time-dependent association requires cautious interpretation and external evaluation.
SN  - 1198-0052
SN  - 1718-7729
ER  -