Evidence map›Paper›PMID 41808702›Full record

ArticleTranslational lung cancer research2026

Association of CT-assessed sarcopenia and the development of immune-related adverse events and overall survival: a multistate survival analysis.

Erick Suazo-Zepeda, Marjolein A Heuvelmans, Douwe Postmus, T Jeroen N Hiltermann, Alain R Viddeleer, Geertruida H de Bock

Abstract read
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Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Erick Suazo-ZepedaDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0003-1518-7405
Marjolein A HeuvelmansDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0002-5712-4085
Douwe PostmusDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0002-9458-7038
T Jeroen N HiltermannDepartment of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0002-0665-2160
Alain R ViddeleerDepartment of Radiology, Medical Imaging Centre, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0002-3288-140X
Geertruida H de BockDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0003-3104-4471

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune checkpoint inhibitors (ICIs) have improved survival in non-small cell lung cancer (NSCLC), yet identifying who benefits from treatment remains difficult. Low skeletal muscle mass (SMM) is associated with poor cancer outcomes. We aim to examine the relationship between computed tomography (CT)-assessed sarcopenia and patient trajectories [death, immune-related adverse events (irAEs) and death after irAEs] following ICI initiation. Methods: We conducted a retrospective cohort study of NSCLC patients treated with ICIs at the University Medical Center Groningen [2015-2021] with baseline low-dose computed tomography (LDCT) scans. Sarcopenia was defined using sex-specific SMM thresholds. Multi-state time-to-event models estimated transition probabilities between ICI initiation and three outcomes: direct mortality (without irAEs), development of irAEs, and mortality after irAEs. Models were adjusted for age, sex, performance status, cancer stage, treatment line, body mass index (BMI), and combination therapy. Separate models were built for severe and any-grade irAEs. Results: Among 363 patients (96-month follow-up), 301 (82.9%) died and 166 (45.7%) developed irAEs, including 76 (20.9%) with severe irAEs. In the severe irAE model, sarcopenia was not associated with developing severe irAEs [hazard ratio (HR) =0.81, 95% confidence interval (CI): 0.42-1.58] or with mortality without severe irAEs (HR =1.19, 95% CI: 0.82-1.74). However, sarcopenia was associated with reduced mortality after severe irAEs (HR =0.39, 95% CI: 0.23-0.65). In the any-grade irAEs model, sarcopenic patients were less likely to develop irAEs (HR =0.63, 95% CI: 0.42-0.93). Sarcopenia was not linked to mortality without irAEs (HR =1.08, 95% CI: 0.70-1.67) or after any-grade irAEs (HR =0.81, 95% CI: 0.52-1.26). Conclusions: In this NSCLC cohort, CT-assessed sarcopenia was not associated with direct mortality without irAEs but was linked to a lower likelihood of developing irAEs and reduced mortality after severe irAEs. These findings suggest that body composition may have prognostic value and influence responses to immunotherapy.

Indexed as

drug-related side effects and adverse reactionsimmune checkpoint inhibitors (ICIs)immune-related adverse events (irAEs)Lung cancersarcopenia

Identifiers

PMID41808702
PMCPMC12969184

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.