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Body composition and lung cancer-associated cachexia in TRACERx

journal contribution
posted on 2024-01-11, 12:11 authored by O Al-Sawaf, J Weiss, M Skrzypski, JM Lam, T Karasaki, F Zambrana, AC Kidd, AM Frankell, TBK Watkins, C Martínez-Ruiz, C Puttick, JRM Black, A Huebner, MA Bakir, M Sokač, S Collins, S Veeriah, N Magno, C Naceur-Lombardelli, P Prymas, A Toncheva, S Ward, N Jayanth, R Salgado, CP Bridge, DC Christiani, RH Mak, C Bay, M Rosenthal, N Sattar, P Welsh, Y Liu, N Perrimon, K Popuri, MF Beg, N McGranahan, A Hackshaw, DM Breen, S O’Rahilly, NJ Birkbak, HJWL Aerts, TRACERx consortium, DA Fennell, JA Shaw
Cancer-associated cachexia (CAC) is a major contributor to morbidity and mortality in individuals with non-small cell lung cancer. Key features of CAC include alterations in body composition and body weight. Here, we explore the association between body composition and body weight with survival and delineate potential biological processes and mediators that contribute to the development of CAC. Computed tomography-based body composition analysis of 651 individuals in the TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy (Rx)) study suggested that individuals in the bottom 20th percentile of the distribution of skeletal muscle or adipose tissue area at the time of lung cancer diagnosis, had significantly shorter lung cancer-specific survival and overall survival. This finding was validated in 420 individuals in the independent Boston Lung Cancer Study. Individuals classified as having developed CAC according to one or more features at relapse encompassing loss of adipose or muscle tissue, or body mass index-adjusted weight loss were found to have distinct tumor genomic and transcriptomic profiles compared with individuals who did not develop such features. Primary non-small cell lung cancers from individuals who developed CAC were characterized by enrichment of inflammatory signaling and epithelial–mesenchymal transitional pathways, and differentially expressed genes upregulated in these tumors included cancer-testis antigen MAGEA6 and matrix metalloproteinases, such as ADAMTS3. In an exploratory proteomic analysis of circulating putative mediators of cachexia performed in a subset of 110 individuals from TRACERx, a significant association between circulating GDF15 and loss of body weight, skeletal muscle and adipose tissue was identified at relapse, supporting the potential therapeutic relevance of targeting GDF15 in the management of CAC.

History

Author affiliation

Department of Genetics and Genome Biology, University of Leicester

Version

  • VoR (Version of Record)

Published in

Nature Medicine

Volume

29

Issue

4

Pagination

846 - 858

Publisher

Springer Science and Business Media LLC

issn

1078-8956

eissn

1546-170X

Copyright date

2023

Spatial coverage

United States

Language

eng