Discussion
muscle gain, cancers, decreased skeletal muscle mass, weight gain, Sarcopenia, weight loss
CANCERS, SARCOPENIA
The results of these analyses in TAGS indicated that ≥ 3% BWL at the end of treatment cycle 1 was associated with unfavorable survival outcomes in patients with mGC/GEJC treated in the third- or later-line setting. The negative association of early BWL with OS was observed in both FTD/TPI and placebo treatment groups. Univariate analysis showed that BWL was prognostic for OS, and multivariate analyses confirmed BWL to be both a prognostic (While mGC is associated with a poor prognosis [Given the importance of keeping patients well across lines of therapy for mGC, safety and tolerability are relevant considerations for individualized patient care. Although correlations of OS and PFS with early BWL have been previously studied [These results also imply that FTD/TPI treatment may help mitigate both weight loss and the negative effects of weight loss. Patients receiving FTD/TPI were less likely to experience weight loss during the first treatment cycle than those receiving placebo. Among patients who experienced ≥ 3% BWL, those receiving FTD/TPI stayed longer on treatment than those receiving placebo (11.7 vs 4.9 weeks). Finally, the treatment effect size was more pronounced in those with ≥ 3% BWL (OS HR, 0.40 for FTD/TPI vs placebo in the ≥ 3% BWL subgroup compared with an OS HR of 0.69 for FTD/TPI vs placebo among all patients). Although these results must be interpreted with caution, given the imbalances between the treatment arms, they nevertheless indicate the potential benefits of FTD/TPI treatment even in patients at risk for weight loss.The detection of early BWL, even as low as 3%, could also have implications for prognosis. Because the weight cutoff is low, it may present an opportunity for intervention to regain BWL in subsequent cycles, with the potential to improve outcomes in these patients. Unfortunately, analyses of weight gain/loss in subsequent cycles could not be carried out for TAGS because of high treatment discontinuation rates following cycle 2. However, such analyses are relevant for the future to examine whether interventions for early BWL can impact survival in patients with mGC/GEJC.It may be pertinent to examine if in converse, patients with weight gain experience any additional benefit from treatment. However, we were limited by extremely small numbers of patients (< 6% of 451 patients) to analyze this further in TAGS. A consideration for evaluating the impact of weight gain is the importance of muscle gain and muscle preservation. Sarcopenia, or decreased skeletal muscle mass, has been associated with poor survival in patients with GC and other cancers [