High fat mass associates with occurrence of targeted therapy-induced left ventricular ejection fraction reduction in patients with renal cell carcinoma.
BACKGROUND & AIMS
Recent research suggests that variations of skeletal muscle (SM) and fat predict the severity of chemotherapy-induced toxicities in patients with renal cell carcinoma (RCC). Cardio-toxicity has not been evaluated in this context.


METHODS
In this study we considered 47 RCC patients who participated in randomized clinical trials of sorafenib or sunitinib (i.e., targeted therapy). To capture cardio-toxicity, multi gated acquisition (MUGA) scan-defined left ventricular ejection fraction (LVEF) tests (at least 3 tests over 1 year of treatment) were abstracted. Computed tomography (CT) cross-sectional images were analyzed before start of targeted therapy and at 1 year to define SM and fat at baseline and changes over time concurrent with MUGA-defined LVEF measurement.


RESULTS
MUGA-defined cardio-toxicity (usually fall in LVEF >10% to an absolute LVEF<55%) occurred in 8/47 (17%) patients over 1 year of targeted therapy (all were male). Percentage of patients with high fat mass (baseline CT-defined total adipose tissue/indexed by height2 greater than the gender-specific median value) was higher among patients with cardio-toxicity versus patients without cardio-toxicity [7 (87.5%) versus 16 (41.0%); p = 0.02]. The percentage of SM loss in patients with cardio-toxicity was higher than the patients without cardio-toxicity [median of loss (%) -7 versus 0 respectively; p = 0.04].


CONCLUSION
Cardio-toxicity in RCC patients might be associated with high fat mass. This finding is distinct from prior observations that low body weight and sarcopenia associated with non-cardiac toxicities of targeted therapies. Concurrence of SM loss over time and development of cardio-toxicity is reported for the first time.
['Kazemi-Bajestani|Seyyed Mohammad Reza|SMR|', 'Becher|Harald|H|', 'Venner|Peter|P|', 'North|Scott|S|', 'Baracos|Vickie|V|']
D000273:Adipose Tissue D000970:Antineoplastic Agents D001823:Body Composition D002292:Carcinoma, Renal Cell D016503:Drug Delivery Systems D005260:Female D006801:Humans D007680:Kidney Neoplasms D008297:Male D008875:Middle Aged D000077157:Sorafenib D000077210:Sunitinib D014057:Tomography, X-Ray Computed D016277:Ventricular Function, Left
Fat Skeletal muscle Cardio-toxicity Body composition