ArticleFrontiers in oncology2025
Low fT3/fT4 ratio as a proxy for muscle wasting in patients with advanced non-small cell lung cancer treated with pembrolizumab.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Novel nutraceutical combination restores hepatic deiodinase expression and protein levels under inflammatory conditions: evidence from anFrontiers in nutrition · 2026Article
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20 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Loss of skeletal muscle mass may serve as a valuable indicator of treatment efficacy and survival in individuals with lung cancer undergoing immunotherapy. This investigation sought to pinpoint accessible markers that could reflect the presence of muscle degradation. Methods: A retrospective study was conducted on patients with advanced non-small cell lung cancer (NSCLC) who received first-line pembrolizumab therapy from June 2018 to September 2021. Data collected included computed tomography (CT)-based body composition, clinical and radiological characteristics, along with thyroid function tests (free triiodothyronine [fT3] and free thyroxine [fT4]). Predictive factors were evaluated using multivariate logistic regression models. Results: Among 31 patients, muscle wasting was observed in 58.1%. Performance Status (PS) emerged as a strong predictor (p=0.005), and a significant link was also found between muscle depletion and fT3/fT4 ratio (p=0.0296). After adjusting for PS, the association with the hormone ratio remained suggestive though not statistically definitive (p=0.091). ROC curve analysis identified a threshold value of 2.84 for fT3/fT4 ratio, which best differentiated patients at higher versus lower risk of muscle loss. Notably, 77.3% of individuals with muscle wasting had a ratio below this cut-off, compared to only 14.3% of those with higher ratios (p=0.006). While no significant correlation was found between the hormone ratio and progression-free survival (PFS), a meaningful association with overall survival (OS) was observed (p=0.032). Conclusions: Despite the limited sample size, fT3/fT4 ratio appears to be a promising and accessible biomarker for identifying muscle wasting, which may be linked to diminished treatment response and shorter survival in patients with NSCLC.
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