Simple physical tests like standing and walking can help manage treatment for metastatic lung cancer, a pivotal study reveals. Researchers identified potential biomarkers, offering hope for improved prognosis and individualized therapy plans.
A new study from researchers in Brazil and the United States has uncovered that simple physical tests such as sitting down, standing up and walking can significantly aid physicians in managing treatments for metastatic lung cancer patients. This pivotal research, published in the European Journal of Clinical Investigation, suggests that physical performance could play a crucial role in prognosis and personalized therapy plans.
The study was led by researchers at the University of São Paulo’s Medical School (FM-USP) in Brazil and Harvard Medical School, with funding from São Paulo Research Foundation (FAPESP). The findings indicate that two blood plasma substances, serine and M22G, could become biomarkers to predict chemotherapy responses.
Cachexia Anorexia Syndrome and Physical Performance
Willian das Neves Silva, the study’s first author who carried out the study for his doctoral research, explains that cachexia anorexia syndrome — a condition marked by the severe loss of skeletal muscle mass — is prevalent in advanced-stage cancer. This syndrome typically leads to symptoms like fatigue, muscle weakness and significant weight loss.
In cases of non-small cell lung cancer (NSCLC), the most common form of lung cancer, the study highlighted that muscle mass alone was insufficient for prognostic assessments. Instead, muscle function proved to be a more crucial factor.
“We saw that function is more important. Not just having muscles, but what the patient can do with them. The study showed that physical fitness matters more than muscle mass. Most patients were debilitated and suffering from some degree of cachexia [pronounced loss of weight and muscle mass]. Patients with better physical performance live longer, and this has nothing to do with their overall condition,” Silva said in a news release.
Implications for Treatment and Future Research
The results of the study suggest that oncologists might better manage chemotherapy regimens and make informed referrals to palliative care or complementary therapies based on patients’ physical test performances.
Gilberto de Castro Junior, a professor at FM-USP who served as one of Silva’s thesis advisors, emphasized the connection between physical test outcomes and oxygen consumption.
“We showed that patients who performed poorly in the simple physical tests also displayed impaired oxygen consumption, whereas patients who performed well were satisfactory in this item,” Castro Junior said in the news release. “We believe the inflammatory process associated with the tumor results in a set of metabolites circulating in the bloodstream with potentially negative effects on muscle cell metabolism.”
Study Sample and Methodology
The research involved 55 NSCLC patients treated at the São Paulo State Cancer Institute (ICESP), most of whom were long-term smokers.
The patients underwent various physical tests and submitted blood samples for analysis. Notably, physical performance, rather than muscle mass, was a better indicator of endurance during chemotherapy.
“At Harvard, the blood samples and muscle cells collected in Brazil were submitted to metabolomic analysis to detect the intermediate or end-products of their metabolism in an attempt to identify molecules that could be used as markers of the disease,” Silva added.
Future Goals
The research team aims to further investigate the potential of these biomarkers and improve understanding of how physical exercise could complement cancer treatments.
Recent findings by the same research team, published in JCSM Communications, shed light on inflammation, food aversion and intramuscular fat as additional predictors of prognosis.
“We know patients with poor muscle function survive less. Could we somehow reverse this process by improving muscle function through exercise? This is what we aim to find out now,” Castro Junior added.