Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Muscle matters: Body composition, sarcopenia and clinical outcomes in patients with head and neck cancer receiving immunotherapy (145976)

Teresa Brown 1 2 , Griffin Trevett-Lyall 2 , Claire Blake 1 , Elise Treleaven 1 , Belinda Camilleri 1 , Michelle Nottage 1 , Judy Bauer 3 , Brett G.M. Hughes 1 4
  1. METRO NORTH HOSPITAL AND HEALTH SERVICE, Brisbane, QLD, Australia
  2. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
  3. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
  4. School of Medicine, University of Queensland, Brisbane, QLD, Australia

Aim

Patients with recurrent or metastatic head and neck squamous cell cancer (R/M HNSCC) are now treated with immune checkpoint inhibitor (ICI) therapy, either as first or second line. Malnutrition and sarcopenia are highly prevalent in patients undergoing curative treatment for HNSCC and are known to be associated with poorer outcomes. The aim of this study was to determine the prevalence of sarcopenia prior to commencing ICI therapy and determine the impact on survival outcomes.

Methods

Retrospective cohort study of patients with R/M HNSCC who received ICI at a tertiary hospital between 2018 and 2023 (n=88), with available CT scans for body composition analysis (n=66). Body composition was assessed at the third lumbar (L3) region using Slice-o-matic software. Patients were classified into Class I and Class II sarcopenia using established cut-off values. Survival data were collected until time of death or until end of follow-up (12/02/2026). Kaplan-Meier survival analysis was performed to compare differences in overall survival between non-sarcopenic and sarcopenic groups.

Results

The cohort was predominantly male (85%) with mean (sd) age of 63.5 +/-10 years. The indication for ICI was mainly local recurrence (35%) or recurrence and metastatic disease (30%), following prior oral cavity (49%) or oropharyngeal cancers (39%). Prior to commencing ICI, 32 patients (49%) were classified sarcopenic, with 22 classified with Class I sarcopenia (moderate) and 10 with Class II sarcopenia (severe). Kaplan-Meir analysis demonstrated improved 5-year survival in the non-sarcopenic group (log rank test p=0.0344) and a trend of increasing sarcopenia severity and poorer survival.

Conclusions

This study found a high prevalence of sarcopenia in patients commencing ICI therapy for R/M HNSCC and a negative impact of sarcopenia as an independent prognosis factor on survival outcomes. This highlights that patients could benefit from ongoing nutrition and exercise intervention during treatment to manage sarcopenia and improve patient outcomes.