lung-cancer

New Asian cachexia criteria reveal hidden high-risk lung cancer patients missed by standard definitions.

Cancer cachexia is common in NSCLC patients receiving immunotherapy and predicts poor outcomes. Western diagnostic criteria (Fearon) may miss cachexia in Asian patients with lower baseline body mass. In 411 Japanese PD-L1-high NSCLC patients, 40.9% were cachectic by Asian Working Group for Cachexia (AWGC) criteria, with significantly shorter OS (18.2 vs. 48.5 months). A unique 'A-only' subgroup missed by Fearon criteria retained immunotherapy response but had shorter survival.

Both criteria predicted prognosis comparably, but AWGC identifies an additional high-risk population. This has implications for earlier supportive care in Asian patients.

Key Findings

40.9% classified as cachectic by AWGC criteria in PD-L1-high NSCLC
AWGC cachexia associated with shorter OS (18.2 vs. 48.5 months, HR 1.539)
AWGC-specific 'A-only' subgroup retained immunotherapy response but had shorter survival
AWGC and Fearon showed comparable overall prognostic value

Implications

Asian-specific cachexia criteria could identify high-risk patients overlooked by Western benchmarks, enabling earlier nutritional intervention and adjusted treatment planning.

Caveats

Retrospective single-nation study; abstract-only. Small 'A-only' subgroup needs prospective validation. Results specific to PD-L1-high advanced NSCLC.

Source: Journal of cachexia, sarcopenia and muscle — 2026-04-01

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