Cancer accounted for more than 19 million new cases worldwide and 10 million deaths in 2020. Optimal management of each patient requires knowing the prognostic factors of cancer, which determine the severity of the disease, in order to guide the treatment to be carried out. For this treatment customisation, clinical, genetic, biological and imaging elements of the disease will be used. Another way of personalising the treatment, carried out in parallel with the measurement of tumor parameters, is the collection and analysis of characteristics specific to the patient. These characteristics can be clinical (such as age, sex, general condition, weight, body mass index -BMI-, etc.) but also paraclinic (i.e. requiring the use of a technical tool for measurement). Among the paraclinic characteristics, body composition (muscle mass, lean mass, subcutaneous fat mass, visceral fat mass) is increasingly of interest to the medical cancer community (Brown J et al, Journal of Cachexia, Sarcopenia and Muscle, 2018). Methods that distinguish muscles from subcutaneous and visceral adipose tissues, such as CT scans, can provide new insights into important risk factors and improve prognosis compared to other clinical measures such as body mass index. In the long term, these measures could also be useful to adapt the treatment, in particular the dosage of anti-cancer drugs, by detecting in particular fragile patients who may develop toxicities. Thus, in a meta-analysis of 38 studies, a small muscle area evaluated from CT scans acquired in the clinic was observed in 27.7 % of cancer patients and associated with lower overall survival [hazard ratio: 1.44, 95 % HERE: 1,32-1,56]. Early detection to identify people with muscle loss, coupled with multimodal interventions including lifestyle action with exercise training and dietary supplementation associated with medication, may be necessary to prevent or slow tissue loss. With regard to the body mass index (BMI), calculated by dividing the patient’s weight by squared size, many studies of various types of cancer have indicated that a higher BMI is associated with better overall survival. From a physiopathological point of view, our team showed, using the Anthropometer3D software, that for patients with advanced lung cancer treated with immunotherapy, this prognostic effect appeared to be related to the amount of subcutaneous fat. Ultimately, these results could pave the way for therapeutic adaptations depending on the morphology of patients. However, randomised clinical trials are still needed to determine whether the effects of body composition are causal, reversible by intervention and to be considered for therapeutic adaptation. The Henri Becquerel Centre, through the collaborations created between research teams (in particular the quantif-LITIS laboratory of the University of Rouen, the Inserm U1245 unit and INSA Rouen) and the clinical services (in particular the departments of imaging, medical cancer, medical haematology, radiation therapy) can now create the necessary conditions for the development of such a solution.
