恶液质的存在对癌症患者的预后产生负面影响。然而，恶液质的发展机制及其对免疫疗法疗效的预后影响尚不完全了解。我们对接受PD-1/PD-L1抑制剂单药治疗的晚期或复发非小细胞肺癌（NSCLC）患者进行了回顾性筛选。在183名患者中，有100名患者的治疗前血浆样本可用。我们将癌症恶液质定义为近6个月内体重下降至少5％或体重下降至少2％且BMI <20。我们在治疗前血浆样本中分析了75种可溶性免疫介质，以探索癌症恶液质发展的可能机制。我们还调查了癌症恶液质是否影响预后。在100名患者中，35名患者有癌症恶液质。逻辑回归分析确定了胃泌素、C-反应蛋白（CRP）、C型过度蛋白-3（PTX-3）和骨桥蛋白（OPN）与恶液质相关的因素。恶液质患者的无进展生存期（PFS）和总生存期（OS）较差，尽管我们未检测到统计学显著差异。分析与恶液质相关的可溶性免疫介质，恶液质与PTX-3或OPN表达水平的组合对PFS具有预测价值，恶液质与CRP或OPN表达水平的组合对OS具有预测价值。 治疗前的胃泌素、CRP、PTX-3和OPN可能与恶液质相关。接受PD-1/L1抑制剂单药治疗的NSCLC患者中，恶液质患者的生存状况较差。需要进行较大规模的研究以确认我们的数据并更好地了解恶液质发展的机制。© 2023 The Authors. 由约翰威立父子出版有限公司出版的《癌症医学》。

The presence of cachexia negatively impacts the prognosis of patients with cancer. However, the mechanisms behind the development of cachexia and its prognostic impact on immunotherapy efficacy are not fully understood.We retrospectively screened patients with advanced or recurrent non-small cell lung cancer (NSCLC) who received PD-1/PD-L1 inhibitor monotherapy. Among 183 patients, pre-treatment plasma samples were available from 100 patients. We defined cancer cachexia as weight loss of at least 5% during the past 6 months or weight loss of at least 2% and BMI <20. We analyzed 75 soluble immune mediators in pre-treatment plasma samples to explore the possible mechanisms behind the development of cancer cachexia. We also investigated whether cancer cachexia affects prognosis.Among 100 patients, 35 had cancer cachexia. Logistic regression analysis identified ghrelin, c-reactive protein (CRP), pentraxin-3 (PTX-3), and osteopontin (OPN) as factors associated with cachexia. Patients with cachexia had worse progression-free survival (PFS) and overall survival (OS), although we did not detect statistically significant differences. Analyzing the soluble immune mediators associated with cachexia, the combination of cachexia and PTX-3 or OPN expression levels was predictive for PFS and the combination of cachexia and CRP or OPN expression levels was predictive for OS.Pre-treatment ghrelin, CRP, PTX-3, and OPN may be associated with cachexia. Among patients with NSCLC who received PD-1/L1 inhibitor monotherapy, those with cachexia had worse survival than those without cachexia. Larger studies will be required to confirm our data and better understand the mechanisms behind the development of cachexia.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.