Jouinot A, Ulmann G, Vazeille C, et al. - In this observational study undertaken at the oncology department of Cochin Hospital, Paris, between June 2012 and November 2017, researchers assessed metastatic non-small cell lung cancer (NSCLC) patients to ascertain the prognostic significance of increased resting energy expenditure (REE). Participants were consecutive patients with newly diagnosed stage IV NSCLC. Prior to treatment start, indirect calorimetry was used to measure REE in the participants. This study included 144 patients with a mean age of 64 years. Of the study sample, 63% were male, 90% non-squamous carcinoma, including 17% with ALK/EGFR alteration. Independent prognostic factors revealed in multivariate analysis were histo-molecular subtype (non-squamous ALK/EGFR mutated vs squamous carcinoma: HR = 0.25), weight loss (> vs ≤ 5%: HR = 1.98), albumin (≥ vs < 35 g/L: HR = 0.56) and the ratio of measured REE to the REE predicted by the Harris Benedict formula (> vs ≤ 120%: HR = 1.90). Overall, in metastatic NSCLC, increased REE was identified as an independent prognostic factor.