TGFA and sarcopenia: With respect to the underlying mechanism of sarcopenia affecting treatment efficacy of ICIs is still not fully known, multiple studies have proposed chronic inflammation might play a central role in adverse affecting immunotherapy, such as increased neutrophil-to-lymphocyte ratio (NLR), leukocyte/lymphocyte ratio (LLR), red blood cell distribution width (RDW), TGF-α, Fibrinogen and CRP (26, 29, 30).