Our latest findings on nutritional care in cancer patients at ESMO

At the annual meeting of the European Society of Medical Oncology (ESMO), Nutricia Oncology’s presence focuses attention on nutrition in oncology care. This year ESMO is held from 19 – 23 October in Munich, Germany.

At the Nutricia Oncology booth #226 in hall B2, the objective is for visitors to explore the causes of cancer-related weight loss and its significant impact on clinical outcomes such as quality of life, treatment tolerance and survival. This year visitors will again be invited to participate in a survey about nutritional care in clinical practice and can collect the ESMO book ‘Head & Neck Cancers: essentials for clinicians’.

Research

This year, recent findings from Danone Research & Innovation collaborations will be presented, related to different relevant aspects of research in the field. Results from a survey conducted during ESMO 2017 will be presented, which explored the reality of nutritional care practice in oncology. The latest findings on a sensory trial about the impact of taste alterations during systemic anti-tumour therapy will be presented by Dr. Jacco De Haan, University Medical Center Groningen (NL). Lastly, the University Medical Centre Utrecht and Danone Research & Innovation will present the latest findings of the retrospective study of the CAIRO3 trial, showing that Skeletal Muscle Index (SMI) can predict time to disease progression. This retrospective study will be presented by Sophie Kurk, University Medical Center Utrecht (NL).

The three poster presentations will be presented on Monday 22 October, 12:45 – 13:45.

Please find below outlines of the abstracts

How is nutritional care practice evolving in oncology? Insights from a survey study conducted during ESMO 2017 – 1731P

Results of a survey among >1800 ESMO 2017 visitors describe the reality of nutritional care practice in oncology.  Healthcare professionals do not sufficiently recognize the impact of malnutrition. Over 40% of healthcare professionals still underestimate the impact of malnutrition on anticancer treatment and quality of life. On the other hand, the use of tailored dietary advice and nutritional support is increasing, but only in Western countries. The survey also reveals geographical and professional heterogeneity in clinical practice, supporting the benefit of tailoring nutritional care recommendations at regional and HCP levels.

A sensory study supports the need for more attention on taste and smell alterations during systemic anti-tumour therapy – 1737P

Up to 70% cancer patients experience taste alterations during chemotherapy.¹Spotten, et al. 2017 Subjective and objective taste and smell changes in cancer. Annals of Oncology. Published on 28: 969–984, 2017 Changes in taste and smell can negatively affect food intake and lead to greater weight loss²Boltong A, Keast R, Aranda S, Experiences and consequences of altered taste, flavour and food hedonics during chemotherapy treatment. Support Care Cancer. Published on 2012; 20(11): 2765–2774 ,³Brisbois, et al. Characterization of Chemosensory Alterations in Advanced Cancer Reveals Specific Chemosensory Phenotypes Impacting Dietary Intake and Quality of Life. Journal of Pain and Symptom … Continue reading while also impacting quality of life.⁴Brisbois, et al. Characterization of Chemosensory Alterations in Advanced Cancer Reveals Specific Chemosensory Phenotypes Impacting Dietary Intake and Quality of Life. Journal of Pain and Symptom … Continue reading,⁵Bressan V, Bagnasco A, Aleo G, Catania G, Zanini MP, Timmins F, Sasso, L 2017 The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review … Continue reading

To date, we have limited knowledge about the relation between taste and smell alterations and patients’ dietary preferences. The objective of the study is to analyze prevalence of sensory alterations in patients during anti-tumor therapy. Additionally, the study explores the overall liking of new adapted medical nutrition flavours and the potential effect of taste and smell changes on the overall liking score.

In this specific trial, over half of the patients undergoing anti-tumour therapy experienced sensory alterations. Patients without taste alterations were less discriminant in liking compared to patient experiencing this challenge, which supports the need to take into account the presence of taste and smell alterations by healthcare professionals prescribing medical nutrition.

For this trial Danone Research & Innovation collaborated with medical oncologists from University Medical Center Groningen (UMCG) in the Netherlands.

CAIRO3⁶Simkens, et al. 2015 Maintenance treatment with capecitabine and bevacizumab in metastatic colorectal cancer (CAIRO3): a phase 3 randomised controlled trial of the Dutch Colorectal Cancer Group. The … Continue reading –SMI trajectory can predict time to disease progression – 1735P

In metastatic colorectal cancer patients (mCRC), skeletal muscle mass loss is suggested to be related with poor survival. Previously, the loss and/or gain of muscle mass in mCRC patients during consecutive systemic treatments was reported.⁷Kurk, et al. 2018 Impact of different palliative systemic treatments on skeletal muscle mass in metastatic colorectal cancer patients. Journal of Cachexia, Sarcopenia and Muscle.  However, little is known about the trajectory of the observed muscle loss and its relationship with time to disease progression. The presented study, shows the loss of muscle (measured by skeletal muscle index (SMI)) could predict the time to progression.

Joint longitudinal-survival modeling was used to estimate hazard ratios for both absolute SMI and SMI trajectory during two periods. Systemic treatment during period one was less intensive CAP-B or observation, and during period two patients received more intensive CAPOX-B or other reintroduction treatment.

The results indicate that SMI in mCRC patients has a relationship with time to progression. A decrease in SMI tended to predict shorter time to progression during less intensive CAP-B or observation, while both absolute SMI and a decrease of SMI predicted shorter time to progression during more intensive CAPOX-B or other reintroduction treatment.

In conclusion, this large longitudinal analysis is the first to show that the trajectory of SMI loss predicts early time to progression and suggests that SMI preservation may be a therapeutic goal.

This study is part of a larger project within the Utrecht Centre on Food & Health. University Medical Center Utrecht (UMCU), Utrecht University – both in The Netherlands – and Danone Research & Innovation are partners in this collaboration.

About ESMO

The ESMO Congress aims to provide a scientific and educational program that supports the daily clinical practice of oncologists. This year, the program also features a dedicated nursing track through a collaboration with the European Oncology Nursing Society (EONS).