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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

4147 - Nutritional cancer care: slowly evolving clinical practice reveals regional and professional HCP variability


22 Oct 2018


Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care


Supportive Care and Symptom Management

Tumour Site


Florian Strasser


Annals of Oncology (2018) 29 (suppl_8): viii603-viii640. 10.1093/annonc/mdy300


F. Strasser1, J. Arends2, A. Laviano3, A. O'Callaghan4, R.A. Audisio5, M.B. Sawyer6, S. Kaasa7

Author affiliations

  • 1 Clinic For Oncology/hematology, Kantonsspital St. Gallen, 9007 - St. Gallen/CH
  • 2 Department Of Medicine, Universitätsklinikum Freiburg Klinik für Innere Medizin Hämatologie, Onkologie und Stammzelltransplantation, 79106 - Freiburg/DE
  • 3 Clinical Medicine, Sapienza University, 00185 - Rome/IT
  • 4 Global Medical Affairs, Nutricia Advanced Medical Nutrition, 1118BG - Schiphol Airport/NL
  • 5 Department Of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg/SE
  • 6 Medical Oncology, University of Alberta Cross Cancer Institute, T6G 1Z2 - Edmonton/CA
  • 7 Department Of Oncology, Oslo University Hospital, Oslo/NO


Abstract 4147


Cancer-related weight loss correlates with poor anticancer treatment (Tx) outcomes and reduced quality of life (QoL). A survey at ESMO 2016 suggested that integration of nutritional care in clinical practice is inadequate. Outcomes of a follow-up survey conducted at ESMO 2017 are reported.


ESMO 2017 delegates visiting the Nutricia booth took part in the survey. The 2017 survey questions were identical to 2016, except 1 new question: “What source helps to determine patient need for nutritional support?”


The 1,894 participants (75% medical oncologists; 64% European) demonstrated consistent overall practice patterns (malnutrition screening and assessment methods, eligibility criteria for nutritional support, goals of nutritional treatment, multimodal management) between 2016–2017. Unfortunately, >40% of HCPs still underestimate the impact of malnutrition on anticancer Tx continuity or toxicity, and QoL or function. Timely and individual tailored dietary advice to minimize/avoid weight loss increased significantly (36% to 49%; P <.001), surpassing medications, but only in Western countries (53%). Further geographic differences were seen. For example, in Africa (n = 183) compared with Europe (n = 1,215), nutritional aspects were more often considered in tumor boards (70%, 54%), but physical exercise programs were less often combined with nutrition (29%, 42%); perceived impact of malnutrition was more about anticancer treatment discontinuation (67%, 28%) than toxicities (44%, 62%); and meetings (42%, 33%) surpass guidelines (44%, 73%) for nutritional decision-making. Concerning HCP specialty, nutritionists (n = 20) estimated the impact of malnutrition 50% less than medical oncologists, and consulted guidelines less (26%, 60%). Surgeons (n = 64) and radiation oncologists (n = 65) judged eligibility for nutritional support and its goals differently than medical oncologists, with less emphasis on weight loss and QoL.


HCP recognition of the impacts of malnutrition and its assessment remains insufficient, while dietary advice is increasing. Our survey data may suggest tailoring nutritional care recommendations at regional and HCP levels.

Clinical trial identification

Legal entity responsible for the study

Nutricia Advanced Medical Nutrition.


Nutricia Advanced Medical Health.

Editorial Acknowledgement

Medical writing support was provided by Joanne Franklin, PhD, CMPP, from TRM Oncology, The Hague, The Netherlands, and funded by Nutricia Advanced Medical Nutrition.


F. Strasser: Honoraria: Danone, Grünenthal, Helsinn, ISIS Global, Mundipharma, Novartis, Novelpharm, Obexia, Ono Pharmaceutical, Psioxus Therapeutics, Prime Oncology, Sunstone Captial, Vifor; Clinical research industry grants: Celgene, Fresenius, Helsinn. A. O'Callaghan: Corporate-sponsored research: Nutricia Medical; Employee: Nutricia Medical. M.B. Sawyer: Honoraria: Nutricia Advanced Medical Nutrition. S. Kaasa: Stock ownership: Eir Solution. All other authors have declared no conflicts of interest.

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