2124P - The impact of NUTRItional status at first medical oncology visit ON Clinical Outcomes: The NUTRIONCO study

Background

Malnutrition affects up to 75% of cancer pts and results from a combination of anorexia and metabolic dysregulation. Metabolic and nutritional abnormalities in cancer pts can lead to cachexia, a multifactorial syndrome characterized by involuntary loss of skeletal muscle mass, systemic inflammation and increased protein catabolism. Cancer cachexia negatively affects patients’ outcomes, compliance to anticancer treatments, quality of life and survival. However, risk of malnutrition and cachexia are still under recognized in cancer pts. The Prevalence of Malnutrition in Oncology (PreMiO) study revealed that 51% of pts had nutritional impairment already at the first medical oncology visit.

Methods

The retrospective, observational NUTRIONCO study included a subpopulation (n=571 pts) of the prospective, observational PREMiO study (n=1952 pts) for whom follow-up data were collected from August 2019 to October 2021 and made available in electronic case report forms at ten medical oncology sites in Italy. The clinical outcomes that were considered for the association analysis with the baseline clinical and nutritional variables were: patient’s rehospitalization, onset of treatment-related toxicity, patient’s death and disease progression.

Results

We highlighted a statistically significant association between baseline variables and patients’ death, rehospitalization, treatment toxicity and disease progression at follow-up. We found a higher overall survival probability in well-nourished general study population vs. malnourished pts (p<0.001). Patients’ stratification revealed that malnutrition decreased the survival probability in non-metastatic pts, but not in metastatic pts (p<0.001). Multivariate analysis confirmed that baseline malnutrition (p=0.004) and VAS score for appetite loss (p=0.0104), in addition to albumin <35 g/L (p<0.0001) and neutrophil/lymphocyte ratio >3 (p=0.0007), were independently associated with death of non-metastatic pts at follow-up.

Conclusions

These findings support the importance of a proactive, early management of malnutrition and cachexia in cancer pts, and in particular in non-metastatic pts, in the perspective of a substantial improvement of their clinical outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

AIOM Foundantion.

Funding

Fresenius-Kabi Italy.

Disclosure

A. Frassoldati: Financial Interests, Personal, Advisory Role: Roche, Novartis, Pfizer, Lilly. All other authors have declared no conflicts of interest.