Abstract 2119P
Background
Malnutrition and weight loss have renowned prognostic value in patients (pts) with localised gastric cancer (GC). We analysed the association of weight loss and early nutritional intervention with outcomes in pts with advanced GC.
Methods
A retrospective cohort of non-resected metastatic GC pts treated with first-line chemotherapy (CT) at the Academic Hospital of Udine (2012-2022) was analysed. Biometric and nutritional parameters were evaluated at diagnosis and during treatment. The prognostic value of >10% weight loss 3 months (mo) after nutritional intervention was assessed. Nutritional interventions and scores (Prognostic Nutritional Index [PNI], neutrophil-lymphocyte ratio [NLR], platelet-lymphocyte ratio [PLR]), dichotomized as high/low per literature-derived cut-offs, were evaluated as predictors of overall survival (OS) and progression-free survival (PFS) with Cox regression model.
Results
100 pts were included (65 male), median age was 69 years. At CT start, 87.8% of pts had lost weight (>10% in 49.4%), with a median loss of 8 Kg. 55.7% of pts had low PNI, more than 60% high NLR and PLR. 71 pts underwent nutritional assessment (NA), 53.5% before CT start; median time from diagnosis to NA was 40 days. 51 pts had >1 NA, 31 pts >2 NA. At first NA, nutritional interventions consisted in oral supplements (53.4%), parenteral nutrition (28.2%) and counselling (59.2%). Overall, 49% of pts gained weight 3 mo after NA; 88.9% of pts’ PNI improved, >50% of NLR and PLR lowered. At disease progression, recorded in 96 pts, PLR and NLR increased significantly (60% vs 48% at 3 mo after NA and 70% vs 34%, respectively). In our cohort, median PFS was 5 mo and median OS was 9 mo. Low PNI (HR 2.05, p = 0.008), high NLR (HR 2.51, p <0.001) and PLR (HR 2.63, p <0.001) at CT start and a >10% weight loss (HR 3.05, p = 0.020) 3 mo after first NA were associated with worse OS. PLR improvement at 3 mo after first NA was associated with better OS (HR 0.46, p = 0.018).
Conclusions
These results underline the importance of early and efficient nutritional assessment and support in cancer pts. The prognostic value of PNI, NLR and PLR reinforces the importance of the interplay between immune system and weight loss for advanced GC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
F. Puglisi: Financial Interests, Research Grant: AstraZeneca, Eisai; Financial Interests, Financially compensated role: AstraZeneca, Roche, Amgen, Lilly, Novartis, Pfizer. All other authors have declared no conflicts of interest.
Resources from the same session
2076P - Topical diclofenac for prevention of HFS in patients receiving capecitabine monotherapy: An exploratory subgroup analysis of the D-ToRCH phase III trial
Presenter: Akhil Santhosh
Session: Poster session 06
2077P - A randomized, placebo-controlled trial assessing the efficacy and safety of the combination of superoxide dismutase, alpha lipoic acid, vitamin B12, B1, B2, B6, E, Mg, Zn and a fatty acid for 6 months in the management of chemotherapy induced neuropathic pain
Presenter: Triantafylos Didangelos
Session: Poster session 06
2078P - Evaluation of chemotherapy-induced nausea and vomiting beyond the delayed phase: Results of a survey of healthcare providers in Japan
Presenter: Florian Scotté
Session: Poster session 06
2079P - Naloxegol for the treatment of opioid-induced constipation in patients with cancer pain: A pooled analysis of real-world studies (NALOPOOL)
Presenter: Maria del Carmen Beato Zambrano
Session: Poster session 06
2080P - Incidence and risks of intravenous chemotherapy-induced neutropenia (ICIN) in oncology: A multicenter retrospective cohort study on real-life data
Presenter: Olivia Rohr
Session: Poster session 06
2081P - The therapeutic effect of anti-inflammatory tripeptide cream on hand-foot syndrome related to anticancer drugs: A prospective, randomized, placebo-controlled pilot trial
Presenter: Yaewon Yang
Session: Poster session 06
2082P - TASMAN: An international survey on the knowledge, aTtitudes and clinical pAtternsS of use of Medical Cannabis for caNcer care
Presenter: Marco Filetti
Session: Poster session 06
2083P - Association between VTE location and risk of recurrent, bleeding and death in the international prospective TESEO SEOM cancer cohort
Presenter: Rocío Martín Lozano
Session: Poster session 06
2084P - Cardiovascular (CV) mortality among metastatic cancer patients: A retrospective cohort study
Presenter: Irbaz Riaz
Session: Poster session 06