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Oral nutritional support to address cancer malnutrition during chemo(radio)therapy

High clinical impact of malnutrition in patients receiving anti-cancer treatment

Due to reduced food intake and disease-related factors, cancer patients are at risk of losing weight during treatment, which can have a negative impact on clinical outcomes. Research in various cancer types shows that malnutrition impairs tolerance to treatment including chemotherapy and is associated with decreased response to cancer treatment, decreased quality of life and shorter survival1,2.

Benefit of nutritional support during chemo(radio)therapy: a systematic review and
meta-analysis of the evidence for oral nutritional intervention on patient outcomes

A systematic review and meta-analysis was published in Annals of Oncology from the fruitful collaboration between Danone Nutricia researchers and international experts. It is the first review to examine the existing evidence from randomized clinical trials with oral nutritional support during chemotherapy, including all options available to the clinicians, such as dietary counselling and/or different types of ONS.

Results show that oral nutritional support is overall beneficial on body weight during chemo(radio)therapy. Cancer-specific ONS enriched in protein and n-3 PUFA provided specific benefits to patients in terms of body weight maintenance, muscle mass and quality of life. This echoes recent ESPEN guidelines on nutrition in cancer which highlight the importance of adequately feeding patients, the increased need in proteins for cancer patients, and the benefit of addressing inflammation with n-3 PUFA during chemotherapy.

Perspectives for future research
Authors call for more high-quality research to fully investigate how nutritional intervention can counteract the adverse impact of malnutrition on clinical outcomes during chemo(radio)therapy. The analysis of available RCTs showed that studies were most often not designed or powered to answer this question, and authors provide recommendations for future research in the field.

Marion Jourdan, Research Program Leader Oncology at Danone Nutricia Research: “The burden of chemotherapy is high for cancer patients, who often experience symptoms that reduce their ability to eat adequately. This translates too often into body weight and muscle mass loss, which significantly impacts cancer patients’ clinical outcome and prognosis. With this systematic review we want to raise awareness for screening and nutritional support for the dietary management of disease related malnutrition due to cancer. Together with the experts involved, we also hope to encourage and provide recommendations for future studies. Danone Nutricia Research is committed to remain a strong partner for high quality research in the field.

1.
Nattenmuller J, Wochner R, Muley T et al. (2017) Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients. PloS one 12, e0169136.
2.
Martin L, Senesse P, Gioulbasanis I et al. (2015) Diagnostic criteria for the classification of cancer-associated weight loss. J Clin Oncol 33, 90-99.
3.
D C Currow, D.C., T.W. LeBlanc, It is time to rethink weight loss in cancer. Annals of Oncology, Volume 29, Issue 5, 1 May 2018, Pages 1090–1091.