PD712 - BEYOND MALNUTRITION AND CACHEXIA: THE ROLE OF NUTRITIONAL INTERVENTIONS AND PHYSICAL ACTIVITY IN SURVIVAL OF METASTATIC PANCREATIC CANCER PATIENTS

PD712

BEYOND MALNUTRITION AND CACHEXIA: THE ROLE OF NUTRITIONAL INTERVENTIONS AND PHYSICAL ACTIVITY IN SURVIVAL OF METASTATIC PANCREATIC CANCER PATIENTS

V. Pacheco-Barcia^1,*, A. Muñoz Martin² on behalf of PANTHEIA-SEOM, M. A. Vicente Conesa³, A. Lamarca⁴, J. Hernando⁵, J. Adeva⁶, E. Brozos Vazquez⁷, L. Visa⁸, E. Grande⁹, P. Jimenez-Fonseca¹⁰ on behalf of PANTHEIA-SEOM

¹Medical Oncology, Hospital Universitario La Luz, ²Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid, ³Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, ⁴Medical Oncology, Hospital Universitario Fundación Jiménez Díaz, Madrid, ⁵Medical Oncology, Hospital Universitario Vall d'Hebron, Barcelona, ⁶Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, ⁷Medical Oncology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, ⁸Medical Oncology, Hospital del Mar, Barcelona, ⁹Medical Oncology, Hospital Ruber Internacional, Madrid, ¹⁰Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain

Rationale: Systemic inflammation and malnutrition contribute to poor outcomes in metastatic pancreatic ductal adenocarcinoma (PDAC). We evaluated the impact of nutritional status, interventions and physical activity on weight loss and survival.

Methods: Multicenter retrospective study of 727 patients with stage IV PDAC. Nutritional status, supportive interventions (ONS, enzyme replacement), and physical activity were assessed. Associations with weight loss and overall survival were analyzed.

Results: A total of 727 patients were included. Median age was 65.8 years. 487 (67%) were male, and 611 (84%) had an ECOG performance status of 0–1. All patients had stage IV pancreatic adenocarcinoma with metastatic disease. At diagnosis, 79 (10.9%) had cachexia and 472 (64.8%) had weight loss. Pancreatic enzyme replacement therapy was used in 189 patients (26.0%), while 361 patients (49.6%) received oral nutritional supplements (ONS), including 37 (5.1%) peptide-based formulas, and 216 (29.7%) were physical active.

ONS use was associated with lower weight loss compared to non-users (4.12 vs 7.67, mean difference 3.56,95% CI 2.22–4.89; p<0.001) and a non-significant trend toward longer overall survival (OS) (16.2 vs 12.2 months; p=0.15).

Cachexia and weight loss were both associated with shorter OS (7.4 vs 10.8 months, p=0.005; and 9.7 vs 12.9 months, p<0.0001, respectively). Physical activity was associated with improved OS (12.1 vs 9.1 months; p<0.0001).

Conclusion: Malnutrition and cachexia are strongly associated with worse survival in metastatic PDAC. Oral nutritional supplements reduced weight loss, while physical activity was associated with improved survival.

Disclosure of Interest: V. Pacheco-Barcia Grant / Research Support from: PANTHEIA-SEOM has received unrestricted grant support from Nutricia Danone, Pfizer, Servier and LEO Pharma. PANTHEIA-CK received a SEOM grant 2024. , Consultant for: Nutricia Danone, Speakers Bureau of: Nutricia Danone, A. Muñoz Martin: None declared, M. A. Vicente Conesa: None declared, A. Lamarca: None declared, J. Hernando: None declared, J. Adeva: None declared, E. Brozos Vazquez: None declared, L. Visa: None declared, E. Grande: None declared, P. Jimenez-Fonseca: None declared