PP103 - EFFECT OF EARLY PERSONALIZED NUTRITIONAL INTERVENTION WITH INDIRECT CALORIMETRY ON THE OUTCOME OF CANCER PATIENTS TREATED WITH IMMUNE CHECKPOINT INHIBITORS. A PROSPECTIVE COHORT.

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PP103

EFFECT OF EARLY PERSONALIZED NUTRITIONAL INTERVENTION WITH INDIRECT CALORIMETRY ON THE OUTCOME OF CANCER PATIENTS TREATED WITH IMMUNE CHECKPOINT INHIBITORS. A PROSPECTIVE COHORT.

J. Noel1,2,*, C. Guidet1,2,3, A. Jouinot1,3, J. Arrondeau1, M. Tiako-Meyo1, P. Boudou1, O. Huillard1, M. Garrec1,2, N. Brahimi-Place1, F. Goldwasser1,2,3,4

1Cochin Hospital, APHP, 2METHEHO group, 3INSERM1016, Cochin Institute, 4Paris Cité University, Paris, France

 

Rationale: In patients (pts) treated with antiPD1 for metastatic renal or lung cancer, Resting Energy Expenditure (REE) has been associated with worse progression-free survival (PFS) and overall survival (OS). We analyzed a cohort of cancer pts with multiple measurements of REE during immune checkpoint inhibitors (ICI).

Methods: The study was prospective, observational, monocentric and included pts treated with ICI for any solid tumor. All pts underwent systematic early dietician assessment; REE was measured with indirect calorimetry at baseline and reassessed under treatment. Normometabolism (Nm), was defined as measured REE over standard REE by Harris and Benedict formula from 90 to 110% while hypermetabolism (Hm) was defined as > 110%. Our main goal was to analyze the variations in REE over time, and its prognostic value.

Results: Amongst 223 pts, 128 (57%) pts were Hm and 95 (42%) were Nm. Baseline Hm was associated with worse Performans Status (PS), higher heart rate, hypoalbuminemia, higher CRP, higher Glasgow Prognosis Score (GPS), higher neutrophils over lymphocytes ratio and weight loss. In Hm pts, during treatment, the lack of caloric coverage fell from 63% to 17% while in all population, covering caloric needs during treatment was associated with better OS (OR 0.51, IC95% 0.33-0.80, q=0.017). At the 2nd assessment, a REE increase was observed in a minority of pts (26; 12%) and was associated in univariate analysis with worse OS (OR 2.09, IC95% 1.17-3.73, p=0.047). Immune-related toxicities were more frequent in baseline Hm pts that covered caloric needs over those who did not cover and were associated with better OS (OR 0.38, IC95% 0.24-0.59, p<0.001). 

Conclusion: Nutritional and energetic status influence outcome in cancer pts treated with ICI.

Disclosure of Interest: None declared