LB100 - EFFECT OF A TAILORED LOW VOLUME, HIGH PROTEIN, OMEGA-3 ENRICHED ORAL NUTRITIONAL SUPPLEMENT ON NUTRITIONAL OUTCOMES IN PATIENTS WITH CANCER UNDERGOING SYSTEMIC TREATMENT

LB100

EFFECT OF A TAILORED LOW VOLUME, HIGH PROTEIN, OMEGA-3 ENRICHED ORAL NUTRITIONAL SUPPLEMENT ON NUTRITIONAL OUTCOMES IN PATIENTS WITH CANCER UNDERGOING SYSTEMIC TREATMENT

C. Scannell¹, E. S. Sullivan^1,2, Š. Tuček³, P. Vandecandelaere⁴, E. De Waele^5,6, P. Holečková ⁷, C. B. Van Der Lugt⁸, M. Imperatrice⁸, A. M. Ryan^1,*

¹University College Cork, Cork, Ireland, ²King’s College London, London, United Kingdom, ³Faculty Hospital Brno, Brno, Czech Republic, ⁴General Hospital AZ Delta, Roeselare, ⁵Universitair ziekenhuis Brussel, ⁶Vrije Universiteit Brussel, Brussels, Belgium, ⁷University Hospital Bulovka, Prague, Czech Republic, ⁸Danone Research & Innovation, Utrecht, Netherlands

Rationale: Low nutritional intake and metabolic changes such as inflammation drive cancer-related malnutrition. ESPEN and ESMO guidelines recommend high protein intake and the use of omega-3 fatty acids to stabilize or improve nutritional intake and status in patients with cancer receiving chemotherapy^1,2. This study evaluated the effect of a low volume, high protein, omega-3 enriched oral nutritional supplement (ONS) on relevant nutritional outcomes, including eicosapentaenoic acid (EPA) incorporation and protein and vitamin D intake in patients with colorectal (CRC) or non-small cell lung cancer (NSCLC) undergoing systemic treatment.

Methods: In a single-arm, open-label, multi-centre and country intervention study, patients with or at risk of malnutrition undergoing systemic treatment received 2 servings/day of Fortimel® Forticare (125ml, 18g protein, 1.1g EPA, 0.73g DHA, 10mcg vitamin D, 306kcal per serving) for at least 8 weeks. EPA incorporation (% of all fatty acids in erythrocyte membrane; primary outcome), protein intake (key secondary outcome), vitamin D intake and body weight (BW) were assessed at T0 (baseline), T1 (end of first in-study treatment cycle) and T2 (first visit after minimal 8 weeks of intervention). Nutritional status was assessed at screening and T2 using the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF). Change in EPA and protein intake from T0 to T1 was tested by paired t-tests and mixed-effect models.

Results: 47 patients (66% male, mean age 61.6±11.9 years, 75% with stage IV cancer at screening) were included. At T1, estimated mean EPA incorporation was significantly higher compared to T0 (2.50±0.26% at T1 vs 0.96±0.17% at T0, p<0.001). Estimated mean protein intake (g/day) significantly increased from 86.9±17.2 at T0 to 104.8±17.8 at T1 (p=0.013). Significant positive mean change was observed from T0 to T2 in protein intake (+26.5 g/day, p=0.003) and vitamin D intake (+7.9 µg/day, p<0.001). Mean BW (kg) was 79.6±14.6 at T0 and 80.2±14.0 at T2. At screening, 53.2% of patients had malnutrition and 46.8% were at risk according to the PG-SGA-SF. At T2, 43.9% had malnutrition, 34.1% were at risk, and 22% had no malnutrition. Safety data did not indicate a health concern associated with the use of the study product.

Conclusion: This study demonstrates that low volume, high protein, omega-3 enriched ONS is an effective and safe solution to support cancer patients undergoing systemic anti-cancer treatment in meeting their nutritional needs, demonstrated by increased EPA incorporation, positive changes in nutritional status, as well as increased protein and vitamin D intake.

References: ¹Arends et al. Clin Nutr. 2017;36(1):11-48 ²Arends et al. ESMO OPEN. 2021;6(3):100092

Disclosure of Interest: None declared