PW09 - MULTIMODAL NUTRITION AND PHYSICAL EXERCISE INTERVENTION STUDY USING A MOBILE HEALTH APP IN PATIENTS WITH ADVANCED CANCER: FIRST RESULTS
PW09
MULTIMODAL NUTRITION AND PHYSICAL EXERCISE INTERVENTION STUDY USING A MOBILE HEALTH APP IN PATIENTS WITH ADVANCED CANCER: FIRST RESULTS
E. Gerrits1,2,*, L. Gafner2, M. Ruehlin2, Y. Krepp3, R. Benkelmann3, B. Rohrbach4, C. J. Ackermann4, A. Tan2, M. Schmocker5, D. Gisi5, P. Meffert6, M. Pless7, C. Britschgi7, P. Ballmer8, L. J. Storck3
1Clinic for Internal Medicine, 2Center of Nutritional Medicine and Therapy, Kantonsspital Winterthur, Winterthur, Switzerland, 3Medizinische Klinik, Klinikum Konstanz, Konstanz, Germany, 4Oncology and Hematology, Spital Thun, Thun, 5Institute for Therapy and Rehabilitation, Kantonsspital Winterthur, Winterthur, Switzerland, 6D-17179, Corvus , Altkalen, Germany, 7Medical Oncology and Hematology, Kantonsspital Winterthur, 8GESKES-SSNC, Winterthur, Switzerland
Rationale: Patients with advanced tumors are at high risk of developing cancer-related malnutrition. A multimodal intervention program combining nutritional counseling and physical exercise may improve Quality of Life (QoL), nutritional status, energy intake, fatigue, as well as muscle mass and strength. The use of mobile Health (mHealth) technologies supports study participation and reduces the need for additional hospital visits.
Methods: Participants were randomly assigned to one of two study arms. The intervention group received a smartphone app for data recording, individualized dietary counseling, a structured home-based exercise program, and a whey protein supplement enriched with leucine and β-hydroxy β-methylbutyrate (HMB). The control group was provided with a limited version of the smartphone app and standard care.
Data were collected at baseline and at the end of the three-month intervention period. The sustainability of the intervention was evaluated at a six-month follow-up.
The primary endpoint was QoL at three months, assessed using the Functional Assessment of Cancer Therapy-General (FACT–G). Secondary endpoints included nutritional status, physical function, clinical outcomes, and fatigue.
Results: Across three study centers in Switzerland and Germany, 73 patients with advanced cancers of the lung or gastrointestinal tract were enrolled. Of these, 62% were male and 38% female, with a mean age of 63.8 ±11.9 years and a mean BMI of 25.4 ±4.2 kg/m2.
At three months, participants in both groups showed improvement in QoL. Patients in the intervention group had a mean score increase of 2.17 points (84.3 ±12.0 at baseline and 86.4 ±16.4 at three months, n = 30) and patients in the control group of 3.23 points (82.5 ±12.6 at baseline and 85.7 ±11.7 at three months, n = 25). The between group difference was not significant (p=0.73, 95% CI: -8.40, 6.95). Compared to the control group, the intervention group had significantly higher energy (p=0.041) and protein intake (p=0.002).
Of the 27 serious adverse events documented during the six-month study period, 13 occurred in 11 patients in the control group and 14 in 11 patients in the intervention group. Most were related to the underlying disease or comorbidities. None of the reported cases was attributed to the multimodal intervention.
Conclusion: Our results confirm the feasibility and safety of the multimodal nutrition and physical exercise program in patients with advanced cancer. Participants in the multimodal intervention showed significantly increased energy and protein intake after three months.
Possible explanations for the subtle differences observed between the study arms may include selection bias, a heterogeneous study population, or increased motivation among control group participants due to app use. Further analysis of the app data, which is ongoing, may help clarify the limited differences observed between groups.
Disclosure of Interest: E. Gerrits: None declared, L. Gafner Grant / Research Support from: FresuCare AG, M. Ruehlin: None declared, Y. Krepp: None declared, R. Benkelmann: None declared, B. Rohrbach: None declared, C. Ackermann Consultant for: J. Ackermann Consultant and travel support: MSD, Roche, AstraZeneca, Daiichi Sankyo, Pfizer, A. Tan: None declared, M. Schmocker: None declared, D. Gisi: None declared, P. Meffert: None declared, M. Pless Consultant for: Consultant for: Bayer, MSD, Boehringer Ingelheim, Amgen, Novartis, Takeda , Speaker Bureau for: Speaker Bureau for: Novartis, Nestlé, Sanofi, Roche, MSD, Vifor, AstraZeneca, Dr. Ouwerkerk, , Other: Travel Support by Daichii Sankyo, C. Britschgi Grant / Research Support from: Grant / Research Support from: Bayer, Consultant for: Consultant for: AstraZeneca, Pfizer, Roche, Takeda, Janssen-Cilag, Boehringer-Ingelheim, Merck KGaA, Sanofi, Other: Other: Travel, Accommodations, Expenses by AstraZeneca, Takeda, Amgen, P. Ballmer Consultant for: Consultant for: Nestlé Health Science (Clinical Nutrition), Other: Other: Royalty by Abbott, L. Storck: None declared