P347 - REDUCTION OF COMPLICATIONS WITH USE OF HIGH PROTEIN ORAL NUTRITIONAL SUPPLEMENTS IN PATIENTS WITH GASTROINTESTINAL CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

P347

REDUCTION OF COMPLICATIONS WITH USE OF HIGH PROTEIN ORAL NUTRITIONAL SUPPLEMENTS IN PATIENTS WITH GASTROINTESTINAL CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

M. Delsoglio^1,*, R. Capener¹, M. Donald², T. Smith³, G. P. Hubbard¹, R. J. Stratton^4,5

¹Clinical Research, Nutricia Ltd, Trowbridge, ²Sussex Cancer Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, ³University Hospitals Southampton NHS Foundation Trust, ⁴Faculty of medicine, University of Southampton, Southampton, United Kingdom, ⁵Research & Innovation, Danone, Utrecht, Netherlands

Rationale: Oral nutritional supplements (ONS) have been shown to reduce complications in many patient types*. This systematic review investigated the use of high protein ONS (HPONS, ≥20% energy from protein) on incidence of complications in gastrointestinal (GI) cancer patients.

Methods: Searches to Jan 2025 identified 14RCT (n=1291) of HPONS in GI cancer patients. Ten RCT (n=1028, mean age range 55-69y) in patients with colon and colorectal (6RCT), pancreatic (2RCT), gastric (1RCT) and all GI (1RCT) cancers reported incidence of complications and were pooled into meta-analysis (Comprehensive Meta-Analysis v4, fixed effects). HPONS was given in the community (4RCT), hospital (1RCT), or in both settings (5RCT). Mean HPONS prescription was 710kcal/d (309-1236); 40.3g pro/d (16.8-72) for 63d (5-365).

Results: Meta-analysis (10RCT; n=1028) showed the use of HPONS alongside dietary intake significantly reduced the incidence of complications vs standard care (OR 0.70, 95% CI 0.52-0.95, I²=4, p=0.02). Complications included infections, non-infectious and surgical complications (e.g. respiratory/cardiac insufficiency, ileus, anastomotic leak) and chemo/radiotherapy-related toxicities. Overall, 28% (140/498) of HPONS supplemented patients had complications vs. 35% (165/474) of controls, number needed to treat (NNT)=14.9. Analysis without studies in pancreatic cancer (OR 0.69, 95% CI 0.51-0.94, I²=10, p=0.02) and studies (7RCT) using HPONS enriched with omega-3 fatty acids showed a similar outcome (OR 0.70, 95% CI 0.50-0.98, I²=34, p=0.04).

Conclusion: This systematic review and meta-analysis showed that use of HPONS alongside dietary intake significantly reduced the incidence of complications in GI cancer patients, with omega-3 enriched HPONS also showing significant benefits.

References: *Cawood et al, 2023. Ageing Res Rev

Disclosure of Interest: M. Delsoglio Other: Nutricia Employee, R. Capener Other: Nutricia Employee, M. Donald: None declared, T. Smith: None declared, G. Hubbard Other: Nutricia Employee, R. Stratton Other: Danone Employee