PD822 - MALNUTRITION, NUTRITIONAL SUPPORT, AND PHYSICAL ACTIVITY SHAPE SURVIVAL IN ELDERLY METASTATIC PANCREATIC CANCER

PD822

MALNUTRITION, NUTRITIONAL SUPPORT, AND PHYSICAL ACTIVITY SHAPE SURVIVAL IN ELDERLY METASTATIC PANCREATIC CANCER

I. Peiro¹, C. Guillen Ponce², R. Hernandez San Gil³, J. Gallego⁴, M. L. Soriano Tabares⁵, I. Hernandez ⁶, A. Martin Carnicero⁷, A. Muñoz Martin⁸, P. Jimenez-Fonseca⁹, V. Pacheco-Barcia^10,* on behalf of PANTHEIA-SEOM

¹Endocrinology, Catalan Institute of Oncology, Barcelona, ²Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, ³Medical Oncology, Hospital Universitario de Canarias, Tenerife, ⁴Medical Oncology, Hospital Universitario de Elche, Elche, ⁵Medical Oncology, Hospital Universitario La Candelaria, Tenerife, ⁶Medical Oncology, Hospital Universitario de Navarra, Pamplona, ⁷Medical Oncology, Hospital San Pedro de Logroño, Logroño, ⁸Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid, ⁹Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, ¹⁰Medical Oncology, Hospital Universitario La Luz, Madrid, Spain

Rationale: Metastatic pancreatic adenocarcinoma in elderly patients presents specific clinical features that may influence prognosis. Inflammatory, nutritional, functional, and thrombotic factors may have a differential impact in this population. 

Methods: Multicenter retrospective study of 727 patients with 264 aged ≥70 years with metastatic pancreatic adenocarcinoma. Nutritional status (Nutriscore, weight loss, symptoms), oral nutritional supplements (ONS), pancreatic enzyme replacement), and physical activity were assessed. Associations with overall survival (OS) were analyzed.

Results: Among 264 patients ≥70 years, malnutrition and nutrition-related symptoms were common. Overall, 58.7% had a Nutriscore ≥5and 53.4% had >5% weight loss . At diagnosis, 66.7% reported weight loss, 51.5% asthenia, 47% anorexia, and 9.1% cachexia.

Nutritional impairment was associated with poorer overall survival (OS).. Patients with a high Nutriscore had worse OS than those with a low Nutriscore (10.6 vs 16 months, p<0.0001). Weight loss was also associated with reduced OS (9.9 vs 13.5 months, p<0.0001). In contrast, physical activity and ONS were associated with longer OS (14.5 vs 10.2 months, p=0.002; and 19.2 vs 12.0 months, p=0.037, respectively).

Regarding nutritional management, 51.9% of patients received ONS, including 6.1% peptide-based formulas, and only 28% received pancreatic enzyme replacement therapy. Despite the high prevalence of malnutrition and nutrition-related symptoms, nutritional intervention was overall scarce.

Conclusion: Malnutrition and nutrition-related symptoms are highly prevalent and associated with worse survival in elderly patients with metastatic pancreatic cancer. In contrast, ONS use and physical activity were associated to improved outcomes. These findings support the need for early and proactive nutritional interventions in this population

Disclosure of Interest: I. Peiro: None declared, C. Guillen Ponce: None declared, R. Hernandez San Gil: None declared, J. Gallego: None declared, M. L. Soriano Tabares: None declared, I. Hernandez : None declared, A. Martin Carnicero: None declared, A. Muñoz Martin: None declared, P. Jimenez-Fonseca: None declared, 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.