Evolution of nutritional status and survival in patients with cancer on tyrosine kinase inhibitors treatment

• Published in: Endocrinologia, diabetes y nutricion Vol. 66; no. 8; p. 472
• Main Authors: Higuera-Pulgar, Isabel, Ribed, Almudena, Carrascal-Fabian, M Luisa, Romero-Jiménez, Rosa M, Velasco-Gimeno, Cristina, Bretón-Lesmes, Irene, Camblor-Álvarez, Miguel, Cuerda-Compes, Cristina, García-Peris, Pilar
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.10.2019
• Subjects: Aged; Antineoplastic Agents - therapeutic use; Body Mass Index; Dietary Proteins - administration & dosage; Eating - drug effects; Energy Intake; Female; Humans; Kaplan-Meier Estimate; Linear Models; Male; Malnutrition - blood; Malnutrition - mortality; Middle Aged; Neoplasms - blood; Neoplasms - drug therapy; Nutritional Requirements - drug effects; Nutritional Status - drug effects; Prospective Studies; Protein-Tyrosine Kinases - therapeutic use; Quality of Life; Statistics, Nonparametric; Estado nutricional; Survival; Inhibidores de tirosina quinasa; Nutritional status; Supervivencia; Tyrosine kinase inhibitors
• ISSN: 2530-0172
• DOI: 10.1016/j.endinu.2019.03.017

Treatment with oral antineoplastic agents known as tyrosine kinase inhibitors (TKIs) is new and, thus, little is known about their impact on nutritional status (NS), dietary intake, quality of life, and survival. The aim of this study was to provide information on these components in order to guide future nutritional recommendations. A prospective, observational study in adults who start treatment with TKIs, in whom NS was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometric measures, biochemical parameters, and dietary intake (24-hour dietary recall). The EORTC QLQ-C30 was used to assess quality of life. Nonparametric tests were used in statistical analysis, and survival was analyzed using Kaplan-Meier and log-rank curves. Of the overall sample, 21.7% had moderate malnutrition according to PG-SGA, and 74.2% moderate weight loss at 6 months, but no patient had BMI<18.5kg/m . Patients with moderate malnutrition had lower survival at four years of diagnosis (log-rank=0.015). Energy intake was lower than recommended by the ESPEN 2017 congress, and no patient covered the protein requirements (1.5g protein/kg weight) during follow-up. A worse score on the global health scale of the EORTC QLQ-C30 was related to worse NS. Treatment with TKIs does not appear to have a significant impact on NS and quality of life after 6 months of follow-up. Malnutrition should be prevented through individualized nutritional advice because it is related to shorter survival.