The impact of clinical nutrition on cancer therapy: a frequently underestimated perspective. A complementary approach to cancer patients

Sukkar, Samir Giuseppe

doi:10.1007/s12349-012-0105-z

Cited by 9 publications

(8 citation statements)

References 13 publications

(11 reference statements)

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“…Cancer patients who were nutritionally ‘at-risk’ had a lower likelihood of being reported as such. This finding is in agreement with a previous study which reported that undernutrition is underestimated among cancer patients [ 35 ] or to the fact that the impact of nutrition intervention on cancer therapy is frequently underestimated [ 36 ].…”

Section: Discussionsupporting

confidence: 93%

Adherence to hospital nutritional status monitoring and reporting guidelines

Khalatbari-Soltani

Marques‐Vidal

2018

PLoS ONE

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Aims of the studyDespite the widespread existence of guidelines regarding undernutrition monitoring and reporting, there is scarce information whether they are followed. We aimed to evaluate the adherence to guidelines regarding undernutrition monitoring and reporting as well as their determinants in a university hospital.MethodsRetrospective analysis of discharged patients with data on Nutritional Risk Screening score (NRS-2002) from the department of internal medicine of the Lausanne University Hospital for years 2013–14. Adherence to the hospital monitoring guidelines, i.e.: 1) discharged patients with NRS-2002 score≥3 should have prealbumin levels measured, and 2) discharged patients with prealbumin levels<0.20 g/l should be rechecked 7 days afterwards, was assessed. Reporting of nutritionally ‘at-risk’ status in the discharge letter was also assessed. Multivariable logistic regression was used to examine potential determinants of adherence to guidelines.ResultsOf the 2,539 discharged patients with NRS-2002 data, 1,605 (63.0%) were nutritionally ‘at-risk’. Complete adherence to the monitoring guideline was observed in 238 (14.8%) of ‘at-risk’ patients. After multivariable analysis, adherence to the first step of monitoring guideline was associated with older age (≥ 80 years) [OR (95% CI): 2.03 (1.29–3.18)], high comorbidity index [1.36 (1.05–1.77)], and nutritional management [5.57 (4.38–7.07)]. Nutritional management was also associated with adherence to the second step of monitoring [3.98 (2.33–6.78)]. Adherence to the reporting guideline was observed in 343 (21.4%) of ‘at-risk’ patients. Multivariable analysis showed that adherence to the reporting guideline was associated with NRS-2002 score>4 [1.97 (1.47–2.64)], nutritional management [3.80 (2.85–5.07)], and adherence to the monitoring guideline [3.33 (2.35–4.71)].ConclusionsOur results show a poor adherence to guidelines regarding undernutrition monitoring and reporting, possibly due to lack of training, staff, and time.

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Section: Discussionsupporting

confidence: 93%

Adherence to hospital nutritional status monitoring and reporting guidelines

Khalatbari-Soltani

Marques‐Vidal

2018

PLoS ONE

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“…Cachexia is strongly correlated with a poor quality of life, reduced tolerance of treatment and a shorter survival in many types of cancer including HNSCC (Aversa et al 2017; Couch et al 2015). However, a simple quantitative assessment of body weight can be misleading, because it does not provide the information on the body qualitative composition or the patient’s hydration status (Sukkar 2012). Moreover, the decrease in body weight alone, without taking into account the metabolic background, cannot predict early enough how large this decrease will be.…”

Section: Discussionmentioning

confidence: 99%

NMR-based metabolomics in real-time monitoring of treatment induced toxicity and cachexia in head and neck cancer: a method for early detection of high risk patients

et al. 2019

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Introduction Nutritional treatment in head and neck squamous cell carcinoma cancer (HNSCC) patients undergoing radio-/chemo-radiotherapy (RT/CHRT) is complex and requires a multidisciplinary approach. In this study the real-time dynamic changes in serum metabolome during RT/CHRT in HNSCC patients were monitored using NMR-based metabolomics. Objectives The main goal was to find the metabolic markers that could help prevent of acute radiation sequelae (ARS) escalation. Methods 170 HNSCC patients were treated radically with RT/CHRT. Blood samples were collected weekly, starting from the day before the treatment and stopping within the week after the RT/CHRT completion, resulting in a total number of 1328 samples. 1 H NMR spectra were acquired on Bruker 400 MHz spectrometer at 310 K and analyzed using principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Additional statistical analyses were performed on the quantified metabolites. Results PCA has detected a group of distinct outliers corresponding to ketone bodies (3HB, Ace, AceAce). These outliers were found to identify the individuals at high risk of weight loss, mainly by the 3HB changes, which was confirmed by the patients’ medical data. In the OPLS-DA models a transition from the lowest to the highest weight loss is seen, defining the metabolic time trajectories for the patients from the studied groups during RT/CHRT. 3HB is a relatively sensitive marker that allows earlier identification of the patients at higher risk of > 10% weight loss. Conclusion Our findings indicate that metabolic alterations, characteristic for malnutrition or cachexia, can be detected already at the beginning of the treatment, making it possible to monitor the patients with a higher risk of weight loss. Electronic supplementary material The online version of this article (10.1007/s11306-019-1576-4) contains supplementary material, which is available to authorized users.

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“…For instance, it will be important to assess the impact of the diet and life style on PIN1 also in humans, and to validate PIN1 as a potential biomarker and target for metabolic diseases such as diabetes (123) and cancer. In this context, also the nutritional status of neoplastic patients might be an important issue to consider since it is associated with tolerability to conventional therapies (183). Moreover, given the impact of PIN1 in p53-dependent apoptosis, PIN1 based therapies could underlie also radiation- and chemotherapy induced sickness in healthy tissues, especially in those with high PIN1 levels (6).…”

Section: Discussionmentioning

confidence: 99%

Oncogenic Hijacking of the PIN1 Signaling Network

et al. 2019

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Cellular choices are determined by developmental and environmental stimuli through integrated signal transduction pathways. These critically depend on attainment of proper activation levels that in turn rely on post-translational modifications (PTMs) of single pathway members. Among these PTMs, post-phosphorylation prolyl-isomerization mediated by PIN1 represents a unique mechanism of spatial, temporal and quantitative control of signal transduction. Indeed PIN1 was shown to be crucial for determining activation levels of several pathways and biological outcomes downstream to a plethora of stimuli. Of note, studies performed in different model organisms and humans have shown that hormonal, nutrient, and oncogenic stimuli simultaneously affect both PIN1 activity and the pathways that depend on PIN1-mediated prolyl-isomerization, suggesting the existence of evolutionarily conserved molecular circuitries centered on this isomerase. This review focuses on molecular mechanisms and cellular processes like proliferation, metabolism, and stem cell fate, that are regulated by PIN1 in physiological conditions, discussing how these are subverted in and hijacked by cancer cells. Current status and open questions regarding the use of PIN1 as biomarker and target for cancer therapy as well as clinical development of PIN1 inhibitors are also addressed.

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The impact of clinical nutrition on cancer therapy: a frequently underestimated perspective. A complementary approach to cancer patients

Cited by 9 publications

References 13 publications

Adherence to hospital nutritional status monitoring and reporting guidelines

Adherence to hospital nutritional status monitoring and reporting guidelines

NMR-based metabolomics in real-time monitoring of treatment induced toxicity and cachexia in head and neck cancer: a method for early detection of high risk patients

Oncogenic Hijacking of the PIN1 Signaling Network

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