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Written by Sarah Bondel – April 8, 2024
Approximately 20% of patients with non-small cell lung cancer respond to immunotherapy treatment. So why aren’t the other 80%?
To determine whether there is a link between the gut and immune response in advanced cancer, a team of researchers and physicians at Moffitt Cancer Center studied the gut microbiome, all the microorganisms that live in the gastrointestinal tract. We have started an investigation.
During observational studies, researchers found trends between nutritional status and treatment response. Malnourished patients also tended to have worse gut microbiota and had worse outcomes. The study results were presented at the annual meeting of the American Association for Cancer Research.
Dr. Larry Robinson
“We saw a very strong correlation between patients who were nutritionally depleted and had some weight loss. They were much less likely to respond to immunotherapy,” says the thoracic oncology surgeon. said Dr. Larry Robinson, lead author of the study. “Unfortunately, most doctors don’t really value nutrition. It’s not talked about very much, but it’s kind of the elephant in the room.”
Malnutrition is present in 15% to 40% of cancer patients and is most likely caused by inflammation, which promotes weight loss. Weight loss impairs tolerance and response to most cancer treatments, including immunotherapies, which rely on a strong immune system.
In this study, patients who responded to immunotherapy had progression-free survival of almost 16 months, whereas patients who did not respond (often malnourished) had progression-free survival of less than 3 months. compared.
“This suggests that we need to consider whether there is anything that can be done in advance, such as ‘prehabilitation’ before treatment begins,” Robinson says. “Can I do something to supplement my nutrition a few weeks in advance to improve the response to immunotherapy?”
Robinson says the easiest way to identify which patients are malnourished is to perform a mini-nutritional assessment before treatment. This screening tool gives patients a score based on recent weight loss, eating patterns, mobility, psychological stress, and more. Patients whose scores indicate malnutrition should be immediately referred for nutritional counseling.
“Preparing patients for treatment needs to play a bigger role,” Robinson says. “This gives patients some control and allows them to be proactive in improving their condition. “They can also contribute to their treatment and increase their chances of getting a positive test result. I think there is a lot of enthusiasm.
