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Madeleine Hewish



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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-13 - The DAIL Trial: Dietetic Assessment and Intervention in Lung Cancer (ID 552)

      10:15 - 18:15  |  Author(s): Madeleine Hewish

      • Abstract

      Background

      Clinical Trial in Progress

      Lung Cancer related weight loss has a complex aetiology. It includes 3 overlapping but distinct syndromes: cachexia, sarcopenia and malnutrition. ESPEN (European Society for Clinical Nutrition and Metabolism) guidelines suggest that everyone with a new diagnosis of cancer is screened for malnutrition, but there is minimal evidence to support this recommendation.

      We have opened the DAIL trial to further investigate the proportion of patients with newly diagnosed Non-Small Cell Lung Cancer (NSCLC) who should be referred to a dietitian, and the proportion of patients who had cachexia, sarcopenia and malnutrition.

      Method

      Primary objectives are:

      1. To identify the proportion of patients diagnosed with NSCLC who are malnourished, cachectic and have sarcopenia before anti-cancer treatment.

      2. To identify the proportion of lung cancer patients who would require dietetic review before anti-cancer treatment.

      Secondary objectives are:

      1. To identify whether malnutrition, cachexia or sarcopenia affects overall survival in metastatic NSCLC.

      2. To identify whether sarcopenia predicts for a poor outcome in NSCLC.

      In the study we use patient generated questionnaires, physical assessments and radiological tests to define malnutrition, sarcopenia and cachexia.

      The specific assessments are:

      Patient generated subjective global assessment (PG-SGA)

      G8

      EORTC QLQC30

      EORTC LC13

      Performance status

      Hand grip strength

      Spirometry

      Psoas muscle assessment from diagnostic cross sectional imaging

      Charlson Co-morbidity Index

      Inclusion criteria are:

      Patients >18 years old who are able to consent to entry into a clinical trial

      Biopsy confirmed Advanced NSCLC (stage IIIb and IV).

      Patient receiving first line systemic palliative anti-cancer treatment.

      Exclusion criteria are:

      Inability to consent to treatment

      Patient declines anti-cancer treatment

      Result

      Section not applicable

      Conclusion

      It is anticipated that the results will clarify if a nutritional screening tool such as the PG-SGA can identify patients at risk of malnutrition prior to starting anti-cancer treatment, as well as highlight those who require dietetic intervention. It is hoped that this research will inform a randomised clinical trial of dietetic counselling in lung cancer.