Efficacy and Safety of a Parenteral Nutrition Program for Patients with RAS Wild-Type Metastatic Colorectal Cancer Administered First-Line Cetuximab Plus Chemotherapy: A Propensity Score Matching Study-Reference-Cited by-同舟云学术

Efficacy and Safety of a Parenteral Nutrition Program for Patients with RAS Wild-Type Metastatic Colorectal Cancer Administered First-Line Cetuximab Plus Chemotherapy: A Propensity Score Matching Study

Published:2023-06-30 Issue:13 Volume:15 Page:2971
ISSN:2072-6643
Container-title:Nutrients
language:en
Short-container-title:Nutrients

Author:

Chang Yu-Tang¹²,Chen Chou-Chen³,Chang Shih-Ching⁴,Chang Yu-Yao⁵⁶^ORCID,Lin Bo-Wen⁷,Chen Hong-Hwa⁸,Hsieh Yao-Yu⁹¹⁰^ORCID,Hsu Hung-Chih¹¹¹²,Hsieh Meng-Che¹³,Kuan Feng-Che¹⁴,Wu Chih-Chien¹⁵¹⁶,Lu Wei-Chen¹⁷,Su Yu-Li¹⁸,Liang Yi-Hsin¹⁹,Chen Joe-Bin²⁰,Huang Shuan-Yuan⁵,Huang Ching-Wen²²¹,Wang Jaw-Yuan²²¹²²²³²⁴^ORCID

Affiliation:

1. Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

2. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

3. Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan

4. Division of Colon and Rectal Surgery, Department of Surgery, Veterans General Hospital, Taipei 11217, Taiwan

5. Department of Colorectal Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan

6. Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan

7. Department of Surgery, National Cheng Kung University Hospital, Tainan 70457, Taiwan

8. Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

9. Division of Hematology and Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan

10. Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan

11. Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan

12. College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan

13. Division of Hematology-Oncology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 84001, Taiwan

14. Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan

15. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan

16. School of Medicine, National Yang Ming Chiao Tung University, Taipei 30010, Taiwan

17. Department of Oncology, National Taiwan University Hospital Yunlin Branch, Yunlin 64041, Taiwan

18. Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung 33305, Taiwan

19. Department of Oncology, National Taiwan University Hospital, Taipei 10002, Taiwan

20. Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

21. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan

22. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

23. Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

24. Pingtung Hospital, Ministry of Health and Welfare, Pingtung 90054, Taiwan

Abstract

Malnutrition is a common problem in patients with metastatic colorectal cancer (mCRC) receiving targeted therapy plus chemotherapy, resulting in severe toxicity and decreased survival rates. This retrospective study employing propensity score matching (PSM) examined the efficacy and safety of a supplemental home parenteral nutrition (HPN) program for patients with RAS wild-type mCRC receiving cetuximab plus chemotherapy. This retrospective nationwide registry study included data from 14 medical centers/hospitals across Taiwan, and the data period ranged from November 2016 to December 2020. Patients with RAS wild-type mCRC receiving cetuximab plus chemotherapy as their first-line therapy were included and divided into HPN and non-HPN program groups. HPN was initiated based on patient-specific factors, such as baseline nutritional status, treatment-related toxicities, and comorbidities. Clinical outcomes were evaluated using response to therapy, duration of response (DoR), progression-free survival (PFS), and overall survival (OS). This study recruited 758 patients, of whom 110 and 648 were included in the HPN and non-HPN program groups, respectively. After 1:3 PSM, the data of 109 and 327 patients from the HPN and non-HPN program groups were analyzed, respectively. The HPN program group had a higher metastasectomy rate (33.9% vs. 20.2%, p = 0.005), and longer duration of treatment and DoR than the non-HPN program group (13.6 vs. 10.3 and 13.6 vs. 9.9 months, p = 0.001 and < 0.001, respectively). The HPN program group tended to have a longer median PFS (18.2 vs. 13.9 months, p = 0.102). Moreover, we noted a significant improvement in the median OS in the same group (53.4 vs. 34.6 months, p = 0.002). Supplemental HPN programs may be recommended for select patients with mCRC receiving targeted therapy plus chemotherapy to improve oncological outcomes.

Funder

Merck Ltd., Taipei, Taiwan, an affiliate of Merck KGaA, Darmstadt, Germany

Ministry of Science and Technology

Ministry of Health and Welfare

health and welfare surcharge on tobacco products

Kaohsiung Medical University Hospital

Kaohsiung Medical University Research Center

Taiwan Precision Medicine Initiative

Taiwan Biobank, Academia Sinica, Taiwan, R.O.C.

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

Link

https://www.mdpi.com/2072-6643/15/13/2971/pdf

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