Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Feasibility study to compare taste changes and dietary intake in patients with head and neck cancer according to genetically determined Taster Status (#239)

Teresa Brown 1 2 , Liang-Dar Hwang 3 , Elise Treleaven 1 , Anita Pelecanos 4 , Brett GM Hughes 1 5 , Charles Y Lin 1 5 , Lizbeth M Kenny 1 5 , Penny Webb 4 , Judy D Bauer 6
  1. Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
  2. Centre for Dietetics Research (C-DIET-R), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
  3. Institute for Molecular Science, The University of Queensland, Brisbane, QLD, Australia
  4. QIMR, Berghofer Medical Research Institute, Brisbane, QLD, Australia
  5. School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  6. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia

Aims Patients with head and neck cancer (HNC) undergoing chemoradiation often experience loss or alteration of taste which impacts oral intake and increases malnutrition risk. An individual’s inborn “taster status” is primarily determined by genetic variation within the bitter taste receptor gene TAS2R38. This taster status has been shown to affect the perception and consumption of food in healthy populations, however, has never been investigated in cancer patients.

Methods Patients with HNC cancer undergoing curative intent chemoradiation were eligible. Taster status was determined using kits supplied by Monell Chemical Sense Center, USA. Taste perception, nutritional status (PGSGA) and dietary intake (online 24-hr recall ASA-24) were measured at baseline, and 1-, 3- and 6-months post-treatment. Primary outcomes were feasibility measures (recruitment and retention rates; acceptability of assessment tools), with clinical secondary outcomes (nutritional and taste).

Results Twenty-four patients enrolled; 92% male, mean age 63.1(SD 9.4) years. Most (92%) had oropharyngeal cancer. All had concurrent chemoradiation. Eight (33%) were classified as non-tasters. Only two patients withdrew. All patients easily completed taste assessments and PGSGA (median 9-10/10). The online 24-h recall was rated more difficult (5-7/10) with lower completion rates (83-96%).

At 1-month, 70% and 83% of patients correctly identified sweet and salty respectively, however was lower for sour (48%), bitter (52%), cool (43%) and burn (65%). Taste perceived intensity improved over 6-months, although sour remained low (36%). Taster patients had steadier energy, protein, fat and carbohydrate intakes over time, whereas non-tasters experienced the greatest decrease in intake at 1-month and were slower to recover. Non-tasters had higher rates of malnutrition at 1-month (88% vs 53%) and 3-months (50% vs 21%).

Conclusions Study design was feasible and assessment tools acceptable. Non-tasters appear to have greater impacts from chemoradiation on their oral intake and nutritional status compared to tasters which warrants further investigation.