Aims: Malnutrition and sarcopenia are often present at cancer diagnosis and can be exacerbated by the side effects of treatment. These conditions can have considerable effect on patient outcomes including reducing quality of life and increasing mortality. Immunotherapy treatments have significantly enhanced response and survival rates for many cancer types, whilst being cited as having reduced side effects compared to traditional treatments, e.g. chemotherapy. However, the impact of immunotherapy on patients’ nutritional status remains unexplored. The aim of this study was to determine the prevalence of malnutrition and risk of sarcopenia in Victorian adult cancer patients treated with immunotherapy compared to those treated with chemotherapy alone.
Methods: A multi-site point prevalence study was conducted across Victorian acute health services in July 2022. Malnutrition was assessed using the GLIM criteria and sarcopenia risk assessed using the Sarc-F and calf circumference tool in adult patients.
Results: A total of 1705 adult oncology patients were recruited across 21 health services. Of these, 172 were treated with immunotherapy and 934 with chemotherapy. Malnutrition prevalence was 31% (n= 54) in immunotherapy treated patients compared to 32% (n=307) in chemotherapy treated patients and 32% (n=550) in the total population. Only 34% (n=20) of the malnourished immunotherapy patients had active dietetic intervention compared to 46% (n=141) of chemotherapy patients. Sarcopenia risk was identified in 20% (n=34) of immunotherapy treated patients with similar rates found in chemotherapy patients (n= 352, 21%) and the total population (n= 352, 21%).
Conclusions: Patients treated with immunotherapy appear to have similar malnutrition and sarcopenia risk profiles as those treated with chemotherapy. Health services should ensure immunotherapy treated patients have access to the same screening and referral pathways to dietetic services as traditional treatments to treat and prevent both conditions and minimise associated adverse outcomes.