P-322 Nutritional Intervention Impact on Body Mass Index and Toxicities Related to 1St-Line Metastatic Colorectal Cancer Treatment with Targeted Therapy

Colorectal cancer (CRC) is the 2nd most common cancer in Europe and 1st in Portugal. 1st-line metastatic CRC (mCRC) treatment is based on chemotherapy (QT) in combination with an inhibitor of epidermal growth factor receptor (i-EGFR) such as panitumumab or an inhibitor of vascular endothelial growth factor (i-VEGF) such as bevacizumab. The choice is based on molecular analysis. Low body mass index (BMI) at diagnosis is usually associated with worse prognosis and increased toxicities. Retrospective analysis of patients with mCRC who received 1st-line treatment with QT plus i-EGFR or i-VEGF, in two Portuguese hospital units between January 2015 and December 2018 was performed. IBM SPSS v25 software was used for statistical analysis. The main goal was to analyse the impact of nutritional intervention (NI) on BMI, toxicities, and outcomes. 178 patients with median age of 65 years old were included; 63% were male and the majority had ECOG PS of 0. Metastasis were present in only one organ in 2/3 of patients, more common in the liver. 65 patients underwent QT plus i-EGFR, all RAS wild-type, with overall response rate (ORR) 64%, progression-free survival (PFS) 13 months and overall survival (OS) of 21 months. 113 patients underwent QT plus i-VEGF with ORR 58%, PFS 9 months and OS of 20 months. Toxicities due to i-EGFR were mainly cutaneous with grade 3 and 4 cutaneous toxicity present in 21,6% of patients. Discontinuation of treatment occurred in 18,5%. The discontinuation of treatment with i-VEGF was 7,4%. The mean BMI was 24,8 Kg/m 2 . An association between BMI at the beginning of treatment and OS and severe toxicities was observed. A negative mean BMI difference (BMIdif) was observed after treatment progression with both therapies. No correlation was evident between BMIdif and OS, but an association between BMIdif and severe cutaneous toxicity (p=0,033; OR 1,99; IC 95%[1,05-1,49]), and i-EGFR discontinuation (p=0,044; OR 2,33; IC 95%[1,02-5,31]) was perceptible. 17,6% of patients were referred to NI, with a positive association with BMIdif as these patients gained weight. NI seems to be useful for preventing weight loss in an early phase of the mCRC. More awareness should be given to early referral for NI as it may improve the patient’s quality of life and reduce unwanted severe toxicities.