Remote Monitoring of a Nutrition Intervention to Optimize Treatment Response for Patients with Borderline Resectable and Locally Advanced Pancreatic Cancer, MONITOR Trial
This clinical trial evaluates a remote nutrition coaching and monitoring intervention to optimize treatment response for patients with pancreatic cancer that is technically resectable but with a high risk of positive margins (borderline resectable) and has spread to nearby tissue or lymph nodes (locally advanced). Pancreatic cancer patients who can maintain weight before and during cancer treatment have statistically significantly improved survival. However, weight maintenance is incredibly challenging as more than 80% of pancreatic cancer patients suffer from significant weight loss at diagnosis along with severe nutrition impact symptoms that impact the ability and desire to eat (e.g., pain, loss in appetite, feeling full, nausea, vomiting, diarrhea/constipation). Pancreatic cancer patients experience increased protein breakdown and energy expenditure further increasing the risk of developing malnutrition and/or severe cachexia (i.e., ongoing loss of skeletal muscle mass with or without fat mass accompanied by impaired body function). Malnutrition and cachexia are recognized as major causes of reduced quality of life and associated with decreased survival, treatment failure, longer hospital stays, increased risk of complications, and reduced response to treatment. Nutritional interventions targeted at increasing protein production and decreasing breakdown hold great promise due to their associations with improvement in lean muscle mass, body composition, and reduced nutrition impact symptom burden in cancer patients. However, the use of innovative nutritional interventions and optimal timing of interventions to prevent weight loss or treat malnutrition in pancreatic cancer patients remains ill-defined. Remote monitoring of a nutrition intervention for patients with borderline resectable and locally advanced pancreatic cancer may be an effective way to optimize treatment response and improve quality of life.