Ask-the-expert: Combining disease-modifying therapies with medical nutrition solutions: an improved approach to patient care?


By: DSM Pharma Solutions Editors

  • Disease-related malnutrition is common in many patients and can lead to several complications that negatively impact prognosis and clinical outcomes, as well as overall quality of life.    
  • To support those at risk of malnutrition and facilitate improved holistic patient care, a growing body of evidence demonstrates the game-changing potential of pairing targeted medical nutrition products – such as oral nutritional supplements, enteral feeding and parenteral nutrition – with disease-modifying therapies, especially in the field of cancer care.
  • In our latest Ask-the-Expert interview, DSM’s Barbara Troesch, Senior Scientific Affairs Manager in Global Pharmaceutics and Medical Nutrition, discusses the benefits of medical nutrition and how pharmaceutical manufactures can innovate in the space.  

 

What is disease-related malnutrition? 

Disease-related malnutrition is a common condition characterized by an inadequate intake of protein, energy and/or other essential nutrients such as micronutrients, as a result of a disease or its treatment. It can be present across a wide range of diseases, including cancer, heart failure and respiratory tract infections, and can lead to altered body composition (decreased muscle mass and weight loss) as well as diminished physical and mental function. Despite it having a negative impact on patient recovery, health, quality of life, clinical outcomes and overall cost of care, it is often left undiagnosed or untreated. 

The promising potential of combining? medical nutrition with disease-modifying therapies 

Nutritional interventions – like medical nutrition therapy – can help to reverse the negative effects of disease-related malnutrition and help maximize the success of disease-modifying therapies, in turn reducing patient care costs. Nutritional care also keeps the immune system healthy, reducing the risk of complications, infections and ultimately supporting patients’ recovery. Additionally, patients who are well nourished are also less likely to suffer from psychological consequences – thus not only have a better prognosis, but a better quality of life.1

Research suggests that tailoring nutrition to therapeutic treatment plans could help improve the effectiveness of nutritional management during patient care. For example, if nutritional products are given between chemotherapy cycles, they are more effective than if they weren’t aligned with these specific treatment cycles. With this in mind, pharmaceutical companies can better support patient care and clinical outcomes by expanding their portfolios to include medical nutrition solutions developed specifically to be combined with their drug therapies. 

Spotlight: a new approach to cancer care

Much of the research in this field has focused on cancer care to date because patients with cancer are at high risk for malnutrition and its consequences. In fact, 10-20% of deaths in patients with cancer are attributable to malnutrition.2 Additionally, malnutrition can have a negative impact on the efficacy of cancer treatment as it increases the toxicity of therapies and accelerates drug catabolism, therefore reducing the effectiveness of cancer drugs.3 4

Mounting evidence highlights the promising potential of incorporating targeted medical nutrition solutions into supportive cancer care plans, in addition to receiving disease-modifying therapies such as chemotherapy, radiotherapy, immunotherapy and surgery.5 However, only approximately 30-60% of patients with cancer who are at risk of malnutrition currently receive nutritional support, highlighting opportunities for innovation in this space.6 

Getting started in medical nutrition


There are two primary approaches to innovation available for pharmaceutical manufacturers looking to explore opportunities in medical nutrition; either combine a generic medical nutrition solution with a disease-modifying treatment or develop a more targeted nutritional intervention that is tailored to a specific drug therapy. If a more tailored medical nutrition product is required, factors such as format and dosage requirements need to be carefully considered. The unique nutritional requirements of individuals at different stages of the patient journey must also be acknowledged – to optimally support that patient from diagnosis to post-treatment. 

Identifying barriers to compliance through in-depth patient insights is a good first step to developing products that will overcome mental or physical barriers to eating such as difficulty swallowing (dysphagia), loss of appetite and nausea, which are all common in patients with cancer. Considering product attributes, like texture, smaller dosages with higher concentrations, different formats (other than liquid) can help to deliver nutrients in an appealing way. Additionally, making solutions that are enjoyable to consume or developing products that can be easily integrated into mealtimes (such as via a sauce) or in snack form, is another way to overcome common barriers to adoption.

Your purpose-led innovation partner 

A targeted approach to innovation creates a myriad of opportunities for pharmaceutical brands to integrate medical nutrition products into their therapeutic portfolios. This game-changing combination helps to better support the health and quality of life of individuals that are diagnosed with, and are undergoing treatment for, diseases such as cancer. 

DSM is passionate about supporting the nutritional needs of patients no matter where they are in their treatment journey. We remain at the forefront of innovation, constantly exploring the potential of medical nutrition – with patient health always front of mind. As a purpose-led innovation partner, we help customers develop and integrate tailored medical nutrition products into their pharmaceutical portfolios – from concept to patient. This takes more than ingredients; it takes a partner. 

Want to learn more? Reach out to one of DSM’s experts today to find out how our high-quality ingredients, expert services and customized solutions can support you.

References

1 Farhangfar et al. Nutrition impact symptoms in a population cohort of head and neck cancer patients: multivariate regression analysis of symptoms on oral intake, weight loss and survival. Oral Oncol., vol. 50, pg. 877-883, 2014.

2 A Beirer. Malnutrition and cancer, diagnosis and treatment, Memo – Magazine of European Medical Oncology, Vol. 14, pg. 1, 2021. 

3 Turner et al. Pembrolizumab exposure-response assessments challenged by association of cancer cachexia and catabolic clearance. Clin Cancer Res., vol. 24, pg. 5841–5849, 2018.

4 Aaldriks et al. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. J Geriatr Oncol., vol. 4, pg. 218-226, 2013.

5 Julie Richards et al. Impact of early incorporation of nutrition interventions as a component of cancer therapy in adults: A review, Nutrients, Vol. 12, No.11, pg. 1, 2020.

6 Giuseppe Aprile et al. The clinical value of nutritional care before and during active cancer treatment, Nutrients, Vol. 13, No.1196, pg. 2, 2021. 

Published on

04 August 2022

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