RANDOMS study making sense of malnutrition

We could gain some clarity on how changes in body composition affect outcomes for people with pancreatic cancer from RANDOMS, a substudy being run as part of the MASTERPLAN clinical trial.

Pancreatic cancer is associated with a high prevalence of weight loss and malnutrition. A loss of muscle tissue can impact general function and wellbeing, and evidence suggests that changes in body composition can affect outcomes for patients at all stages of pancreatic cancer.

Despite the impact body composition can have on outcomes for patients, very little is known about how it operates and how to treat it, and it can be difficult to measure. Pancreatic cancer patients commonly have their body mass index (BMI) monitored, but this does not accurately identify changes in muscle tissue. The gold standard of body composition measurement is CT scan assessment, but this is time consuming and requires skilled staff, and so it is not always a viable option.

In the RANDOMS study, led by Ms Belinda Steer, another tool, the Patient Generated Subjective Global Assessment (PG-SGA) will be used and compared to CT scan assessments. The PG-SGA is a quick, accessible and low-cost tool commonly used by dietitians to assess the presence of malnutrition, which includes a subjective assessment of muscle tissue. Researchers believe that this tool could possibly be shown to be a suitable alternative to CT scans to determine significant levels of muscle loss.

RANDOMS is being conducted as a substudy of the MASTERPLAN trial for pancreatic cancer patients. The study presents an opportunity for researchers to collect malnutrition and body composition assessment data on this patient population and compare the two measurement tools. Ms Steer believes that this study is an important first step in the process of finding out more about body composition in pancreatic cancer patients.

“Comparing these two tools could help us to improve our assessment, and therefore our management of pancreatic cancer patients in the future,” she says. “This is also an opportunity for us to collect valuable information on the nutritional status of pancreatic cancer patients as part of a wider study.”

Although it is clear that body composition has a significant impact on pancreatic cancer outcomes, the best way to use this information is not yet clear. The results of this study will bring researchers one step closer to understanding and treating this disease.

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