(Photo caption: CHUS Team: Ana Belén Crujeiras, Rocío Villar Taibo, Miguel Ángel Martínez Olmos, Ana Cantón Blanco and Alicia Santamaria Nieto / CHUAC Team: Alfonso Vidal Casariego, Gloria Lugo Rodríguez, Francisco Pita Gutiérrez)


On the occasion of the congress of the SENPE (Spanish Society of Clinical Nutrition and Metabolism), which was held on May 31, June 1 and 2, 2019 in the city of Santiago de Compostela, Adventia has collaborated financing a grant to the best project of research on the impact of a formula with immunomodulatory nutrients.

The jury, constituted by the Scientific Educational Committee (CCE) of SENPE and a member of the Board of Directors of SENPE, have awarded the ADVENTIA scholarship to the project entitled: "Multicenter randomized clinical trial of the effect of preoperative immunonutrition versus standard enteral nutrition in surgery. elective oncology of upper digestive tract ". This is a multicenter study, whose main investigators are Dr. Miguel Ángel Martínez Olmos and Dr. Alfonso Vidal Casariego, and will include the work of the researchers of both Endocrinology and Nutrition Services of the University Hospital Complex of Santiago (CHUS) and of the University Hospital Complex of A Coruña (CHUAC).

Dra. Rocío Villar Taibo, Licentiate Specialist in Endocrinology and Nutrition of the University Hospital Complex of Santiago, brings us a little closer to the research project.

- What is the study you are going to do?

This is a randomized, double-blind, multicenter clinical trial that will evaluate the results of immuno-nutrition in the preoperative period in patients with cancer of the upper digestive tract (esophagus, stomach, and pancreas). The objective is to compare the specific effect of the immunonutrients with respect to an equivalent formula in caloric-protein intake but without immunonutrients. The study will be carried out in the health areas of Santiago de Compostela and A Coruña, has the approval of the Research Ethics Committee of Galicia and will begin in the coming weeks.

- How important is immunomodulatory nutritional support in patients with cancer of the esophagus, stomach and pancreas?

Immunonutrition in this context aims to modulate the inflammatory response and improve the immune response in the peri-surgical period. In this way, we want to improve the clinical evolution of oncological patients in terms of reduction of postoperative morbidity and hospital stay.

- What new developments can this study assume, at the level of immuno-nutrition, compared to those already existing in the scientific literature and at a practical level?

Several studies have shown the benefits of immunonutrition, setting the basis for the recommendation of perioperative immunonutrition in high digestive neoplasms in international guidelines (ESPEN and ASPEN). But not all studies have found the same benefits, in fact we can find discordant results in the literature. Probably the lack of homogeneity in the formulas of immunonutrition used, in the doses of immunonutrients, the time of treatment or the route of administration used, as well as insufficient sample sizes or the lack of randomization and blinded studies, may explain the disparity of found results and the existing difficulty to compare different studies. Our study aims to shed light on this issue, evaluating the usefulness of a specific immunonutrition guideline, with a formula with adequate and adequate immunonutrient intake. In addition, the one that includes polyphenols exclusive of extra virgin olive oil (EVOO) is totally new, since the formulas traditionally used in immuno-nutrition studies did not incorporate them.

- What benefits can the patient who receives an immunomodulatory formula with arginine, omega 3, nucleotides, antioxidants and polyphenols exclusive of EVOO?

What we seek with the contribution of immunonutrients is to reduce infectious and non-infectious complications after surgery in patients with esophageal, gastric or pancreatic cancer and reduce their hospital stay. We hope that the added effect of the EVOO polyphenols, in terms of its anti-inflammatory, antioxidant and even anti-tumor action, is a point of difference with respect to other existing works in the literature.

- What future research lines can this study assume?

On the one hand, it would be interesting to investigate the effect of these formulas on the clinical evolution of other groups of patients (such as patients with head and neck cancer or some critical patients). However, we would also like to continue deepening in other aspects such as changes in body composition, in lymphocyte populations or in the oxidation-reduction state of the organism with immunonutrition, as well as epigenetics.

- What does it mean for you to have this SENPE scholarship sponsored by Adventia?

I would like to emphasize that this is a team project, in which I am just one more of the members. Companions of the Endocrinology and Nutrition Services of the University Hospital Complex of Santiago and of the University Hospital Complex of A Coruña have united to design and implement this exciting project and the scholarship that we have achieved will make it possible to carry it out. We hope that the scientific evidence resulting from this work can be useful for our daily clinical practice and can be extrapolated to other care areas and on behalf of the entire team we thank Adventia Pharma for its commitment to research and support.