Objectives/purpose
Side-effects of cancer treatment often lead to reduced food intake, known as nutrition impact symptoms (NIS). Sub-optimal management of common and distressing NIS could be improved with personalised nutrition intervention. This multisite prospective cohort study (DISCo) will identify therapeutically targetable nutritional biochemistry and dietary intake profiles to address NIS during systemic cancer therapy. DISCo will also validate the first participant-reported NIS tool in four languages.
Sample/setting
At least 850 adults commencing systemic cancer therapy will be recruited and followed throughout their treatment (n=450 in Australia, n=200 in Indonesia and the Philippines). Participants in Australia will be recruited through Queensland hospitals, health services, and community channels.
Procedures
Study outcomes will be measured at two timepoints using participant-reported online surveys: before starting systemic cancer therapy and two months into treatment. Dietary intake will be assessed using country-specific EPIC-Norfolk Food Frequency Questionnaires. Blood tests will measure nutritional biomarkers (iron, vitamins D and B12, folate, CRP). The NIS tool will assess 28 symptoms. Lifestyle and patient factors will be measured, including nutrition status via the PG-SGA. Latent Class Analysis will identify dietary and biochemical profiles, and multivariable regression will examine associations between these profiles and NIS outcomes, adjusted for lifestyle/patient factors. The validity and internal consistency of the NIS tool will be evaluated using factor analysis and reliability statistics.
Results
DISCo will recruit participants from August 2025-2027 and be the first study to assess pre-treatment lifestyle factors to identify targets for preventing cancer treatment side effects. The cancer-specific NIS tool will be validated in English, Indonesian, Filipino, and Chinese, supporting culturally inclusive monitoring across diverse populations.
Conclusion
This will be the first study to measure cancer-specific personalised nutrition therapeutic targets to improve patient-centred nutrition care during cancer treatment. This research is pivotal in guiding the future change in cancer treatment-related NIS illness trajectory.