Oncology Nutrition 2022 Symposium: Advances and Trends in Oncology Nutrition - Electrolyte Management, CAR-T and Bariatric Surgery

This symposium was hosted live on June 10 - 12, 2022.

Come learn about cutting edge oncology nutrition from the leading experts in the field. This bundle of sessions is focused on Electrolyte Management, CAR-T and Bariatric Surgery.

Clinical Strategies for Fluid and Common Electrolyte and Mineral Deficiencies

This session will review 4 common deficiencies in the oncologic patient population, including hypokalemia, hypomagnesemia, iron deficiency and B12 deficiency. The session will review risk factors for the development of these deficiencies, clinical manifestations of the deficiency, interpretation of laboratory parameters, recommendations for replacement/treatment and potential adverse effects and monitoring with replacement. 

CPEU: 1.0
CPE Level: 3
Performance Indicators: 10.2.14, 8.1.4, 8.1.5

Learning Objectives

• For hypokalemia, hypomagnesemia, iron deficiency and B12 deficiency in oncology patients:
  
  1. Identify risk factors and etiology for the development
  2. List clinical manifestations

Speaker:

Rina Patel, PharmD, BCNSP
UT MD Anderson

What the Oncology Dietitian Needs to Know about Immunotherapy and CAR T-cell Therapy

1. Introduction/Background
   
   1. The term “Immunotherapy”
      
      1. Different types of Immune Effector Cells (IECs)
      2. Monoclonal Antibodies/Checkpoint Inhibitors
   2. Not a new concept (1977 Nutrition and Chemotherapy/Immunotherapy paper)
2. Immunotherapy (Checkpoint inhibitors)
   
   1. Case Introduction
   2. MOA
      
      1. CTLA4
      2. PD1/PDL1
   3. Place in therapy
   4. Side Effects
      
      1. Common
      2. Immune Mediated Adverse Effects (irAEs)
      3. Side effect management
         
         1. Highlight steroids
         2. Highlight infliximab
         3. Possibility of diabetes
      4. Drug-Food Interactions
3. Car-T Cell Therapy
   
   1. Patient Case
   2. MOA (CD19, mention BCMA)
   3. Place in therapy
   4. Side effects
      
      1. Common
      2. CRS
      3. Neurotoxicity
      4. Management of side effects, additional therapies (prophylaxis, etc.)
   5. Drug-Food Interactions
4. Summary – Role of the Dietician (objective 5) 

CPEU: 1.0
CPE Level: 3
Performance Indicators: 10.4.1, 10.4.5, 8.1.1

Learning Objectives

1. Explain the pharmacology of immunotherapy agents (checkpoint inhibitors) and CAR T-cell therapy, and discuss their current place in cancer therapy
2. Describe common and unique side effects of these agents
3. Summarize common supportive care measures utilized in conjunction with these therapies

Speaker:

Helen Marshall, PharmD, BCPS, BCOP
Seattle Cancer Care Alliance

When Two Worlds Collide: Intersection of Bariatric and Oncology Nutrition

As more and more people undergo bariatric surgery oncology dietitians are increasingly likely to interact with this patient population. In 2019, the American Society for Metabolic and Bariatric Surgery estimated 256,000 patients received bariatric surgery. Bariatric patients present a unique challenge to the oncology dietitian. The intersection of patients being treated for cancer and having a history of bariatric surgery poses the risk for significant malnutrition which can negatively impact cancer treatment and outcomes. This talk will educate oncology dietitians on the common side effects of bariatric surgery and nutrition recommendations for bariatric patients including vitamins and minerals. Attendees will learn strategies to manage oncology patients with a history of bariatric surgery, including those who are malnourished and/or require nutrition support. Case studies will be used to illustrate management of this complex patient population.

CPEU: 1.0
CPE Level: 3
Performance Indicators: 10.1.2, 10.1.3, 8.1.4

Learning Objectives

1. Describe nutritional challenges unique to cancer patients with a history of bariatric surgery.
2. Describe common nutrition issues seen in post bariatric surgery patient.
3. Develop/create/individualize treatment approaches to meet the needs of oncology patients who have undergone bariatric surgery.

Speakers:

Carole Havrila, RD, CSO
UVA Health System/Morrison Health Care

Rebecca Heming, RDN, CNSC
UVA Health System/Morrison Healthcare