title: Dysgeusia and weight loss under treatment with vismodegib: benefit of nutritional management.
abstract: OBJECTIVE
  Whereas vismodegib is effective in the treatment of locally advanced/metastatic basal cell carcinoma, dysgeusia and weight loss are common side effects of such treatment. The main objective of this study was to monitor the nutritional status of vismodegib-treated patients. Secondary objective was to assess the incidence of dysgeusia and the benefit of early nutritional management.
  
  
  METHODS
  This prospective study included all patients who started vismodegib between October 2011 and May 2013 at Nantes University Hospital. Prior to July 2012, patients treated with vismodegib had not received any specific nutritional management (Historical cohort). Body weight and presence of dysgeusia were recorded monthly. Patients treated after July 2012 (Nutrition cohort) were evaluated by a physician of the Nutrition Support Unit and received dietary counseling at vismodegib initiation. A standardized nutritional management protocol was initiated in case of significant weight loss.
  
  
  RESULTS
  Forty-five patients (21 and 24 in the Nutrition and Historical cohort, respectively) were enrolled. In the Nutrition cohort, five patients (24 %) were undernourished at vismodegib initiation, and the 6-month cumulative incidence of dysgeusia was 71 %. Eight patients (38 %) and 13 patients (54 %) had a weight loss greater than 5 % in the Nutrition and Historical cohort, respectively (p = 0.3727).
  
  
  CONCLUSIONS
  The results of this pilot study suggest the benefit of early nutritional screening. The potential benefit of nutritional support in this setting warrants further investigation.
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Le Moigne
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Saint-Jean
authors.affiliation: Nutrition Support Team IMAD, DHU 2020, University Hospital Hôtel-Dieu, Nantes, France.
authors.forename: Adam
authors.initials: A
authors.lastname: Jirka
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Quéreux
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Peuvrel
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France.
authors.forename: Anabelle
authors.initials: A
authors.lastname: Brocard
authors.affiliation: SEB, University Hospital Hôtel-Dieu, Nantes, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Gaultier
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France.
authors.forename: Amir
authors.initials: A
authors.lastname: Khammari
authors.affiliation: Nutrition Support Team IMAD, DHU 2020, University Hospital Hôtel-Dieu, Nantes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Darmaun
authors.affiliation: Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Nantes, France. brigitte.dreno@wanadoo.fr.|Inserm, UMR 892, CIC Biotherapy Inserm 0503, Nantes, France. brigitte.dreno@wanadoo.fr.|Dermato-cancerology Unit, University Hospital Hôtel-Dieu, Place Alexis Ricordeau, 44093, Cedex 01, France. brigitte.dreno@wanadoo.fr.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dréno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000813:Anilides / Q000008:administration & dosage / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D015331:Cohort Studies; D004408:Dysgeusia / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000188:drug therapy*; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D000813:Anilides; D000970:Antineoplastic Agents; C538724:HhAntag691; D011725:Pyridines
keywords: Dysgeusia; Malnutrition; Nutritional management; Vismodegib; Weight loss