Abstract 809: Food choices of patients with advanced cancer at start of early-phase combination trials with immune checkpoint blockade

Abstract Purpose: We examined baseline diet and its association with outcomes and social determinants of health (SDoH) factors among patients (pts) enrolled in early-phase immune checkpoint blockade-included combination trials in a comprehensive cancer center. Methods: Pts (ECOG 0-1) scheduled to begin an early-phase combination trial with immune checkpoint blockade were recruited into a prospective, longitudinal study design, and completed the validated Multifactor Dietary Screener (0-8, higher score = more frequent use of food during the past 30 days) prior to trial start. Clinical data were extracted from the EMR. Statistics included t-tests and Spearman correlations. Results: Among 259 pts (52% male, 85% White, age=25-83y, BMI=14-46, median prior lines of treatment=3, 41% had ≥2 metastatic organ involvement), increased intakes of vegetables and whole grain breads were associated with longer trial duration (P<0.029 for each). Frequent use of nuts/ seeds was linked to prolonged overall survival (P=0.014), and beans to extended progression-free survival (P=0.039). Lower regular sugar desserts and white potatoes were associated with superior treatment response (CR / PR) (P<0.005 each). Males had bacon/ sausage, hot dogs, red meat, milk, and ice-cream more often than females, and fruits, green leafy vegetables, and other vegetables less often (P<0.008 each). White pts had milk and ice-cream more often, and lettuce and leafy vegetables less often than minority pts (P<0.002 each). Hispanic pts had beans (P=0.024) more often, and cheese, and other vegetables less often than non-Hispanic pts (P<0.006 each). Young adults (25y-39y) had pasta more often than older patients (P=0.006); pts >70y had shellfish and milk more often than younger pts (P<0.028 each). Higher BMI was linked to more frequent intakes of regular fat sausage or bacon, hot dogs, fried potatoes (P<0.003 each), and regular fat salad dressing or mayonnaise (P=0.013), less frequent intakes of fruit (P<0.001), and fewer years of education (P=0.037). Less education was associated with more frequent use of bacon/ sausage, doughnuts/ other baked desserts (P<0.002 each), regular fat salad dressing, and hot dogs (P<0.016 each), and less frequent intakes of whole grain breads, fruits, greens, other vegetables, nuts, yogurt (P<0.004 each), and fish (P=0.013). Conclusions: Dietary food choices, increasingly recognized as impacting the hallmarks of cancer, may offer tangible interception of disease outcomes even during treatment in early-phase combination trials incorporating immune checkpoint blockade. Food preferences for pts in trials may be bidirectionally influenced by SDoH factors including educational attainment, gender, race/ ethnicity, and age, and as such, these factors need to be considered when developing wholesome individualized dietary prescriptions and dietary interventions for trial participants. Citation Format: Goldy C. George, Hangil Lee, Sarina A. Piha-Paul, Ecaterina Dumbrava, Apostolia Tsimberidou, Siqing Fu, Grace Appleton, Laila Noor, Jordi Rodon, Timothy A. Yap, Funda Meric-Bernstam, David S. Hong. Food choices of patients with advanced cancer at start of early-phase combination trials with immune checkpoint blockade [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 809.