Practical cancer nutrition, from guidelines to clinical practice:a digital solution to patient-centred care

Malnutrition affects 20-70 % of cancer patients, depending on tumour type, disease stage and clinical setting. While nutritional care is essential for improving patients’ quality of life and clinical outcomes, it is not systematically integrated into routine cancer care. MyPath is an EU project aiming to implement patient-centred care (PCC) at nine European cancer centres using implementation science. Multidisciplinary teams have developed standardized digitally supported PCC pathways based on patient-reported outcomes (PROs) with linked evidence-based management options. Through systematic assessment and management of common symptoms and psychosocial problems in cancer patients, MyPath aims to facilitate changes in clinical practice to improve PCC for all. As part of this, the MyPath Nutrition Care Pathway (NCP) aims to facilitate necessary clinical changes to routinely assess and address nutrition in all patients.<br/>Methods: Between September 2022 and August 2024, an international multidisciplinary team reviewed evidence-based nutrition guidelines to select relevant PROs and other variables necessary to systematically assess and classify patients, allowing for tailored nutritional care.<br/>Results: The MyPath NCP classification relies on nutritional status (Malnutrition Screening Tool (MST) for malnutrition risk, modified Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition, and body mass index/weight change for obesity/unintentional weight gain), health status (functional status, cancer diagnosis and prognosis, and prehabilitation needs) and inflammatory status (C-reactive protein (CRP) levels). Based on this classification, the digital solution suggests tailored, evidence-based nutritional interventions. Continuous monitoring through PROs and clinical assessments will customise care to patients’ dynamic nutritional needs. The first version of this digital solution will be piloted in 2025.<br/>Conclusions: Inconsistent implementation of nutrition guidelines is a key challenge in cancer care. The MyPath NCP offers an accessible, patient-centred classification and management system that integrates nutritional care into routine cancer care, providing a versatile solution that can be implemented across diverse healthcare settings.<br/>