Early identification and treatment of nutritional deficiencies can lead to improved outcomes in the quality of life (QoL) and survival of patients with nonsmall cell lung cancer (NSCLC). Noninvasive techniques are needed to evaluate changes in body composition as part of determining nutritional status. The aim of the study was to evaluate the association of nutritional parameters in health-related quality of life (HRQL) and survival in patients with advanced NSCLC. Chemotherapy-naïve patients with advanced NSCLC with good performance status Eastern Cooperative Oncology Group (ECOG) 0-2 were included prospectively in the study. We evaluated inflammatory parameters such as C-reactive protein, platelet/lymphocyte index, neutrophil/lymphocyte index, serum interleukin (IL)-6, and tumor necrosis factor-α, and nutritional variables such as body mass index (BMI) and serum albumin levels. Bioelectrical impedance analysis including phase angle was obtained before cisplatin-based chemotherapy was started. HRQL was assessed by application of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)-C30 and QLQ-LC13 instruments at baseline. Overall survival (OS) was calculated with the Kaplan-Meier method and analyzed with log-rank and Cox proportional hazard models. One hundred nineteen patients were included. Mean BMI was 24.8 ± 4.5 kg/m(2), average weight loss of patients was 8.4%, and median phase angle was 5.8°. Malnutrition measured by subjective global assessment (SGA), weight loss >10%, BMI >20 was associated with lower HRQL scales. Patients with ECOG 2, high content serum IL-6, lower phase angle, and malnutrition parameters showed lower OS; however, after multivariate analysis, only ECOG 2 [Hazard ratio (HR), 2.7; 95% confidence interval (95% CI), 1.5-4.7; P = 0.001], phase angle ≤5.8° (HR = 3.02; 95% CI: 1.2-7.11; P = 0.011), and SGA (HR = 2.7; 95% CI, 1.31-5.5; P = 0.005) were associated with poor survival. Patients were divided into low-, intermediate-, and high-risk groups according to regression coefficients; OS at 1 yr was 78.4, 53, and 13.8%, respectively. Malnutrition is associated with low HRQL and is an independent prognostic factor in advanced NSCLC. The results warrant prospective trials to evaluate the impact of different nutritional interventions on HRQL and survival.

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analysis was performed with SPSS, Inc., Chicago, IL (level of significance < 0,05). Result: Statistical correlation was found between the 6MWT and chemotherapy endurance. Low 6MWT results (with a cut-off of 360 and 300 m respectively) were significantly associated with a very high risk of hematologic complications (36% and 42%), hospitalization (42% and 56%) and 3-month mortality (45% and 69%). No statistical correlation was found between 6MWT to PS, age, FEV1, BMI and initial lab values. Conclusion: 6MWT seems to be a simple, reliable and objective tool in assessing a patient's fitness to palliative chemotherapy for advanced NSCLC. Optimisation of treatment protocols, using 6MWT as a supportive tool to facilitate PS assesment, might prevent overtreatment of the patient and abuse of health service/insurance budgets.

e19068 Background: Afatinib, an irreversible tyrosine kinase inhibitor of ErbB-family, has shown clinical benefits and prolonged progression free survival in EGFR mutated patients. Adverse effects related to afatinib such as diarrhea, stomatitis and rash can negatively impact on QoL and survival by interrupting treatment. Dose of TKI´s of EGFR are fixed regardless of weight or body surface (BS), which could affect the severity of treatment related toxicity. Methods: We prospectively studied patients with advanced NSCLC treated with afatinib in order to determine if malnutrition and clinical factors are associated to higher incidence of severe toxicity. Prior treatments with afatinib 40mg, 78 patients were assessed. Nutritional status was assessed by Subjective Global Assessment (SGA), and toxicity was obtained during 2 cycles by CTCAE 4.0, severe toxicity is defined as grades 3 and 4. Results: Mean age was 59.2 years, 71.8% were women, 89.7% had adenocarcinoma, 76.9% had a good performance status (ECOG 0-1), and median weight and BS were 59.9kg and 1.58m2. Sixty percent of patients had some grade of malnutrition (SGA B+C). Factors associated to severe diarrhea, mucositis and other gastrointestinal toxicity are shown in Table 1, no factors were found to be associated with the development of severe rash. Conclusions: The performance status, malnutrition and body surface are independent factors related to severe gastrointestinal toxicity to Afatinib. This study suggests that for the initial dose selection of TKI´s of the EGFR these factors should be considered in order to reduce the risk of severe toxicity.