Record ID: MS-N088 · Family: Nutrition support / active treatment · Clinical question: Do high-protein oral nutritional supplements improve nutrition, function or quality of life in older adults receiving neoadjuvant chemotherapy for gastric cancer?

Evidence label: One small randomized trial improved nutritional assessment and reduced malnutrition risk, but did not preserve function or quality of life over eight weeks.

Evidence at a glance

• Benefit: Improved energy/protein intake and Mini Nutritional Assessment scores; fewer participants remained at malnutrition risk.
• Certainty: Low because the trial was small, single setting and abstract-level appraisal only.
• Risk: Formula intolerance, taste fatigue, glycemic load, fluid/electrolyte issues and disease-specific protein limits.
• Cancer control: Supportive nutrition outcome only; no tumor-response, surgical or survival benefit was established.

What was studied

A prospective randomized trial enrolled 46 adults age 65 or older with newly diagnosed locally advanced gastric cancer receiving neoadjuvant chemotherapy. Twenty-three received a high-protein oral nutritional supplement plus standard nutrition care and 23 received standard care alone for eight weeks.

Outcomes included Mini Nutritional Assessment (MNA), handgrip strength, activities of daily living, instrumental activities of daily living, body composition and EORTC QLQ-C30 quality of life. The abstract did not report the supplement’s full formulation or dose; those details are therefore not verified here.

What the results show

Energy and protein intake were higher with supplementation. At week 8, malnutrition risk was reported as 4.3% in the supplement group versus 17.4% in controls (P=0.003), and MNA scores improved in the supplement group.

Activities of daily living remained stable in both groups. Quality-of-life functioning declined and symptoms increased in both groups; fatigue rose markedly. The study did not report tumor response, treatment completion, postoperative complications or survival as demonstrated benefits.

Important limits

• Only 46 participants and eight weeks of follow-up.
• The accessible appraisal was based on the full PubMed abstract; formulation, adherence, missing-data handling and detailed between-group estimates were not fully available.
• MNA is clinically useful but is not a cancer-control endpoint.
• The trial enrolled older adults with locally advanced gastric cancer in one treatment context, limiting generalisability.
• The registry was checked for design identity; registration itself is not efficacy evidence.

Safety and practical context

Oral supplements should complement—not automatically replace—food and individualized assessment. Review swallowing safety, early satiety, dumping symptoms, diabetes, kidney function, lactose or ingredient intolerance, and total fluid volume with an oncology dietitian.

Questions for the care team

• What product, calories and grams of protein were actually studied?
• Am I malnourished, at risk, or maintaining weight adequately?
• Could the formula worsen early satiety, glucose control, diarrhea or renal concerns?
• Which outcome will we monitor—weight, intake, strength, treatment tolerance or surgical recovery?

Sources checked

• Randomized high-protein ONS trial, Supportive Care in Cancer 2025 (PMID 40782206)
• Trial registry record (NCT06645912)

Funding and conflicts: The PubMed abstract reports no competing interests; funding was not reported in the accessible abstract and was not independently verified.

Last literature search: October 20, 2026 · Record appraisal: October 20, 2026

Educational information only. This record is not a prescription and does not replace advice from the oncology team, registered dietitian or oncology pharmacist.