The demand of cancer patients to anticipate the management of undernutrition: is a nutrition prehabilitation before treatment conceivable as supportive care to improve quality of life? Argument for the NEHOTEL concept.

Purpose: Our translational research team in nutrition and cancer works to identify changes in eating and cooking behaviors since the diagnosis. Educational tools have been standardized as supportive care workshops in culinary practice and nutrition to enhance quality of life with regards to symptoms associated with treatment. Ongoing work with a cluster of expert patients led to the conclusion that such tools are essential but may be addressed too late, once symptoms are present and undernutrition is set. We thus investigated the concept of an early nutritional and multimodal prehabilitation program to improve quality of life. Methods: Over a period of one year, 10 patients, together with researchers and caregivers co-constructed the NEHOTEL educational program. The relevance of this program was then confronted to the practical, medical and ethical points of view. Results: An innovative multimodal supportive care 5-days course has been validated with our panel of expert patients. In this setting, new cancer patients will be invited to a non-medical hotel facility specifically designed for this project. Conclusions: In the synopsis of the cancer care path as currently conceived in France, the early positioning of this intervention, which formalizes the need for unmet supportive care of patients in nutrition, raises questions about its medico-technical feasibility and the chances of visualizing a benefit on the quality of life. NEHOTEL concept design is the outcome of this translational work, supported by an ongoing clinical feasibility study. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial NCT05495165 ### Funding Statement The clinical study is co-funded by the Research Program 2021 of the Hauts-De-France Regional Council delivered by the Direction de la recherche, de l'enseignement superieur et des formations sanitaires et sociales (DRESS), and by the Malakoff Humanis group. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics Committee of Ile de France III gave ethical approval for this work on July the 6th 2022 under the reference 21.04970.003904. International ClinicalTrials.gov identifier is [NCT05495165][1]. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors (study protocol not started) [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05495165&atom=%2Fmedrxiv%2Fearly%2F2024%2F02%2F14%2F2024.02.13.24302761.atom