Immunonutrition to Reduce Toxicities in Non-Small Cell Lung Cancer

Inclusion Criteria:

Patients will be recruited from the Moffitt Cancer Center Thoracic Oncology Outpatient Clinic when identified by a thoracic oncologist that the patient will undergo all of their chemoradiotherapy at Moffitt.

Men and women ≥18 years of age.
Diagnosed with unresectable stage IIIA or IIIB non-small cell lung cancer.
Patients plan to undergo all cancer treatment at Moffitt Cancer Center with definitive concurrent chemotherapy and radiotherapy.
No prior treatment of NSCLC.
Able to provide informed consent.
Performance status 0, 1 or 2.
Life expectancy >3 months.
No esophagitis within 90 days.

Exclusion Criteria:

Mental incompetence or chronic psychiatric disease.
Incarcerated individuals.
Use of antibiotics or probiotic supplements within one month of chemoradiotherapy.
Allergy to any of the components of Impact® Advanced Recovery or Boost® High Protein.
Pregnant female or breast-feeding. Any female patient <45 years old not using appropriate contraceptive measures during the treatment.
Sepsis or active infection.
Chronic renal failure stage IV (requiring protein restriction) or stage V requiring dialysis.
Malnutrition defined as BMI <16.
Inflammatory bowel disease (ulcerative colitis or Crohn's disease).
Severe hepatic dysfunction (baseline prothrombin time off any anticoagulation of international normalized ratio (INR) >1.8).
Significant digestive disease with nausea, vomiting or diarrhea, NCI Grade >1.
Use of IL-6 inhibitors (tocilizumab or siltuximab) within last 6 months.