Clinical Research Directory

Inclusion Criteria: * diagnosis of epithelial neoplasia of the gastrointestinal tract in advanced stage with indication for first-line chemotherapy for palliative purposes and with circulating lymphocytes \< 29.7% of the number total white blood cells in the blood. * ECOG PS ≤ 2 * start of first-line palliative chemotherapy agreement with AIOM guidelines. * adequate nutritional counseling carried out before starting of the treatment * willing to participate by providing written informed consent Exclusion Criteria: * age \< 18 years * current or indicated artificial nutrition * gluten intolerance * prediction of use of granulocyte growth factors * confirmed diagnosis of COPD, chronic heart failure, insufficiency chronic kidney disease, chronic liver failure, collagen disease, diseases endocrine, insulin-dependent diabetes, malignancy in other locations. All these conditions are associated with documented alterations in the plasma profile of amino acids and potentially of subsets of circulating T lymphocytes.