From: "Dr. D. Kossove" <doctordee@telkomsa.net>
Subject: !omega-3 vs megace for cancer-assoc wasting
Date: Thursday, January 01, 2004 11:37 AM

http://www.asco.org/asco/publications/abstract_print_view/1,1148,_12-002489-00_18-002003-00_19-00100748-00_28-00RESULTPAGE,00.html

 

Year:   2003  Bookmark  
 
Category:   Patient Care  
SubCategory:   Supportive Care  
 
 
 
An eicosapentainoic acid (EPA)-enriched supplement versus megestrol acetate (MA) versus both for patients with cancer-associated wasting. A collaborative effort from the North Central Cancer Treatment Group (NCCTG) and the National Cancer Institute of Canada.  
Abstract No: 2987 
Citation: Proc Am Soc Clin Oncol 22: page 743, 2003 (abstr 2987) 
Author(s): A. Jatoi, K. M. Rowland, C. L. Loprinzi, J. A. Sloan, S. R. Dakhil, N. MacDonald, B. Gagnon, P. J. Novotny, J. A. Malliard, J. E. Krook; Mayo Clinic, Rochester, MN; Carle Clinic Assoc, Champaign, IL; Cancer Ctr of Kansas PA, Wichita, KS; Clinical Research Institute of Montreal, Montreal, Canada; McGill University, Montreal, Canada; St. Joseph's Hospital, Omaha, NE; Duluth Clinic Limited, Duluth, MN 
Abstract: PURPOSE: Studies suggest EPA, an omega-3 fatty acid, augments weight, appetite, and survival in cancer-associated wasting. This study was designed to determine if an EPA-enriched nutritional supplement -- alone or with MA -- was better than MA. METHODS: 421 evaluable patients were randomly assigned to 1) an EPA-enriched supplement + placebo, 2) MA liquid suspension 600 mg/day + an isocaloric, iso-nitrogenous supplement, or 3) both agents. All patients acknowledged loss of weight and/or appetite was a concern, and all reported weight loss of > 5 pounds over 2 months and/or a daily intake of < 20 calories/kg body weight. RESULTS: Groups were comparable at baseline with respect to age, gender, tumor type, and weight loss. A smaller percentage of patients who took the EPA-enriched supplement gained  10% of baseline weight compared to those who received MA: 6% versus 18%, respectively (p=0.004). Combination therapy resulted in weight gain of  10% above baseline in 11% of patients, lower than observed with MA (P=0.17 across all arms). The percentage of patients who noted appetite improvement by the NCCTG Anorexia/Cachexia Questionnaire was not statistically different between arms: 63%, 69%, and 66%, in EPA-, MA- and combination-treated patients, respectively (P=0.69). In contrast, 4-week data, from the FAACT-AN, suggested that MA-containing arms experienced superior appetite stimulation compared to the EPA-enriched supplement alone, with scores of 40, 55, and 55 in EPA-, MA, and combination-treated arms, respectively (P=0.004). Survival was not significantly different between arms. The single-item Uniscale, a global quality of life measure, found no statistically significant differences between arms. With the exception of increased impotence with MA, toxicity was comparable between groups. CONCLUSIONS: In patients with cancer-associated wasting, this EPA-enriched nutritional supplement, either alone or in combination with MA, does not improve weight or appetite better than MA alone. 
 
Associated Presentation(s): 
 
1.  An Eicosapentainoic Acid (EPA)-Enriched Supplement Versus Megestrol Acetate (MA) Versus Both for Patients with Cancer-Associated Wasting. A collaborative effort from the North Central Cancer Treatment Group (NCCTG) and the National Cancer Institute o 
Year: 2003 
Presenter: Aminah Jatoi, MD
Session: Pain, Side Effects of Therapy, Patient Wishes (Scientific Program) 
(Presentations not available) 

 


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